Changes in circulating androgens

The significance of changes in androgen secretion is a neglected area of female reproductive ageing. One important study has documented a 50% fall in circulating total and free testosterone concentrations in normal regularly cycling women between the ages of 20 and 40 (Zumoff et al 1995). This has been postulated to reflect declining levels of adrenal androgen precursor secretion. Across the menopausal transition itself, studies from the authors' laboratory indicate that there is no significant change in the circulating concentrations of total testosterone, whilst there is a fall in sex hormone binding globulin and an increase in free androgen index (Burger et al 2000b). Studies from other investigators suggest that there may be a further increase in circulating androgen levels in the late 50s and 60s (Laughlin 2000). The precise consequences of these changes in androgen for womens' health in general are unknown. On the other hand, loss of androgen as may occur following ovariectomy may lead to significant consequences of loss of drive and energy and loss of sexual interest which can be corrected by androgen substitution (Shifren et al 2000).

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