Androgen levels in adult females: changes with age, menopause, and oophorectomy. Beyond adrenal and ovarian androgen generation: Increased peripheral 5 alpha-reductase activity in women with polycystic ovary syndrome. Relationship Between Androgen Levels and Blood Pressure in Young Women With Polycystic Ovary Syndrome Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial Association of body mass index, age, and cigarette smoking with serum testosterone levels in cycling women undergoing in vitro fertilization. Serum testosterone levels decrease in middle age in women with the polycystic ovary syndrome. Relation of demographic factors, menstrual history, reproduction and medication use to sex hormone levels in postmenopausal women Cognitive decline in women in relation to non-protein-bound oestradiol concentrations Effect of exercise on serum androgens in postmenopausal women: a 12-month randomized clinical trial. Correlation of biochemical markers and clinical signs of hyperandrogenism in women with polycystic ovary syndrome (PCOS) and women with non-classic congenital adrenal hyperplasia (NCAH) Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. Testosterone deficiency in young women with 46,XX spontaneous premature ovarian failure. Early postoperative changes in testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin after hysterectomy with or without concomitant oophorectomy. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women Decreases in ovarian cytochrome P450c17 alpha activity and serum free testosterone after reduction of insulin secretion in polycystic ovary syndrome. Endogenous androgen levels and well-being: differences between premenopausal and postmenopausal women
CONTEXT Changes in and rogen levels across the adult female life span and the effects of natural menopause and oophorectomy have not been clearly established . OBJECTIVE The objective of this study was to document the effects of age on and rogen levels in healthy women and to explore the effects of natural and surgical menopause . DESIGN , SETTING , AND PARTICIPANTS A cross-sectional study was conducted of 1423 non-healthcare-seeking women , aged 18 - 75 yr , r and omly recruited from the community over 15 months . MAIN OUTCOME MEASURES Serum levels by age of total testosterone ( T ) , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione in a reference group of women free of confounding factors . Women in the reference group had no usage of exogenous steroid therapy ; no history of tubal ligation , hysterectomy , or bilateral oophorectomy ; and no hyperprolactinemia or polycystic ovarian syndrome . The effects of natural and surgical menopause on sex steroid levels were also examined . RESULTS In the reference population ( n = 595 ) , total T , calculated free T , dehydroepi and rosterone sulfate , and and rostenedione declined steeply with age ( P < 0.001 ) , with the decline of each being greater in the earlier than the later decades . Examination of serum and rogen levels by year in women aged 45 - 54 yr showed no independent effect of menopausal status on and rogen levels . In women aged 55 yr or older , those who reported bilateral oophorectomy and were not on exogenous steroids had significantly lower total T and free T levels than women 55 yr or older in the reference group . CONCLUSIONS We report that serum and rogen levels decline steeply in the early reproductive years and do not vary because a consequence of natural menopause and that the postmenopausal ovary appears to be an ongoing site of testosterone production . These significant variations in and rogens with age must be taken into account when normal ranges are reported and in studies of the role of and rogens in women Hyper and rogenism , a main clinical feature of polycystic ovary syndrome ( PCOS ) , is thought to result from enhanced ovarian and adrenal and rogen generation . To investigate the contribution of peripheral steroidogenesis , we used an oral challenge with dehydroepi and rosterone ( DHEA ) and analyzed its downstream conversion toward and rogens in eight women with PCOS ( age , 20 - 32 yr ; body mass index , 20 - 41 kg/m(2 ) ) and eight healthy women matched for age and body mass index . They underwent frequent serum sampling and urine collection for 8 h on three occasions : at baseline , and after 4 d of dexamethasone ( Dex ; 4 x 0.5 mg/d ) , followed by ingestion of 100 mg DHEA or placebo . Dex induced similar significant suppression of circulating steroids