EXOGENOUS ANDROGENS IN POSTMENOPAUSAL WOMEN

There is an increasing awareness that androgens are of therapeutic val ue in postmenopausal women. Evidence is emerging demonstrating the rol e of testosterone in both female embryologic development and normal se xual behavior and mood. Women who are androgen depleted develop physic al and behavioral symptoms referred to as female androgen deficiency s yndrome. To a lesser degree, women who undergo an oophorectomy are dep rived of endogenous ovarian androgens and have consistently been shown to have impairment of sexual functioning, loss of energy, depression, and headaches. Testosterone seems to act synergistically with estroge n in the treatment of these symptoms. The combination of estradiol and testosterone has been shown to have a beneficial effect on the skelet on, although not significantly better than estradiol therapy alone. Co smetic side effects are rare if Supraphysiologic doses are avoided. Th e potential metabolic complications have not been consistently demonst rated in studies to date. Androgen replacement therapy is a neglected area of medical practice and further research is needed to identify al l women who will benefit hom it since studies in menopausal women have shown parenteral administration to be well tolerated and safe. Such t herapy is underused and very much underresearched. While testosterone implants work adequately, it would be more desirable and convenient to use a testosterone patch and safer, more effective oral androgens, if these products were available.