ANDROGENS AND THE MENOPAUSE - A STUDY OF 40-60-YEAR-OLD WOMEN

OBJECTIVE The impact of the menopause on androgen production is poorly understood. We have investigated the impact of the menopause, as well as other factors such as age, body mass index (BMI) and cigarette smo king, on ovarian and adrenal androgen levels in women aged 40-60 years . DESIGN Cross-sectional study of blood hormones sampled weekly over o ne month in volunteer 40-60-year-old women. SUBJECTS One hundred and f orty-one women, aged between 40 and 60, recruited from community sourc es (non-clinical), not using hormone replacement or steroidal contrace ptives, and with a current sexual partner. Fifty were categorized as p remenopausal (ovulating), 37 as perimenopausal and 54 as post-menopaus al. MEASUREMENTS The following variables were assessed; menopausal sta tus (based on menstrual history and pattern and plasma progesterone), age, BMI, smoking, oestradiol (E(2)), oestrone (E(1)), LH, FSH, total testosterone (TT), androstenedione (A), SHBG, free androgen index (FAI ), dihydroeplandrosterone (DHEA), dihydroeplandrosterone sulphate (DHE AS) and cortisol. RESULTS are based on multiple regression analysis. T T was positively related to A, BMI and LH. A was negatively related to age and FSH, and positively to DHEA, DHEAS and premenopausal status. SHBG was negatively related to BMI and positively to El and non-smokin g. DHEA and DHEAS were negatively related to age and were higher in sm okers. Both E, and Ep were related to menopausal status and to FSH. Su rprisingly, E(2) was negatively related to BMI. CONCLUSIONS A variety of factors influence androgen production in this age group. Whereas it is difficult to predict the effect of menopause on androgen levels, L H stimulation of post-menopausal interstitial cells, modulated by a va riety of factors including nutrition, and smoking, are likely to be re levant.