in both groups . The oral DHEA challenge led to similar significant increases in the area under the concentration-time curve ( 0 - 8 h after Dex )  of serum DHEA , DHEA sulfate , and rostenedione , and testosterone . However , after oral DHEA , PCOS women had significantly higher increases in serum 5 alpha-dihydrotestosterone ( P < 0.01 ) , its main metabolite and rostanediol glucuronide ( P < 0.05 ) , and the 5 alpha-reduced urinary and rogen metabolite and rosterone ( P < 0.05 ) . PCOS women also had significantly higher baseline excretion of 5 alpha-reduced glucocorticoid ( P < 0.01 ) and mineralocorticoid metabolites ( P < 0.05 ) . Taken together , these data indicate enhanced peripheral 5 alpha-reductase activity in PCOS . Thus , not only ovary and adrenal , but also liver and peripheral target tissues , significantly contribute to steroid alterations in PCOS The role of testosterone on the development of hypertension is controversial , especially in women with polycystic ovary syndrome ( PCOS ) who have higher prevalence of obesity and insulin resistance than women without PCOS . Little is known about the association between serum testosterone level and blood pressure in young women with PCOS . In the 151 young Taiwanese women with PCOS enrolled in this cross-sectional study , we measured the body mass index , waist circumference , blood pressure , fasting glucose , fasting insulin , lipid profile , and hormone profiles .  The  free and rogen index , total testosterone , and sex hormone-binding globulin  , but not the level of dehydroepi and rosterone sulfate  , significantly correlated with both systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) . In multiple linear regression models adjusted for age , body mass index , and other anthropometric , metabolic , and hormonal variables , the level of serum free and rogen index  or total testosterone , but not the sex hormone-binding globulin , were independently related to SBP and DBP . The age- and body mass index – adjusted least-square mean of serum-free and rogen index levels were significantly different between the highest quartile and other quartiles of the SBP and DBP levels . The high bioavailable testosterone levels ( free and rogen index : ≥19 % ) in women with PCOS increased the risk of elevated blood pressure ( SBP ≥130 mm Hg and /or DBP ≥85 mm Hg ) with an odds ratio of 3.817 ( P=0.029 ; 95 % CI : 1.14 to 12.74 ) after adjustment for age , anthropometric measures , and metabolic profiles . Our results suggest that the characteristic hyper and rogenemia in young women with PCOS was associated with an elevated SBP and DBP independent of age , insulin resistance , obesity , or dyslipidemia Objective This study aims to determine the dose-dependent effects of testosterone on sexual function , body composition , muscle performance , and physical function in hysterectomized women with or without oophorectomy . Methods Seventy-one postmenopausal women who previously underwent hysterectomy with or without oophorectomy and had total testosterone levels less than 31 ng/dL or free testosterone levels less than 3.5 pg/mL received a st and ardized transdermal estradiol regimen during the 12-week run-in period and were r and omized to receive weekly intramuscular injections of placebo or 3 , 6.25 , 12.5 , or 25 mg of testosterone enanthate for 24 weeks .  Total and free testosterone levels were measured by liquid chromatography – t and em mass spectrometry and equilibrium dialysis , respectively . The primary outcome was change in sexual function measured by the Brief Index of Sexual Functioning for Women . Secondary outcomes included changes in sexual activity , sexual distress , Derogatis Interview for Sexual Functioning , lean body mass , fat mass , muscle strength and power , and physical function .  Results Seventy-one women were r and omized ; five groups were similar at baseline . Sixty-two women with analyzable data for the primary outcome were included in the final analysis . The mean on-treatment total testosterone concentrations were 19 , 78 , 102 , 128 , and 210 ng/dL in the placebo , 3-mg , 6.25-mg , 12.5-mg , and 25-mg groups , respectively . Changes in composite Brief Index of Sexual Functioning for Women scores , thoughts/desire , arousal , frequency of sexual activity , lean body mass , chest-press power , and loaded stair-climb power were significantly related to increases in free testosterone concentrations ; compared with placebo , changes were significantly greater in women assigned to the 25-mg group , but not in women in the lower-dose groups . Sexual activity increased by 2.7 encounters per week in the 25-mg group . The frequency of and rogenic adverse events was low . Conclusions Testosterone administration in hysterectomized women with or without oophorectomy for 24 weeks was associated with dose and concentration-dependent gains in several domains of sexual function , lean body mass , chest-press power , and loaded stair-climb power . Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects OBJECTIVE [ 1 ] To examine the effects of body mass index ( BMI ) , age , cigarette smoking , cause of infertility , and use of oral contraceptives on baseline serum testosterone ( T ) , and [ 2 ] to examine associations between baseline serum T and IVF outcomes such as pre-hCG serum E(2 ) , number of oocytes retrieved , oocyte fertilization rate , and pregnancy outcome in regularly cycling women . DESIGN Prospect i ve , cohort study . SETTING Three IVF programs in eastern Massachusetts . PATIENT(S ) Four hundred twenty-five regularly cycling women planning to undergo IVF . Women with polycystic ovary syndrome , ovulatory infertility , or irregular cycles were excluded from this study . INTERVENTION(S ) Collection of epidemiological data and baseline serum in women undergoing IVF . MAIN OUTCOME MEASURE(S ) Baseline serum total T , sex hormone binding globulin ( SHBG ) , and calculation of free and rogen index . RESULT ( S ) Body mass index > 26 kg/m(2 ) was associated with a significant increase in serum T ( P<.01 ) and free and rogen index ( P<.0001 ) . Serum T decreased significantly throughout the fourth decade of life ( P<.03 ) . A history of cigarette smoking > 10 pack years was associated with increased serum T ( P<.01 ) . A diagnosis of endometriosis was associated with decreased serum T. Serum T correlated positively with pre-hCG serum E(2 ) and number of oocytes retrieved . However , serum T did not significantly influence fertilization or pregnancy rates . CONCLUSION ( S ) In cycling infertile women , increasing BMI and cigarette smoking are associated with increased serum T. Advancing age and endometriosis are associated with decreased serum OBJECTIVE To determine whether testosterone levels change as women with the polycystic ovary syndrome ( PCOS ) grow older . DESIGN A follow-up cross-sectional study of a cohort of women with PCOS identified up to 20 - 25 years ago . SETTING Women with PCOS were recruited primarily from practice records between 1970 and 1990 .  Voter registration tapes and household directories were used to identify age- , race- , and neighborhood-matched controls . PARTICIPANT(S ) Eighty-four women with PCOS , 20 - 57 years of age , and 37 age-matched controls participating in a study of the risk for cardiovascular disease in women with PCOS . INTERVENTION(S ) Clinical data were collected by question naire and fasting blood sample s were obtained r and omly throughout the menstrual cycle . MAIN OUTCOME MEASURE(S ) Total and non-SHBG-bound testosterone levels . RESULT ( S ) Total and non-SHBG-bound testosterone levels were similar in women with PCOS who were 20 - 42 years of age but were reduced by approximately 50 % among women 42 - 47 years of age and remained stable in women older than 47 years of age . Testosterone levels were increased in younger and older women with PCOS compared with controls but were similar to controls in women 42 - 47 years of age . CONCLUSION ( S ) Hyper and rogenism partly resolves before menopause in women with PCOS . This change may explain the tendency of women with PCOS to cycle regularly as they grow older . Testosterone levels remain elevated in older women with PCOS , however , and may contribute to their increased risk for cardiovascular disease , endometrial cancer , and other diseases In postmenopausal women , levels of estrogens , and rogens , and perhaps prolactin have been related to risk of breast and other hormonal cancers in women . However , the determinants of these hormone concentrations have not been firmly established . Associations among various demographic , menstrual , and reproductive factors , medication use and endogenous sex hormone concentrations ( estradiol , free estradiol , estrone , estrone sulfate , testosterone , free testosterone , sex hormone binding globulin , and rostenedione , dehydroepi and rosterone ( DHEA ) , DHEA sulfate ( DHEAS ) , dihydrotestosterone , and prolactin )  were evaluated