Androgens may be called “male hormones,” but don’t let the name fool you. Both men’s and women’s bodies produce androgens, just in differing amounts. In fact, androgens have more than 200 actions in women, and they are present in higher amounts than estrogens.

1. WHAT IS ANDROGEN?
Overview
Androgensmaybe called“male hormones,”butdon’tletthe name fool you.Bothmen’sandwomen’s
bodiesproduce androgens,justindifferingamounts.Infact,androgenshave more than200 actionsin
women,andtheyare present inhigheramountsthanestrogens.
The principal androgensare testosteroneandandrostenedione.Theyare,of course,presentinmuch
higherlevelsinmenandplayan importantrole inmale traitsandreproductive activity.Otherandrogens
include dihydrotestosterone(DHT),dehydroepiandrosterone(DHEA) andDHEA sulfate (DHEA-S).
In a woman’sbody,one of the mainpurposesof androgensisto be convertedintothe female hormones
calledestrogens.
Androgens in Women
In women,androgensare producedinthe ovaries,adrenalglandsandfatcells.Infact,womenmay
produce too muchor too little of these hormones––disordersof androgenexcessanddeficiencyare
amongthe more commonhormonal disordersinwomen.
In women,androgensplayakeyrole inthe hormonal cascade that kick-startspuberty,stimulatinghair
growthin the pubicand underarmareas.Additionally,thesehormonesare believedtoregulate the
functionof manyorgans,includingthe reproductive tract,bone,kidneys,liverandmuscle.Inadult
women, androgensare necessaryforestrogensynthesisandhave beenshowntoplayakeyrole inthe
preventionof bone loss,aswell assexual desireandsatisfaction.
Androgen-Related Disorders
High Androgen Levels
Excessamountsof androgenscan pose a problem,resultinginsuch“virilizingeffects”asacne,hirsutism
(excesshairgrowthin“inappropriate”places,likethe chinorupperlip) andthinningof haironthe head
(balding).
About10 percentof womenwithhighlevelsof aform of testosterone called“free”testosterone have
polycysticovarysyndrome (PCOS),characterizedbyirregularorabsentmenstrual periods,infertility,
bloodsugardisorders(prediabetesandtype 2 diabetes),and,insome cases,symptomslike acne and
excesshairgrowth.Most womenwithPCOSare overweightorobese,thoughasmall percentage have a
normal bodyweight.Leftuntreated,highlevelsof androgens,regardlessof whetherawomanhasPCOS
or not, are associatedwithserioushealthconsequences,suchasinsulinresistance anddiabetes,high
cholesterol,highbloodpressure andheartdisease.
In additiontoPCOS,othercausesof highandrogenlevels(calledhyperandrogenism) includecongenital
adrenal hyperplasia(ageneticdisorderaffectingthe adrenal glandsthatafflicts aboutone in10,000 to

2. one in18,000 Americans,abouthalf of whomare women) andotheradrenal abnormalities,andovarian
or adrenal tumors.Medicationssuchasanabolicsteroids,occasionallyabusedbybodybuildersand
otherathletesforperformance enhancement,canalsocause hyperandrogenicsymptoms.
Low Androgen Levels
Low androgenlevelscanbe a problemaswell,producingeffectssuchaslow libido(interestinordesire
for sex),fatigue,decreasedsense of well-beingandincreasedsusceptibilityto bone loss,osteoporosis
and fractures.Because symptomslikeflaggingdesire andgeneral malaise have avarietyof causes,
androgendeficiency,like hyperandrogenism,oftengoesundiagnosed.
Low androgenlevelsmayaffectwomenatanyage,but mostcommonlyoccur duringthe transitionto
menopause,or“perimenopause,”aterm usedtodescribe the time before menopause(usuallytwoto
eightyears).Androgenlevelsbegindroppinginawoman’s20s, and by the time she reachesmenopause,
have declined50percentor more fromtheirpeakas androgenproductiondeclinesinthe adrenal
glands,andthe mid-cycle ovarianandrogenboostlessensorevaporatesaltogether.
