Hormonal profile of menopausal women receiving androgen replacement therapy: a meta-analysis.
PURPOSE
Ovarian and adrenal aging leads to a progressive decline in androgen levels and deleterious effects on the quality of life. Despite this, specific replacement is not routinely recommended in the management of women with a physiological or pathological decline in their production, mainly due to the lack of long-term follow-up safety data. The purpose of this paper was to meta-analyze and summarize the existing data about hormonal profile changes in menopausal women receiving androgen replacement treatments. Full-text articles published through May 30, 2018 were found via MEDLINE and Embase and selected according to the strict inclusion criteria.


METHODS
Randomized clinical trials and case-control studies were enrolled. Studies not reporting steroid serum levels or not providing a control group were excluded from the analysis. Studies enrolling women with genetic defects or severe chronic systemic diseases were excluded. 113 papers fulfilled the inclusion criteria and 56 papers were included in the analysis. Desired data were compiled and extracted by independent observers.


RESULTS
Androgen administration increases E1, E2, testosterone, DHEA and DHEAS serum levels, and reduces SHBG. However, the E1 and E2 increase is evident only when DHEA is administered.


CONCLUSIONS
Whatever androgen formulation we choose in postmenopausal women, the end result is a rise in testosterone serum levels. However, DHEA regimen is also associated with an increased estrogenic availability. This might be crucial when choosing the best possible treatment for each patient individually taking into consideration if potential benefits outweigh the risks.
['Marina|L|L|', 'Sojat|A S|AS|', 'Maseroli|E|E|http://orcid.org/0000-0002-1472-6051', 'Spaggiari|G|G|', 'Pandurevic|S|S|', 'Santi|D|D|']
D000728:Androgens D016022:Case-Control Studies D004958:Estradiol D005260:Female D012739:Gonadal Steroid Hormones D020249:Hormone Replacement Therapy D006801:Humans D008593:Menopause D016032:Randomized Controlled Trials as Topic D013739:Testosterone
Menopause Androgen replacement therapy Androgens Testosterone DHEAS Estradiol