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Overview of androgen deficiency and therapy in women

Author
Laurence C Udoff, MD
Section Editors
Robert L Barbieri, MD
William F Crowley, Jr, MD
Deputy Editor
Kathryn A Martin, MD

INTRODUCTION

All women produce androgens, which may contribute to maintaining normal ovarian function, bone metabolism, cognition, and sexual function. This topic will review androgen production in pre- and postmenopausal women, the possible consequences of androgen deficiency, and the effects of androgen therapy in postmenopausal women. A more detailed discussion of the diagnosis and management of female sexual dysfunction, specifically, female sexual interest/arousal disorder (formerly referred to as hypoactive sexual desire disorder), is found separately. (See "Sexual dysfunction in women: Management".)

ANDROGEN PRODUCTION

Premenopausal women — The major androgens in the serum of normal cycling women are dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione, testosterone, and dihydrotestosterone (DHT), in descending order of serum concentrations [1]. Though abundant in the circulation, DHEAS, DHEA, and androstenedione may be considered pro-hormones, requiring conversion to testosterone or DHT to express their androgenic effects. DHT is the main intracellular androgen.

Androgens are produced in the adrenal gland, the ovary, and from the peripheral conversion of pro-hormones.

DHEAS, although a weak androgen, is the most abundant androgen. It is produced solely by the adrenal gland at a rate of 3.5 to 20 mg per day [2]. Circulating levels are in the range of 75 to 375 mcg/dL (2 to 10 µmol/L).

DHEA is also produced in the adrenal gland (50 percent), the ovary (20 percent), and from peripheral conversion of DHEAS (30 percent), with total production rates of 6 to 8 mg per day [3]. Serum DHEA concentrations range from 0.2 to 0.9 mcg/dL (7 to 31 nmol/L). DHEA is converted to DHEAS in the adrenal, liver, and intestines (which contain a sulfotransferase).

                 

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Literature review current through: Nov 2016. | This topic last updated: Wed Apr 20 00:00:00 GMT+00:00 2016.
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