Furtherdeclinesinthe decade followingmenopause indicate ever-decreasingovarianfunction.For
manywomen,the effectsof thisfurtherandrogendeclineinclude aggravationof hotflashesand
acceleratedbone loss.These effectsmaynotbecome apparentuntil the womenare intheirlate 50s or
early60s.
Treatment for Low Androgen Levels
Combinationestrogen/testosteronemedicationsare availableforwomeninbothoral andinjected
formulations.Smallstudiesfindtheyare effective inboostinglibido,energyandwell-beinginwomen
withandrogendeficiencies,aswell asprovidingaddedprotectionagainstbone loss.One studyshowed
some increasedrisksof breastandendometrial cancer,alongwithseveral otheradverse effects,from
one oral formof combinedestrogenandtestosterone,buttheseriskshave notbeendemonstratedwith
otherformsof treatment.
Testosterone isalsoaneffective treatmentforAIDS-relatedwastingandisundergoingstudiesfor
treatingpremenstrual syndrome (PMS) andautoimmune diseases.WomenwithPMSmayhave below-
normal levelsof testosteronethroughoutthe menstrual cycle, suggestingthatatestosterone
supplementmayhelp,butsuchtreatmentshave notbeenproveneffective.
Diagnosis
Your androgenlevelsmaybe normal,toohigh(hyperandrogenism) ortoolow (hypoandrogenism).A
healthcare professional canassesswhetheryoursymptomssuggestabnormal levelsandcanorder a
bloodtestto measure hormone levels.Butresultsfrombloodtestsare oftenmisleadingandmaynotbe
conclusive because thereisnoagreementonjustwhatconstitutes“normal”androgenlevelsinwomen.
Plus,levelsfluctuatedependingonawoman’sage,the timingof hermenstrual cycle andher
menopausal status.Further,manystandardlaboratorytests,optimizedformeasuringtestosteronein

3. men,maynot be sensitive enoughtoaccuratelymeasure women’s levels.Asaresult,itiseasierto
diagnose androgenlevelsthatare too high,ratherthan levelsthatare toolow.
If you suspectyouhave a hyperandrogeniccondition,itisimportanttoseeka diagnosisanddevelopand
begina treatmentplan.Hyperandrogenismcanproduce bothersomecosmeticsymptomslikeunwanted
hair onyour upperlipandchin.Psychologically,the clinical manifestationsof hyperandrogenemia
(persistentacne,excessfacial orbodyhair,thinningof haironthe scalpand obesity) canbe devastating
to younggirlsand womenof reproductive age andmaycontribute tofeelingsof low self-esteem,
anxiety,depressionandantisocial behavior.Womenwithexcessive,uncomfortable sexual tensionmay
alsohave highlevelsof androgens.
Hyperandrogenicconditionsare alsoassociatedwithserioushealthproblemslikeinsulinresistance (a
precursorto diabetes),diabetesandheartdisease.
Hyperandrogenicsyndromesoftengoundiagnosed,eventhoughsymptomsmaybe treated.For
example,youmaybe treatedforacne,withoutbeingevaluatedforglucose toleranceoraskedabout
menstrual regularity.Itmaybe up to youto tie togethersome of yourhyperandrogenicsymptomsand
ask fora more integratedevaluationandtreatmentapproach.
The signs and symptoms of hyperandrogenism are:
 Hirsutism(excessfacial orbodyhair)
 Persistentacne and/oroilyskin
 Alopecia(thinninghaironthe head)
 Insulinresistance
 Acanthosisnigricans(rough,darklypigmentedareasof skin)
 Highbloodpressure
 Low HDL cholesterol (“goodcholesterol”) andhighLDLcholesterol (“badcholesterol”)
 Obesityaroundthe mid-abdomen
 Irregularor absentperiodsorfrequentskippedcycles
 Enlargementof the clitoris
 Deepor hoarse voice
If your symptomsinclude irregularorabsentperiods,youmayhave polycysticovarysyndrome (PCOS)––
the most commonconditionassociatedwithhyperandrogenism.The menstrualirregularityindicates
infrequentorabsentovulation,makingPCOSaleadingcause of female infertility,whichisoften
treatable.