in a cross-sectional analysis from a simple r and om sample of 274 postmenopausal women selected from the Women ’s Health Initiative Dietary Modification Trial . In multiple regression analyses on log-transformed hormones , the concentrations of DHEA , and DHEAS were negatively and statistically significantly associated with age ( both β = −0.03 , P < 0.001 , respectively ) . Estradiol , estrone , DHEA , and free testosterone concentrations were higher in African-American than in non-Hispanic White women , but after multivariate adjustment the associations were statistically significant only for free testosterone ( β = 0.38 , P = 0.01 ) . Women who had a history of bilateral oophorectomy had a mean 35 % lower testosterone concentration compared with women with at least one ovary remaining ( β = −0.43 , P = 0.002 ) , and lower free testosterone ( β = −0.42 , P = 0.04 ) after multivariate adjustment . Women who reported regular use of NSAIDs had higher DHEA concentrations ( β = 0.20 , P = 0.04 ) and lower prolactin concentrations ( β = −0.18 , P = 0.02 ) compared with non-users . These results suggest that while age , oophorectomy status , and NSAID use may be associated with selected sex hormone concentrations , few menstrual or reproductive factors affect endogenous sex hormones in the postmenopausal period BACKGROUND Previous studies have found no association between serum concentrations of total oestradiol and cognitive function , but these measurements may not reflect concentrations of hormone available to the brain . We tested the hypothesis that concentrations of non-protein-bound ( free ) and loosely bound ( bioavailable ) sex hormones are associated with cognitive function  in older women . METHODS We measured cognitive performance with a  modified mini mental status examination ( mMMSE ) at baseline ( 1986 - 88 ) and 6 years later in 425 women ( 65 years or older ) . Concentrations of non-protein-bound and bioavailable oestradiol and total and non-protein-bound testosterone were measured by RIA in serum sample s taken at baseline . FINDINGS Initial cognitive scores did not differ by tertile of non-protein-bound oestradiol , bioavailable oestradiol , or testosterone . Cognitive impairment ( a decrease of 3 points or more in mMMSE score ) occurred in five ( 5 % ) of 94 women in the high tertile for non-protein-bound oestradiol and in 17 ( 16 % ) of 106 in the low tertile ( odds ratio 0.3 [ 95 % CI 0.1 - 0.8 ] ) . After adjustment for age , years of education , body-mass index , current oestrogen use , history of surgical menopause , and baseline mMMSE score , the odds ratio was 0.3 ( 0.1 - 0.9 ) . The results were similar for bioavailable oestradiol ( five [ 5 % ] vs 15 [ 15 % ] ; adjusted odds ratio 0.3 [ 0.1 - 1.0 ] ) . There was no association between risk of cognitive impairment and serum testosterone . INTERPRETATION Women with high serum concentrations of non-protein-bound and bioavailable oestradiol , but not testosterone , were less likely to develop cognitive impairment than women with low concentrations . This finding supports the hypothesis that higher concentrations of endogenous oestrogens prevent cognitive decline Postmenopausal women with elevated circulating and rogen concentrations have an increased risk of developing breast cancer , yet interventions to reduce and rogen levels have not been identified . We examined the effects of a 12-month moderate intensity exercise intervention on serum and rogens . The study was a r and omized clinical trial in 173 sedentary , overweight ( body mass index > or = 24.0 kg/m(2 ) , body fat > 33 % ) , postmenopausal women , ages 50 to 75 years , not using hormone therapy and living in the Seattle , WA area . The exercise intervention included facility-based and home-based exercise ( 45 minutes , 5 days per week of moderate intensity sports/recreational exercise ) . A total of 170 ( 98.3 % ) women completed the study , with exercisers averaging 171 minutes per week of exercise . Women in the exercise and control groups experienced similar , nonsignificant declines in most and rogens . Among women who lost > 2 % body fat , testosterone and free testosterone concentrations fell by 10.1 % and 12.2 % between baseline and 12 months in exercisers compared with a decrease of 1.6 % and 8.0 % in controls ( P = 0.02 and 0.03 compared with exercisers , respectively ) . Concentrations of testosterone and free testosterone among exercisers who lost between 0.5 % and 2 % body fat declined