Androgens in postmenopausal women: Production, possible role, and replacement options

The physiology of normal androgen production in women has not been well understood. Aging, per se, accounts for much of the reduction in both ovarian and adrenal androgen production; and natural menopause does not result in an abrupt decline in testosterone production. Therefore, the definition of an androgen deficiency state in women, in the absence of adrenal suppression and/or bilateral oophorectomy, has been difficult. Nevertheless there are well-documented beneficial effects of androgen on many organ systems, including bone and the brain, This review focuses on the physiology of androgens in postmenopausal women and includes a discussion of the definition of an androgen deficiency state, the anticipated effects of androgen on several parameters of health, and possible ways in which androgens may be administered to women. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to explain the physiology of androgen production in women, outline the risks of androgen replacement, and summarize the treatment options for a women with relative androgen deficiency.