Some womenwithhyperandrogenismmayexperiencespontaneousovulation,andpregnanciesmay
occur. However,womenwithhighandrogenlevelsalsohave anincreasedriskof miscarriage.
Hyperandrogenicsymptomsmayalsobe causedbya geneticdisease calledcongenital adrenal
hyperplasia(CAH).Severe casescanresultinsuchextreme effectsasgenital malformationand
virilization(facialhair,acne) ata youngage.

4. Mildercasesmay looka lotlike PCOS,withsymptomspossiblyincludingfacial hair,irregularperiodsand
highbloodpressure.WomenwithmildCAHmayalsobe shorterthan theirparents,vulnerable to
infectionsandhave asomewhat“masculine build,”withsquare shouldersandnarrow hips.
A thoroughmedical historyandphysical examination provide the mostimportantinitial diagnostic
information.Laboratorytestsusuallyserve toconfirmthe presence of hyperandrogenemia,amedical
termmeaningtoomuch androgeninthe blood.A bloodtestfortotal and free testosterone maybe
ordered,as well asa lipidprofile (tomeasure cholesterol levels),luteinizinghormone(LH),follicle-
stimulatinghormone(FSH),prolactinanda fastingglucose test.Several endocrinefunctiontestsmay
alsobe orderedtodetermine the site(s) of abnormal androgen secretion,suchasDHEA or its sulfate
form,DHEAS. Thyroidtestsare usuallyincludedinthe evaluation.Inflammationisalsoacomponentof
PCOS,so a physicianmaychoose tomeasure some inflammatorymarkersaswell.
Hormone therapy(HT),whichconsists of eitherestrogenandprogestin(sometimesreferredtoas
hormone replacementtherapy,orHRT) or estrogen-onlytherapy(ET),andbirthcontrol pillscontaining
estrogen,are othertreatmentoptions.Oral estrogensboostlevelsof sex hormone bindingglobulin
(SHBG),a proteinmade inthe liverthatbindstestosterone andestrogen.Thisreduceslevelsof free
testosterone,whichmaybe triggeringsymptoms.Glucocorticoids(cortisone),whichare often
prescribedforasthmaor inflammation,canalsosuppressproductionof androgens.
Androgen Deficiency
Androgenlevelsinwomenpeakduringtheir20s.Thena decline indailyproductionbeginsthat
continuesthroughoutawoman’slife.The onlytime asuddendrop-off inandrogenlevelsoccursisin
womenwhohave theirovariesremoved(abouthalf of all androgensare producedinawoman’sadrenal
glandsand half inherovaries).Bythe time a womanreachesmenopause,bloodandrogenlevelsare
abouthalf of whattheywere at theirpeak.
Low androgenlevelsinwomenduringtheirreproductive years,aswell asfollowingmenopause,result
inthree noticeable symptoms:lowlibido,fatigueandareducedsense of well-being.Low androgen
levelsalsohave beenlinkedtobone lossandosteoporosis(adisease thatcausesthin,fragile bones),
possiblyexplainingthe phenomenonof excessivebone lossinsome womenwhogothroughovarian
failure orsurgical removal of the ovaries.
Low sex drive andvaginal drynessare twocommonsymptomsexperiencedbysome womenduringthe
transitiontomenopause,makingsex uncomfortableorpainful.Thesechangeshave beenrelatedtolow
estrogenaswell aslowandrogenlevels.If yourecognize anyof the followingchanges,youshouldsee
your healthcare professional todiscussyourconcerns.
1. Have you noticedthatit takeslongerforyourvaginato become lubricatedbefore orduringsex?
2. Have you noticedthatthe amountof vaginal lubricationisless?
3. Do youhave discomfortor painduringvaginal penetration?
4. Do youhave sex lessfrequently?
5. Do youand/or yourpartner wishyouhadsex more often?

5. 6. Are you lessresponsive tosexual stimulation?
7. Do youhave difficultyreachingorgasm?
8. Has your desire forsex decreased?
To diagnosisandrogendeficiency,yourhealthcare professional will considersymptomssuchaslow
libidoandfatigue.Otherconditionsthatcancause similarsymptomswillalsoneedtobe ruledout.