by 4.7 % and 10.4 % . In controls who lost this amount of body fat , concentrations of testosterone and free testosterone declined by only 2.8 % and 4.3 % ( P = 0.03 and 0.01 compared with exercisers , respectively ) . In summary , given similar levels of body fat loss , women r and omized to a 12-month exercise intervention had greater declines in testosterone and free testosterone compared with controls . The association between exercise and breast cancer risk may be partly explained by the effects of exercise on these hormones Background : Polycystic ovary syndrome ( PCOS ) is the most common cause of hyper and rogenism in women . Non-classic congenital adrenal hyperplasia ( NCAH ) is very close to PCOS . The diagnosis of hyper and rogenism is not based on the finding of decreased or increased levels of a single hormone . Objective : In our paper , we are going to test correlation between clinical signs and biochemical markers of hyper and rogenism . Material s and Methods : In this prospect i ve study , we calculated  free testosterone ( cFT ) , bioavailable testosterone ( cBT ) , free and rogen index ( FAI ) , free estrogen index ( FEI ) , total testosterone ( TT ) , sex-hormone binding globulin ( SHBG ) , estradiol ( E2 ) , dehydroepi and rosterone-sulfat ( DHEA-S ) , 17α -hydroxyprogesterone ( 17α -OHP ) , prolactin ( P ) , C-peptid and homeostasis model assessment for insulin resistance ( Homa-IR ) were measured in two groups of young untreated women with PCOS and NCAH . Results : In our research , we did not find any significant differences between PCOS and NCAH groups by age , hormonal and calculated parameters of and rogens . Waist to hip ratio ( WHP ) and body mass index ( BMI ) values were higher in the group of patients with PCOS than NCAH group . But in all patients we found positive correlation between hirsutism score and FAI , cFT , cBT , as well as we found negative correlation between hirsutism score and SHBG . We also tested hormonal and calculated parameters of and rogens between PCOS patients by upper body and lower body obesity , but we did not find any significant differences . There was not any difference by the hirsutism score in these groups either . Conclusion : In our research we found that the calculated values of cFT , cBT and FAI are helpful for determinate hirsutism score in all hirsute patients , despite of ovarian or adrenal hyper and rogenemia BACKGROUND Higher levels of endogenous sex steroid hormones are associated with increased risks  of breast cancer in postmenopausal women . Data for premenopausal women are sparse , in part because of the complexity of measuring hormone levels that vary cyclically . We prospect ively evaluated associations between plasma sex hormone levels and breast cancer risk among premenopausal women in a case-control study nested within the Nurses ' Health Study II . METHODS From 1996 to 1999 ,  blood sample s were collected from 18,521 premenopausal women during the early follicular and midluteal phases of their menstrual cycles . A total of 197 cases of breast cancer were diagnosed among these women after blood collection and before June 1 , 2003 ; these case subjects were matched to 394 control subjects .  Logistic regression models , controlling for breast cancer risk factors , were used to calculate relative risks ( RRs ) and 95 % confidence intervals ( CIs ) . All statistical tests were two-sided . RESULTS Women in the highest ( versus the lowest ) quartiles of follicular total and free estradiol levels had statistically significantly increased risks of breast cancer ( RR = 2.1 [ 95 % CI = 1.1 to 4.1 ] , P(trend ) = .08 , and RR = 2.4 [ 95 % CI = 1.3 to 4.5 ] , P(trend ) = .01 , respectively ) ; the associations were stronger for invasive breast cancer and for estrogen and progesterone receptor-positive ( ER+/PR+ ) tumors . Luteal estradiol levels were not associated with breast cancer risk . Higher levels of total and free testosterone and and rostenedione in both menstrual cycle phases were associated with modest , non-statistically significant increases in overall risk of breast cancer and with stronger , statistically significant increases in risks of invasive and ER+/PR+ cancers ( e.g. , RR of invasive cancers for the top [ versus bottom ] quartile of luteal total testosterone levels = 2.0 [ 95 % CI = 1.1 to 3.6 ] , P(trend ) = .05 , and RR of ER+/PR+ cancers = 2.9 [ 95 % CI = 1.4 to 6.0 ] , P(trend ) = .02 ) . Levels of estrone , estrone sulfate , progesterone , and sex hormone-binding globulin were not associated with breast cancer risk . The absolute number of cases observed over 3 years were 30 among women in the lowest 25 % of follicular total estradiol levels and 50 among women in the highest 25 % . CONCLUSIONS Levels of circulating estrogens and and rogens may be important in the etiology of premenopausal breast cancer OBJECTIVE To determine whether women with 46,XX spontaneous premature ovarian failure have lower serum free-T levels than do control women . DESIGN Cross-sectional . SETTING National Institutes of Health Clinical Research Center . PATIENT(S ) Women with 46,XX spontaneous premature ovarian failure ( n = 130 ) . INTERVENTION(S ) Evaluation while off any estrogen therapy and then again after receiving a st and ardized hormone regimen .  Regularly menstruating control women ( n = 65 ) were sample d during the midfollicular phase . MAIN OUTCOME MEASURE(S ) Serum total T by RIA  after extraction and column chromatography , free T by equilibrium dialysis , and sex hormone-binding globulin by immunoradiometric assay . RESULT ( S ) While off estrogen therapy patients had a median serum free-T concentration that was statistically significantly lower than controls ( 2.2 vs. 3.3 pg/mL ) . This dropped significantly lower to 1.9 pg/mL while the patients were on physiologic transdermal E(2 ) therapy . This is despite the fact that sex hormone-binding globulin levels did not change . While on E(2 ) therapy , 13 % of women ( 95 % confidence interval , 7.9%-20.3 % ) had serum free-T levels below the lower limit of normal ( < 1.1 pg/mL ) . CONCLUSION ( S ) As a group , young women with 46,XX spontaneous premature ovarian failure have reduced circulating free-T levels , both during an interval off of estrogen therapy and while on physiologic transdermal E(2 ) therapy OBJECTIVE To investigate the cross-sectional associations of  hysterectomy and oophorectomy  status , chronological age , and body mass index with early postoperative plasma levels of total and free T , DHEAS , and sex hormone-binding globulin ( SHBG ) . DESIGN A cross-sectional study . SETTING University hospital . PATIENT(S ) Ninety-two women age 35 - 47 years who were scheduled for hysterectomy and /or oophorectomy , advocated for benign gynecological pathologies . INTERVENTION(S ) Ninety-two eligible premenopausal women underwent hysterectomy and /or oophorectomy  , with plasma T , DHEAS , and SHBG levels assayed before surgery and during the postoperative period . MAIN OUTCOME MEASURE(S ) Effects of time x operation and age x operation interactions between oophorectomized and nonoophorectomized groups and within-subject main effect of time on plasma and rogen levels . RESULT ( S ) Of 92 women , hysterectomy alone was performed in only 49 ( 53.3 % ) cases . Oophorectomy , either unilateral or bilateral , was performed in 35.8 % of cases . Age x within-group interactions exhibited an important difference ( P=.03 ) in total T levels . The time x between- and within-group interaction effects on plasma DHEAS levels of postoperative day 7 , compared with day 1 , were statistically significant ( P<.001 ) . The effect of time x group interaction was remarkable , in terms of SHBG levels during the postoperative period . Age x oophorectomy interaction exhibited a statistically significant change of decline in DHEAS levels on postoperative day 7 ( P=.05 ) . CONCLUSION ( S ) The present study demonstrated a time and operation effect decline in plasma DHEAS levels . In contrast , the time x operation interaction on SHBG levels exhibited an increase toward postoperative day 7 Aging in humans is accompanied by a progressive decline in the secretion of the adrenal and rogens dehydroepi and rosterone ( DHEA ) and DHEA sulfate ( DS ) , paralleling that of the GH-insulin-like growth factor-I ( GH-IGF-I ) axis . Although the functional relationship of the decline of the GH-IGF-I system and catabolism is recognized , the biological role of DHEA in human aging remains undefined . To test the hypothesis that the decline in DHEA may contribute to the shift from anabolism to catabolism associated with aging , we studied the effect of a replacement dose of DHEA in 13 men and 17 women , 40 - 70 yr of age . A r and omized placebo-controlled cross-over trial of nightly oral DHEA administration ( 50 mg ) of 6-month duration was conducted . During each treatment period , concentrations of and rogens , lipids , apolipoproteins , IGF-I , IGF-binding