Persistent Poor Metabolic Profile in Postmenopausal Women With Ovarian Hyperandrogenism After Testosterone Level Normalization

Abstract

Context Data on prevalence of metabolic risk factors in hyperandrogenic postmenopausal women are limited. Also, the correlation between metabolic disorders and androgen excess in this scenario is poorly understood. Objectives We aimed to assess the prevalence of obesity, hypertension, type 2 diabetes (T2D), and dyslipidemia (DLP) in postmenopausal women with hyperandrogenism of ovarian origin before and after surgical normalization of testosterone (T) levels, as well as the impact of androgen normalization on body mass index (BMI), glucose, and lipid metabolism. Design Retrospective study. Setting Tertiary health center. Participants Twenty-four Brazilian women with postmenopausal hyperandrogenism who underwent bilateral oophorectomy between 2004 and 2014 and had histologically confirmed virilizing ovarian tumor (VOT) or ovarian hyperthecosis (OH) and T-level normalization after surgery were selected. Main Outcome Measures FSH, LH, total and calculated free T, BMI, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG) serum levels were accessed before (n = 24) and 24 months after (n = 19) bilateral oophorectomy. Results At baseline, the overall prevalence rates of obesity, T2D, DLP, and hypertension were 58.3%, 83.3%, 66.7%, and 87.5%, respectively. No significant difference in prevalence was found between patients with OH and VOTs. At follow-up, FSH, LH, and total and free T levels had returned to menopausal physiologic levels, but mean BMI and mean FPG, HbA1c, LDL-C, HDL-C, and TG levels did not differ from baseline. Conclusions Postmenopausal hyperandrogenism is associated with adverse metabolic risk. Long-term normalization of testosterone levels did not improve BMI, glucose, or lipid metabolism.

Ficus deltoidea ameliorates biochemical, hormonal, and histomorphometric changes in letrozole-induced polycystic ovarian syndrome rats

“…Meanwhile, epigallocatechin and apigenin were proven to inhibit 17β-HSD, 3β-HSD enzymes, and P450 activity that lead to inhibitory effects on testosterone production. However, Rocha et al [42] demonstrated that normalization of testosterone levels did not improve BMI, glucose, or lipid metabolism in postmenopausal hyperandrogenism rats. It should be mentioned that the effects of serum androgen normalization are different in reproductive and non-reproductive status.…”

Ficus deltoidea ameliorates biochemical, hormonal, and histomorphometric changes in letrozole-induced polycystic ovarian syndrome rats

“…Meanwhile, epigallocatechin and apigenin were proven to inhibit 17β-HSD, 3β-HSD enzymes, and P450 activity that lead to inhibitory effects on testosterone production. However, Rocha et al [ 43 ] demonstrated that normalization of testosterone levels did not improve BMI, glucose, or lipid metabolism in postmenopausal hyperandrogenism rats. It should be mentioned that the effects of serum androgen normalization are different in reproductive and non-reproductive status.…”

Androgen Effects on the Adrenergic System of the Vascular, Airway, and Cardiac Myocytes and Their Relevance in Pathological Processes

“…Fluctuations in androgen concentrations throughout life stages can affect the vascular tone, and T may contribute to developing hypertension [ 58 ]. In this sense, hyperandrogenism (HA) in pre- and postmenopausal women has been associated with an unfavorable metabolic profile, obesity, and hypertension [ 199 – 201 ]. HA is defined as an excess of androgen production and secretion by adrenal glands or the ovaries [ 202 ].…”

“…HA is defined as an excess of androgen production and secretion by adrenal glands or the ovaries [ 202 ]. Moreover, the development of HA in females has shown to be associated with ovarian disorders, e.g., ovarian hyperthecosis (OH) [ 203 ], virilizing ovarian tumors (VOTs) [ 204 ], and polycystic ovary syndrome (PCOS) [ 199 – 201 ]. PCOS is one of the most common endocrine disorders affecting women of reproductive age [ 205 ].…”