Bloodtestsfortestosterone andSHBGwill likelybe partof your evaluation.SHBGbindstotestosterone,
makingitlessavailable forinfluencingcellularactions.SHBGlevelscanvarydramaticallyinresponse to
oral estrogentherapyfollowingmenopause ortooral contraceptives.Insome women,SHBGchanges
are modestandhave minimal effectonfree androgenlevels,while inothers,itcanincrease greatlyand
give rise toloweredsex drive (undesirable) orreducedfree testosterone andaresultingdecreaseinside
effectssuchas acne and hirsutism(desirable)
Bloodtestingfortestosteroneinhypoandrogenicwomenisproblematic.Healthcare professionalshave
not reacheda consensusaboutwhatconstituteslow levelsinwomen,andlevelsatthe lowerendof the
female range are difficulttomeasure withmanycommerciallyavailablelaboratorytests.Forthisreason,
Endocrine SocietyClinical Practice Guidelinesrecommendagainstmakingaformal diagnosisof
androgendeficiency.
The causes of androgendeficiencyare varied.The mostcommoncause of low androgen isaging.If your
symptomsbotheryou,youmaywant to talkto yourhealthcare professional aboutandrogen
replacement.
Androgen deficiency may be a particularproblem if:
 Your ovarieshave beenremoved
 You have undergone earlymenopause(generallydefinedasmenopauseoccurringpriortoage
40)
 You have Turner’ssyndrome,ageneticgrowthdisorderthatoccursinabout one in2,000 girls
that ariseswhenone,orpart of one,of the two Xchromosomesismissing(twoX’scode fora
female,anXYfor a male). Thisisa conditioninwhichthe ovariesfail todevelop.
 You are postmenopausal
 You have undergone chemotherapyorradiationtreatmentforcancer
Otherconditionsassociatedwithlowtestosteroneinclude hypothalamicamenorrhea(absence of
menstrual periodsresultingfromexcessive dietingandexercising)andhyperprolactinemia
(characterizedbyhighlevelsof prolactin,the hormone thatdrivesmilkproductionwhenawoman
breastfeeds).Additionally,avarietyof pituitaryglandtumorsare alsoassociated withlow productionof
testosterone,aswell asotherhormones.
Sometimesthere isnoobviouscause of androgendeficiency.Otherwisehealthywomenof reproductive
age can sufferfromlowandrogens,whichcanbe confirmedwithbloodtestsandafterother potential
causesof lowlibidoandfatigue are eliminated.

6. To exclude otherpotential causesof lowlibidoandfatigue,yourhealthcare professional mayaskyou
aboutpast psychological orrelationshipproblemsandcheckforotherpotential causesof fatigue,such
as depression,hypothyroidismandirondeficiency.
If you are postmenopausal andare takinghormone replacementtherapy(estrogenalone oran
estrogen/progestincombination),yourestrogenlevelsmaybe checkedtoensure yourestrogendosage
ishighenough.Therapywithoral estrogens(oral estradiol) andconjugatedestrogens(conjugated
equine estrogenorsyntheticconjugatedestrogens) oresterifiedestrogenscanbe difficultbecauseoral
estrogensare metabolizedtoestrone,whichcanbe difficulttomeasure,andconjugatedandesterified
estrogensare largelycomposedof estrogeniccompoundsnotmeasuredincommerciallyavailable
hormone tests.Transdermal estrogens(patches,gels,injections,etc.),are more easilyassessedwith
commercial laboratorytests.
Treatment
Androgendisorderscannotbe curedbuttheycan be treated,usuallywithmedication.If youare
overweight,losingaslittle as5 to 10 percentinbodyweightcan restore fertilityanddecrease hirsutism
insome womenwithandrogen excess.
