Androgens (PCOS Mentioned)

Overview
Androgens are the so-called “male hormones,” but don’t let the name fool you. Men and women produce all hormones, just in differing amounts. Women do produce androgens in the ovaries, adrenal glands and fat cells. In fact, many women produce too much of these hormones — disorders of androgen excess affect between five percent and 10 percent of women, and are the most common endocrine (hormonal) disorders in women.

The most familiar androgen is testosterone. This hormone can be converted into a more powerful androgen, dihydrotestosterone (DHT), in areas that affect the skin and hair.

Androgens are, of course, present in much higher levels in men and are an important factor in male traits and reproductive activity. Androgens include testosterone and DHT, as well as other hormones that can be converted into testosterone or DHT, including androstenedione, dehydroepiandosterone (DHEA) and DHEA sulfate.

The ovaries and adrenal glands produce about half of the “free” testosterone in your bloodstream (testosterone that is available for conversion into an active form like DHT), as well as the testosterone precursor adrostenedione. Conversion of such precursors accounts for the other half of your free testosterone.

Androgens play key roles in regulating proper body function before, during and after menopause, the time when a women stops having her periods. They kick-start puberty in girls, stimulating hair growth in the pubic and underarm areas. They also increase the sensitivity of erogenous zones. These hormones are believed to regulate the function of many organs, including the reproductive tract, kidneys, the liver and muscles. In adult women, androgens are necessary for estrogen synthesis and have been shown to play a key role in the prevention of bone loss as well as sexual desire and satisfaction.

According to “Medical Guidelines For Clinical Practice For the Diagnosis and Treatment of Hyperandrogenic Disorders”, issued in 2001 by the American Association of Clinical Endocrinologists, excess amounts of androgens can pose a problem, resulting in such “virilizing effects” as acne, hirsutism (excess hair growth in “inappropriate” places, like the chin or upper lip, for example), and thinning hair. Many women with high levels of androgens have polycystic ovary syndrome, characterized by hyperandrogenic symptoms and irregular or absent menstrual periods. Other symptoms of hyperandrogenism may include those that involve the female reproductive system, including infertility. If untreated, hyperandrogenism can lead to serious health consequences, such as insulin resistance and diabetes, uterine cancer, high cholesterol and heart disease, and high blood pressure.

The causes of hyperandrogenism include polycystic ovary syndrome, congenital adrenal hyperplasia (a genetic disorder affecting the adrenal glands that afflicts about one in 14,000 women) and other adrenal abnormalities, and ovarian or adrenal tumors. Medications such as anabolic steroids can also cause hyperandrogenic symptoms.

Low androgen levels can be a problem as well, producing effects such as low libido (interest or desire in sex), fatigue, decreased sense of well being and increased susceptibility to osteoporosis. Because symptoms like flagging desire and general malaise have a variety of causes, androgen deficiency, like hyperandrogenism, often goes undiagnosed.

Low androgen levels may affect women at any age, but most commonly occur during and after perimenopause (a term used to describe the five to seven years just prior to menopause when menopausal symptoms are most common). During perimenopause and just following menopause (when you haven’t had a menstrual period for 12 consecutive months) levels fall by 50 percent or more as androgen production declines in the adrenal glands and the midcycle ovarian boost evaporates.

Testosterone supplements are available for women in both oral and injected formulations and have been shown in small studies to be effective in boosting libido, energy and well being in women with androgen deficiencies, as well as providing added protection against bone loss. Current research revolves around testosterone patches developed for women. More research is needed to determine how much to give and in which women it will be effective without side effects.

Testosterone is also an effective treatment for AIDS-related wasting, and is undergoing studies for treating premenstrual syndrome (PMS) and autoimmune diseases. Women with PMS may have below-normal levels of testosterone throughout the menstrual cycle, suggesting a supplement may help. As for autoimmune diseases, women are much more vulnerable than men to these conditions, in which the immune system attacks healthy tissues. Androgens appear to dampen immune responses and may account for men’s lower susceptibility to autoimmune diseases.

References

American Journal of Obstetrics and Gynecology. Bachmann G. “Androgen cotherapy in menopause: Evolving benefits and challenges.” AJOG. Vol. 180, No. 3, March 1999.

American Journal of Obstetrics and Gynecology. Shoupe D. “Androgens and bone: Clinical implications for menopausal women.” Vol. 180, No. 3, March 1999.

Association of Reproductive Health Professionals. “Androgens and Women’s Health: Pharmacodynamic Considerations for Contraception.” http://www.arhp.org/androgens.htm

Journal of the American Medical Association. Friedrich MJ. “Can Male Hormones Really Help Women?” May 24/31, 2000 — Vol. 283, No. 20. http://jama.ama-assn.org/issues/v283n20/ffull/jmn0524-3.html

Journal of Clinical Endocrinology and Metabolism. Davis, S. “Androgen Replacement in Women: a Commentary.” JCEM; Vol. 84, No. 6. June 1, 1999.

The Journal of Gender-Specific Medicins. Davis S. “Androgens and Female Sexuality.” JGSM. Vol. 3, No. 1. Jan/Feb 2000. http://www.mmhc.com/jgsm/articles/JGSM0001/davis.html

The Medical Journal of Australia. Davis S. MJA 1999; 170: 545-69. “Androgen treatment in women.” http://www.mja.com.au/public/issues/jun7/davis/davis.html

U.S. Pharmacist. Cutler S, Cutler J, et al. “Testosterone Replacement in Women.” U.S. Pharmacist. Sept. 2000. http://www.uspharmacist.com/NewLook/DisplayArticle.cfm?item_num=574

American Association of Clinical Endocrinologists. “Medical Guidelines For Clinical Practice For the Diagnosis and Treatment of Hyperandrogenic Disorders.” Issued 2001. http://www.aace.com/clin/guidelines/

The American College of Obstetricians and Gynecologists. “Androgen Replacement No Panacea for Women’s Libido” News Release. Oct. 2000. http://www.acog.org/from_home/publications/press_releases/nr10-31-00-1.htm

The Journal of Clinical Endocrinology & Metabolism. Miller K. “Androgen Deficiency in Women” Vol. 86, No. 6, June 2001.

Solvay Pharmaceuticals – Estratest Fact Sheet. Accessed August 2001. http://www.solvaypharmaceuticals-us.com/Products/Womens_Health/ESTRATEST/default.asp

Source: http://www.healthywomen.org/content.cfm?L1=3&L2=5.0