Use of androgens at different stages of life: reproductive period

Abstract

Although there are several situations that can potentially lead to lower androgen levels, until now is not defined a syndrome or biochemical criteria to diagnose androgen deficiency in women. Benefits of androgen therapy in these situations are controversial.• Girls with delayed puberty manifesting primarily as a lack of development of secondary sex characters and primary amenorrhea may be deficient in sex hormone production, including androgen production deficiency. • Due to surgical menopause and premature ovarian failure, androgen levels may be reduced compared to agematched normal controls. • Young women with hypopituitarism, anorexia nervosa, and adrenal insufficiency may have lower serum androgen levels. • The use of androgens and anabolic steroids for aesthetic purposes has increased considerably due to issues related to the cult of the body and beauty. However, this is associated with undesirable and potentially irreversible aesthetic manifestations, in addition to an increase in morbidity. Recommendations• There is no evidence for the use of androgen therapy in adolescent women, even in cases of hypogonadism due to ovarian (premature ovarian failure) or central causes. • There is no evidence for routine androgen therapy in adult women with hypopituitarism, hypogonadotropic hypogonadism, adrenal insufficiency and anorexia nervosa. • Androgen therapy, preferably by the transdermal route, may be considered for women with premature ovarian insufficiency (POI) or surgical menopause complaining of female sexual dysfunction (FSD), in addition to estrogen therapy. • The use of androgens and anabolic steroids for aesthetic purposes is not recommended.• The measurement of total testosterone or the calculation of the free androgen index can be used to control androgen replacement in women, but the available laboratory techniques do not present adequate sensitivity.Although the mass spectrometry technique has greater sensitivity, it is costly, which limits the use in clinical practice. FEBRASGO POSITION STATEMENTUse of androgens at different stages of life: reproductive period

Testosterone Therapy for Women: Still Many Questions to be Answered

“…These positions are being published in two articles divided according to recommendations for women's reproductive phase or climacteric with the aim to help health professionals in decision-making, whether for patient assessment or the indication of androgen therapy, its dosage and reassessment of results. 8,9 Conflicts of Interest: None to declare.…”