Treatmentmayalsoinclude oral contraceptives.Keepinmindif youare of reproductive age,the right
oral contraceptive choice canreduce hyperandrogenicsymptoms,while the wrongone canmake them
worse.Whenyouhearthe termoral contraceptivesorbirthcontrol pills,itmostoftenrefersto
“combinationpills”—pillsthatcontainbothestrogenandprogestin.The estrogenusedisalmostalways
ethinyl estradiol invaryingdoses,butnumerousprogestinsare used,alsoinvaryingdoses.The keyi s
the type of progestinincluded.Someprogestinscanmimicandrogensandmake symptomsworse,but
some avoidthisproblem,allowingthe estrogeninbirthcontrol pillstoraise levelsof sex hormone
bindingglobulin(SHBG),reducingbloodlevelsof free testosterone andimprovingsymptoms.Standard-
dose birthcontrol pills,whichcontain35 mcg of ethinyl estradiol,maybe preferable inthese
circumstancestopillscontaininglowerdosesof ethinyl estradiol.Talktoyourhealthcare professional
abouta pill formulationwithprogestinsthatdonot have an androgeneffectandwhichare knownto
elevate SHBG,suchas norgestimate,drospirenoneordesogestrel.
For some women,the mostbothersome symptomsof highlevelsof androgenare acne and hirsutism.
For womenwithsuchsymptoms,spironolactone(Aldactone orSpironol) maybe prescribed.The drug,a
diuretic,hasfewside effects,andathighdosescan clearoilyskinandmake unwantedhairfiner.The
combinationof spironolactone andoral contraceptivesis frequentlyused.If youare tryingtoconceive,
however,donottake thisdrug because itcan harm an unbornbaby.
Bear inmindthat itcan take up to nine monthstosee effectsonhairgrowthand a yearto achieve peak
effect.The hairwill still be there,butwill generallygrow more slowlyandwill be lighterandfiner.
Electrolysisorrepeatedlasertreatmentsare the onlywaystogetrid of the hair for extendedperiodsor
permanently.

7. A classof drugscalled5-alphareductase inhibitorsmayhelpsome women,thoughtheyshouldbe taken
onlywithextreme caution.These drugsinhibitanenzyme crucial toconvertingtestosterone to
dihydrotestosterone (DHT).Finasteride (PropeciaandProscar) andflutamide (Eulexin)are inthisclass.
Theywere designedtotreatprostate growthandcancer inmen(whichisexacerbatedbyexcessive
androgenlevels),whilePropeciaisalsoprescribedasatreatmentformale patternbaldness.
These drugsare notspecificallyapprovedbythe U.S.Foodand Drug Administrationforuse inwomen,
and manufacturersadvise againstwomentakingthem.If one isprescribedforyou,youwill have tobe
especiallyvigilantaboutbirthcontrol,because bothcause birthdefects.Flutamidehasthe potential,
althoughinfrequent,adverse effectof fatal livertoxicity.
Treatingcongenital adrenal hyperplasia(CAH) isabitmore complex,because CAHischaracterizednot
justby highlevelsof androgens,butbylow levelsof twootherhormones,cortisol andaldosterone.
Treatmentinan adultwomanmay incorporate aglucocorticoid,suchasprednisone,tomake upforthe
missingcortisol.
Androgen Deficiency
If you are androgendeficient,the benefitsof ahormonal supplementcanmake itworth yourwhile to
investigatewhethersuchadrug is rightfor you.Althoughnottypicallyprescribedsolelytoprevent
osteoporosis,testosteronesupplementshave beenshowninseveral studiestonotonlyslow bone loss,
but alsoto stimulate bone formationinpostmenopausal womenandwomenwithsurgicallyinduced
menopause.
Some compoundingpharmaciesmaybe able toprovide testosterone creamsthatare appliedtothe
vulvaformore targeteddeliveryof the hormone,butsuchformulationsare notwidelyavailable.And
there isa lack of publisheddatademonstrating safety,whetherornottheyare effectiveandif the
speciallymade batchwill be exactlythe same eachtime.
There’salsoa prescriptioncombinationestrogen(esterifiedestrogens)andtestosterone (oral
methyltestosterone) pill thatmayhelpcombatandrogendeficiency.These pillshave neverbeen
formallyapprovedbythe FDA forsuch usages,andtheymay varygreatlyby potency.There isconflicting
evidence andopinioninthe medical communityconcerningwhetherornotthe benefitsof the
combinationof estrogenandtestosterone outweighthe risks,whichmayinclude increasedriskof
breastand endometrialcancer,adverse effectsonbloodcholesterol andlivertoxicity.
