Androgen deficiency (AD) in women is considered a rather controversial issue. In women, the primary clinical sign of androgen deficiency is reduced libido. However, because low libido can have a myriad of psychosocial causes (interpersonal relationships, social stressors, physical inactivity and the partner), linking low testosterone and/or other androgens has been controversial. A recent review by a group of physicians from Brazil details the research on androgen deficiency in women and provides new insight about how androgens affect women’s health.
Androgen Deficiency in Women: What is it?
It is estimated that 16 million North American women over the age of 50 have reduced libido and a significant proportion of them have reduced androgen concentrations in serum. For this reason, many doctors support increasing testosterone prescriptions. This issue remains controversial since there is no clear evidence that testosterone by itself without estrogens provide benefits in terms of libido or coital frequency.
What is an Androgen?
Androgens are hormones that contribute to growth and reproductive processes in both men and women. Androgens are often erroneously considered male hormones because of their role in male sexual development and masculinization . However, the female body produces and depends upon the full complement of androgens just as men do. Women simply have lower concentrations of these hormones than men.
Androgens are steroids that originate from cholesterol. Common androgens include: DHEA, DHEAS, androstenediol, testosterone, dihydrotestosterone (DHT). In women, androgens are produced by the adrenal glands, ovaries and in fat. As we age, androgen production diminishes. However, in young women any type of reduction in androgens may be a sign of AD. Some common causes of AD include: oophorectomy ( surgical removal of an ovary or ovaries), those hypogonadotropic hypogonadism (a lack of the FSH and LH), gonadal dysgenesis (Turner Syndrome) or adrenal dysfunction. Not only does AD affect libido, it also reduces feeling of well-being and often elicits mood changes, can cause persistent tiredness, loss of bone mass, reduction in muscle strength, thinning of hair and altered cognitive function and memory. Androgens are just as important to women as to men.
Androgens, Aging and Health
As we age, DHEA, the primary source of androgens in men and women, declines by as much as 60%. The reduction in DHEA affects our bones, muscles, brain, mammary glands and vaginal health. It also affects metabolism of fats, carbs and our insulin production. Perhaps most importantly, DHEA affects immune function – our ability to fight disease. Many researchers are suggesting that the natural decline in DHEA as we age may also be linked to a our increased risk for disease.
For women who suffer from early menopause either naturally or surgically, androgen deficiency can be a real health problem beyond the bedroom.
As scientists learn more about hormones and women’s health, it is becoming clearer that the original designations of male and female and hormones are no longer valid. Steroid hormones affect a broad array of physiological functions.
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Let’s Talk Hormones: Common Misconceptions