Risks of menopausal androgen supplementation.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or new human data
PubMed 9711680 · doi:10.1055/s-2007-1016265
What was done
This was a narrative review examining the side-effect profile and safety of menopausal androgen replacement therapy (MART) in women undergoing natural or surgical menopause. The paper evaluated the impact of drug formulation, dose, alkylation, and route of administration on hepatic safety, cutaneous and virilizing outcomes, endometrial hyperplasia, and theoretical breast cancer risk.
What was found
Observational studies cited in the abstract showed acne in up to 38% and hirsutism in up to 36% of oral methyltestosterone-treated patients, whereas prospective studies suggested a much lower incidence of approximately 5%. Other reported virilizing effects included voice deepening and clitoromegaly. Significant hepatic events were not observed at standard female doses despite the theoretical risk from alkylated compounds. Concomitant progestins protected against endometrial hyperplasia, and increased breast cancer risk was not demonstrated in clinical practice.
Why it matters
This paper summarizes clinical safety considerations for postmenopausal androgen therapy, emphasizing that virilizing and cutaneous changes are the main clinical risks when supraphysiologic levels are avoided.
Limits
The review is narrative rather than systematic, with no search strategy, study selection criteria, or sample size (n) reported. Discrepancies between observational and prospective rates of adverse events (e.g., 36–38% vs. ~5%) highlight significant risk of bias and heterogeneity across the underlying literature. Furthermore, effects on lipid profiles were explicitly omitted.
Cited by
- supports Testosterone supplementation above low-normal physiological levels in women can cause side effects including voice deepening and unwanted hair growth.