Informationfromthe Nurses’HealthStudyindicatedthatthe combinationof estrogenandandrogen
usedto treathypoandrogenismcouldincrease breastcancerrisk.However,otherstudiesindicated
androgensmaydecrease breastcancerrisk.Follow-upstudiesonthe Women’sHealthInitiative found
womenwhoreceivedestrogenandnoprogestogen showedasignificantdecreaseincardiovascular
disease (CVD) andbreastcancer.Thishascauseda reconsiderationof androgensaddedtoestrogens.
Still,the FDA requiresdemonstrationof CVDandbreastcancer safetyforany productcontaining
androgens orestrogenplusanandrogen;that has notbeendone.

8. Womenwithandrogendeficiencymaybenefitfromtreatmentwithdehydroepiandrosterone (DHEA),a
hormone producedbythe adrenal glands.DHEA isavailable over-the-counterwithoutaprescriptionin
the UnitedStatesand isnot FDA-regulated.Itmayimprove suchandrogen-deficiencyside effectsas
sexual dysfunction.However,while the hormone isavailableoverthe counter,itshouldnotbe taken
withoutmedical guidance.
The quantityand qualityof DHEA containedinavailable preparationsare notroutinelymonitoredor
testedforcontaminantsorconsistency.Therefore,it’simportantthatyourhealthcare professional
monitorbloodlevelsof DHEA,itsmetabolicproducts(estrogensandandrogens)andanyside effectsif
you’re takingthe hormone.
Since DHEA isconvertedtoestrogenandtestosterone inwomen,the levelsof these hormonesshould
alsobe measuredwhentakingDHEA.The resultsof studiesonthe benefitsof DHEA supplementationin
bothmenand womenwithandrogendeficiencyhave beenmixed.A recentreviewof studiesfoundno
convincingevidence forthe effectivenessof oral DHEA in treatingsymptomsof hypoandrogenismin
women.
Androgensupplementsare generallysafe atthe dosagesprescribedforwomen,butpossible sideeffects
include facial hairgrowth,deepeningof the voice,thinninghairandacne.
Noncosmeticside effectscan include fluidretention,livertoxicityandunfavorablechangesinyour
cholesterol levels,whichshouldbe monitoredperiodically.If theyoccur,side effectscanbe minimized
or eliminatedwithlowerandrogendosesandcan usuallybe reversedbydiscontinuingtherapy.Higher
dosescan cause deepeningof the voice orclitoral enlargement,whichmaybe irreversible.However,
thisisnot oftenseenindosesproperlyprescribedforwomen.Earlyside effects(thoseseeninthe first
90 days of treatment) usuallyincludeoilyskinormildacne.These affectsmaybe temporaryandgo
away ontheirown.If theyoccur, talk to yourhealthcare professional aboutdecreasingyourdose
before more seriousside effectsoccur.
Researchcontinuesontestosterone patches,skingelsandvaginal suppositoriesorcreamsthat could
raise androgenlevelsinwomen.Testosterone patchesforwomen,soldunderthe brandname Intrinsa,
have beenapprovedforuse inCanadaand Europe but notin the UnitedStates.These patcheshave
recentlybeenwithdrawnfromthose marketsforcommercial reasons,notmedical ones.A testosterone-
containingskingel,nasal sprayandvaginal suppositoriesare inclinical trialsorpendingFDA approval.
DHEA containingvaginal suppositoriesare alsobeinginvestigatedforvulvarandvaginal atrophy.
Androgensupplementsare notthe answerforeveryone withaslumpinglibidoandfatigue—particularly
if you have anysignsof androgenexcess,suchashirsutism, acne orthinninghair.Suchmedicationsare
alsoruledoutif youare pregnantor nursing.