protein-1 ( IGFBP-1 ) , IGFBP-3 , insulin sensitivity , percent body fat , libido , and sense of well-being were measured . A subgroup of men ( n = 8) and women ( n = 5 ) underwent 24-h sampling at 20-min intervals for GH determinations . DHEA and DS serum levels were restored to those found in young adults within 2 weeks of DHEA replacement and were sustained throughout the 3 months of the study . A 2-fold increase in serum levels of and rogens ( and rostenedione , testosterone , and dihydrotestosterone ) was observed in women , with only a small rise in and rostenedione in men . There was no change in circulating levels of sex hormone-binding globulin , estrone , or estradiol in either gender . High density lipoprotein levels declined slightly in women , with no other lipid changes noted for either gender . Insulin sensitivity and percent body fat were unaltered . Although mean 24-h GH and IGFBP-3 levels were unchanged , serum IGF-I levels increased significantly , and IGFBP-1 decreased significantly for both genders , suggesting an increased bioavailability of IGF-I to target tissues . This was associated with a remarkable increase in perceived physical and psychological well-being for both men ( 67 % ) and women ( 84 % ) and no change in libido . In conclusion , restoring DHEA and DS to young adult levels in men and women of advancing age induced an increase in the bioavailability of IGF-I , as reflected by an increase in IGF-I and a decrease in IGFBP-1 levels . These observations together with improvement of physical and psychological well-being in both genders and the absence of side-effects constitute the first demonstration of novel effects of DHEA replacement in age-advanced men and women Objective Circulating testosterone in women declines during the late reproductive years such that otherwise healthy women in their 40s have approximately half the testosterone level as women in their 20s . Despite this , research showing the benefits of and rogen replacement has been limited to the postmenopausal years . In view of the known premenopausal physiological decline in testosterone , we have evaluated the efficacy of transdermal testosterone therapy on mood , well-being , and sexual function in eugonadal , premenopausal women presenting with low libido . Design Premenopausal women with low libido participated in a r and omized , placebo-controlled , crossover , efficacy study of testosterone cream ( 10 mg/day ) with two double-blind , 12-week , treatment periods separated by a single-blind , 4-week , washout period . Results Thirty-four women completed the study per protocol , with 31 women ( mean age 39.7 ± 4.2 years ; serum testosterone 1.07 + 0.50 nmol/L ) providing complete data  . Testosterone therapy result ed in statistically significant improvements in the composite scores of the Psychological General Well-Being Index [ + 12.9 ( 95 % CI , + 4.6 to + 21.2 ) , P = 0.003 ] and the Sabbatsberg Sexual Self-Rating Scale [ + 15.7 ( 95 % CI , + 6.5 to + 25.0 ) , P = 0.001 ] compared with placebo . A mean decrease in the Beck Depression Inventory score approached significance [ −2.8 ( 95 % CI , −5.7 to + 0.1 ) , P = 0.06 ] . Mean total testosterone levels during treatment were at the high end of the normal range , and estradiol was unchanged . No adverse effects were reported . Conclusions Testosterone therapy  improves well-being , mood , and sexual function in premenopausal women with low libido and low testosterone . As a substantial number of women experience diminished sexual interest and well-being during their late reproductive years , further research is warranted to evaluate the benefits and safety of longer-term intervention BACKGROUND Insulin resistance and increased ovarian cytochrome P450c17 alpha activity are both features of the polycystic ovary syndrome . P450c17 alpha , which is involved in and rogen bio synthesis , has both 17 alpha-hydroxylase and 17,20-lyase activities . Increased activity of this enzyme results in exaggerated conversion of progesterone to 17 alpha-hydroxyprogesterone in response to stimulation by gonadotrophin . We hypothesized that hyperinsulinemia stimulates ovarian P450c17 alpha activity . METHODS We measured fasting serum steroid concentrations and the response of serum 17 alpha-hydroxyprogesterone to leuprolide , a gonadotrophin-releasing hormone agonist , and performed oral glucose-tolerance tests before and after oral administration of either metformin ( 500 mg three times daily ) or placebo for four to eight weeks in 24 obese women with the polycystic ovary syndrome . RESULTS In the 11 women given metformin , the mean ( + /- SE ) area under the serum insulin curve after oral glucose administration decreased from 9303 + /- 1603 to 4982 + /- 911 microU per milliliter per minute ( 56 + /- 10 to 30 + /- 6 nmol per liter per minute ) ( P = 0.004 ) . This decrease was associated with a reduction in the basal serum 17 alpha-hydroxyprogesterone concentration from 135 + /- 21 to 66 + /- 7 ng per deciliter ( 4.1 + /- 0.6 to 2.0 + /- 0.2 nmol per liter ) ( P = 0.01 ) and a reduction in the leuprolide-stimulated peak serum 17 alpha-hydroxyprogesterone concentration from 455 + /- 54 to 281 + /- 52 ng per deciliter ( 13.7 + /- 1.6 to 8.5 + /- 1.6 nmol per liter ) ( P = 0.01 ) . The serum 17 alpha-hydroxyprogesterone values increased slightly in the placebo group . In the metformin group , the basal serum luteinizing hormone concentration decreased from 8.5 + /- 2.2 to 2.8 + /- 0.5 mlU per milliliter ( P = 0.01 ) , the serum free testosterone concentration decreased from 0.34 + /- 0.07 to 0.19 + /- 0.05 ng per deciliter ( 12 + /- 3 to 7 + /- 2 pmol per liter ) ( P = 0.009 ) , and the serum sex hormone-binding globulin concentration increased from 0.8 + /- 0.2 to 2.3 + /- 0.6 microgram per deciliter ( 29 + /- 7 to 80 + /- 21 nmol per liter ) ( P < 0.001 ) . None of these values changed significantly in the placebo group . CONCLUSIONS In obese women with the polycystic ovary syndrome , decreasing serum insulin concentrations with metformin reduces ovarian cytochrome P450c17 alpha activity and ameliorates hyper and rogenism Objective : We investigated whether there is a relationship between and rogens levels and well-being in pre- and postmenopausal women . Design : We r and omly recruited 1423 women aged 18 to 75 years from the community via the electoral roll . Each provided a morning blood sample and completed the Psychological General Well Being Index question naire on the same day . Women were excluded if they took medication for any psychiatric illness , had abnormal thyroid function , or had documented polycystic ovarian syndrome . Analysis was by linear regression for well-being , including demographic and lifestyle variables as well as serum levels of and rogens . Results : We included 1224 women in the analysis . Being partnered was positively associated with well-being in premenopausal women . In postmenopausal women , well-being was positively related to age and exercising , whereas smoking , obesity , and postmenopausal hormone therapy use were each negatively associated with well-being . None of the measured and rogens ( total and free testosterone , dehydroepi and rosterone sulfate , and and rostenedione ) made an independent contribution to well-being in postmenopausal women ( n = 603 ) . However , for premenopausal women ( n = 621 ) , levels of dehydroepi and rosterone sulfate were independently and positively associated with the domain score for vitality . Conclusions : Our findings do not support an important independent role for and rogens as determinants of well-being in postmenopausal women . That dehydroepi and rosterone sulfate alone is associated with greater vitality in premenopausal women is of interest but requires further evaluation as an a priori hypothesis in another study
Subgroup analysis for assay type was statistically significant for spontaneous POI only .
Sensitivity analyses of high- quality studies did not change the results , and result ed in a substantial decrease in heterogeneity in spontaneous POI studies .
The current meta- analysis demonstrates that total testosterone concentrations are decreased in women with spontaneous POI or iatrogenic menopause .
BACKGROUND Increasing age and post-menopausal status are associated with decreasing and rogen concentrations in females .
Women with premature loss of ovarian function , such as primary ovarian insufficiency ( POI ) or iatrogenic menopause may be at increased risk for diminished testosterone levels at a relatively young age .
Differentiation between a hypo and rogenic or normo and rogenic state in women with premature loss of ovarian function is problematic due to trueness and precision problems using various testosterone assays .
The current meta- analysis was conducted to evaluate current literature reporting serum total testosterone concentrations under these conditions , including stratification for various testosterone assays .