John Libbey Eurotext

Médecine de la Reproduction

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Androgen deficiency in menopause : should it be treated ? Volume 14, issue 3, Juillet-Août-Septembre 2012

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Centre de santé de la MGEN 178, rue de Vaugirard 75015 Paris France

Androgen deficiency in menopausal women occurs progressively with age but is more abrupt in surgical menopause. Most often, androgen insufficiency symptoms are a diminished sense of well-being or dysphoric mood, a persistent, unexplained fatigue and sexual function changes (decreased libido, sexual receptivity, and pleasure). For the diagnosis, in the absence of a sufficiently sensitive assay or absolute threshold, free testosterone values should be at or below the lowest quartile of the normal range for the reproductive age, in conjunction with the presence of clinical symptoms and adequate estrogen status, without confounding conditions. Most convincing studies on efficacy of androgen therapy in menopausal women are those of transdermal testosterone in surgically menopausal women with hypoactive sexual desire disorder (HSDD). Long term tolerance of this type of treatment is not completely documented. In randomized, placebo-controlled trials of DHEA on sexual function, well-being, metabolic parameters and cognitive function, no evidence of any efficiency was shown.