As yourbodychanges,itis veryimportanttocommunicate withbothyourpartnerand yourhealthcare
professional.Tell bothaboutyoursymptomsandthe changesinyourbody.Your partner’ssupportcan
be helpful toease the stresscausedbysymptomsthataffectintimacy.Because everywomanisunique,

9. youand your healthcare professionalwillneedtoworktogethertodetermine whichtreatmentoption
bestmeetsyourmedical andpersonal needs.
Prevention
Researchersare still workingtocharacterize fullythe role of androgensinwomenandthe nature of
androgendisorders.Youcan,however,preventsome of the worstconsequencesof androgen-related
disorders.If youare hyperandrogenic,youmaybe at higherrisk forglucose intolerance,diabetesand
highcholesterol.Medicationtoreduce yourandrogenlevelscanreduce these risks,butyoumaywant
to talkto a healthcare professionalaboutmonitoringforthese conditionsandaboutlifestyle changes
(suchas dietand exercise) thatmighthelpreduce risk.
If you are hypoandrogenic,supplementingwithtestosteronemayhelppreventbone lossand
osteoporosisandmayprovide alifttoyour sex life andenergylevels.Rememberthatcommunicating
withyourpartner and healthcare professional aboutyoursymptomsisvital tomaintainingahealthy
lifestyle andsex life.
Andbe sure to tell yourpartneraboutthe treatmentsrecommendedbyyourhealthcare professional.
Beingopenaboutproblemsandtreatmentsisthe best waytomaintaina healthyrelationship.
Facts to Know
1. Mistakenlythoughtof asonlya male sex hormone,androgensare alsonatural tothe female
body,where theyare producedinthe ovaries,adrenal glandsandothertissues.
2. Testosterone isthe androgenyou’veprobablyalreadyheardabout.Othersinclude
dihydrotestosterone (DHT),androstenedioneanddehydroepiandrosterone (DHEA) andDHEA
sulfate (DHEA-S).
3. Androgensare partlyresponsible forthe growthspurtat pubertyandare believedtoregulate
the functionof manyorgans, includingthe reproductivetract,bone,kidneys,liverandmuscle.
4. Androgenshave beenreportedtoplaya keyrole ina woman’ssex drive,orlibido,cognitive
abilities,energylevel andsense of well-being.
5. Androgens,eitherdirectly orindirectlythroughconversiontoestrogen,affectbone cellsorthe
environmentsurroundingbone cells,leadingtobetterbone health.
6. Androgenproductiondropsasyouage.By the time you reachmenopause,ithasdropped50
percentor more fromits peakinyour 20s.
7. The onlytime a suddendrop-off inandrogenlevelsoccursisinwomenwhohave hadtheir
ovariessurgicallyremoved(abouthalf of all androgensare producedina woman’sadrenal
glandsand half inherovaries).
8. If you take an androgensupplement,watchoutfor“virilizing”side effects,suchasfacial hair
growth,thinninghaironyourheadand changesin yourvoice.If an androgendose istoohigh,it
can have adverse effectsonyourcholesterollevels.
9. The right oral contraceptive choice canreduce hyperandrogenicsymptoms,while the wrongone
can exacerbate them.The keycomponentisthe type of progestinincluded.Talktoyourhealth

10. care professionalaboutapill formulationwhose progestincomponentisdrospirenone,
desogestrelornorgestimate.
10. If you have symptomsof hyperandrogenism(hirsutism,acne and/orirregularperiods),seea
healthcare professional.If the symptomsstemfrompolycysticovarysyndrome,youcouldbe at
higherriskforheart disease anddiabetes.
Key Q&A
1.Why do women need androgens?
Androgenswere formerlythoughtof asthe “male sex hormones,”butnow we know thattheyhave an
importantrole inwomenaswell,eventhoughwomen’slevelsare muchlowerthanmen’s.Inwomen,
androgenshave more than200 cellularactions,includinghelpingmaintainahealthysex drive,
preventingfatigue andcontributingtoa woman’soverall senseof well-being.Theyalsopreventbone
lossand bone disease andplayarole inthe formationof estrogen.
2. What happens if my body does not produce enough androgens?
Your sex drive,orlibido,maydrop,andyou mayexperiencefatigueanda decline inyouroverall sense
of well-being.Lowandrogenlevelscanalsocontribute tobone lossandbone disease.
