Postmenopausal Androgen Therapy is a specialized clinical intervention involving the administration of exogenous androgens, most commonly testosterone or DHEA, to women following the cessation of ovarian function. This treatment is specifically aimed at addressing symptoms associated with androgen deficiency, which may include diminished libido, persistent fatigue, and reduced bone mineral density, that are not adequately resolved by estrogen replacement alone. Treatment requires careful titration and rigorous monitoring of circulating hormone levels.
Origin
This therapeutic concept evolved from the understanding that the ovaries and adrenal glands continue to produce androgens, and that the decline in these hormones post-menopause contributes to specific quality-of-life deficits. While estrogen replacement therapy (ERT) addresses many menopausal symptoms, the unique role of androgens in female physiology led to the development of targeted replacement protocols. It remains a nuanced area of endocrinology with specific guidelines for clinical use.
Mechanism
The mechanism involves the administered androgen binding to the androgen receptor in target tissues, including the central nervous system, muscle, and bone. In the brain, testosterone and DHEA can enhance neurotransmitter function and influence mood and sexual motivation. Peripherally, they promote protein synthesis, contributing to muscle mass maintenance and stimulating bone formation. The careful clinical goal is to restore circulating androgen levels to a physiological range appropriate for premenopausal women, thereby maximizing therapeutic benefit while mitigating virilizing side effects.
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