3. What happens if my body produces too much androgen?
Androgenlevelsinwomenpeakduringtheirtwenties.Thenadecline indailyproductionbeginsthat
continuesthroughoutawoman’slife.The onlytime asuddendrop-off inandrogenlevelsoccursisin
womenwhohave hadtheirovariesremoved(abouthalf of all androgensare producedinawoman’s
adrenal glandsandhalf inher ovaries).Bythe time awomanreachesmenopause,bloodandrogenlevels
are abouthalf of whattheywere at herpeak.
As yourandrogenlevelsriseabove the normal range,youmayexperience such“virilizing”effectsas
facial hairgrowth,androgenicalopecia(thinningof the hairon yourhead),acne and oilyskin.Inaddition
to these cosmeticeffects,if yourandrogenexcessisrelatedtopolycysticovarysyndrome (PCOS),you
may experience irregularperiodsthatindicate youare notovulating.HyperandrogenismorPCOScan
alsoput youat riskof heart disease,glucose intolerance anddiabetes.
4.Is medication available to treat hypoandrogenism?
Yes,oral methyltestosteroneisavailable incombinationwithesterifiedestrogensbyprescription.This
combinationisnotwithoutitsrisks,however,soif youare consideringthistreatment,discussthese
riskswithyourdoctor. Inaddition,DHEA,a hormone thatis convertedintobothestrogensand
androgens,isavailable withoutaprescriptioninthe UnitedStatesbutisnotFDA regulated.Therefore,
monitoringof serumestradiol andtestosteronelevelsandside effectsisessentialinanyone takingthis
hormone.Some compoundingpharmaciesmayalsobe able toprovide vulval creamsformore targeted
delivery.Remember,efficacyandsafetystudiesare lackinginnon-FDA regulatedproducts.

11. 5.What are the side effects of those medications?
If the dosage istoo high, youmayexperiencesymptomsof hyperandrogenism, suchasfacial hair
growth,acne or oilyskin,clitoral enlargementandsensitivityora deepeningof yourvoice.Androgen
supplementsmayalsonegativelyaffectcholesterol levels(thusincreasingyourrisk of heartdisease).If
younotice any side effects,tell yourhealthcare professional atonce.A lowerdose canusuallyresolve
side effects,andstoppingtakingitmayreverse themaltogether.
6.I clearly have the symptoms of hypoandrogenism, so why won’t my health care professional
prescribe supplements?
The symptomsof lowandrogenlevels—reducedlibidoandenergy,sense of malaise—mirrorthose of
manyother disorders.A healthcare professional shouldbe cautiousandrule outothercommon
problemsbefore consideringtestosterone replacement,particularlyif youare under40 andhave no
otherconditionthatwouldcause hypoandrogenism,suchasovarianfailure.A healthcare professional
may wantto explore yourhealthhistoryandtestforconditionslike hypothyroidismandirondeficiency.
7. Is medication available to hyperandrogenism?
Yes,a varietyof medicationsmayhelpreduce testosteroneorpreventitsconversionintoanactive
form.Theyinclude oral birthcontrol pills(withdrospirenone,desogestrelornorgestimate);
spironolactone (Aldactone orSpironol),adiuretic;andflutamide (Eulexin) andfinasteride(Propecia),
whichare usedinmento treatprostate growthand cancer and male patternbaldness.
8. What precautions should I take with those medications?
You shouldadhere toa birthcontrol regimenwithaddedvigilance if ahealthcare professional
prescribesanandrogen-inhibitingdrug.These medicationscancause birthdefectsif takenwhile
pregnant.Talkto a healthcare professional aboutotherpossibleside effects.See the oral
contraceptivestopiconthissite fora complete discussionof the side effectsof birthcontrol pills.
9. What is polycystic ovary syndrome (PCOS)?
Polycysticovarysyndrome isahyperandrogenicdisorder;it isdistinguishedbyirregularorabsent
periods,whichindicateawomanmaynot be ovulating.
For more informationvisitusourwebsite:http://www.healthinfi.com