Androgen deficiency in the oophorectomized woman.

Women experience a significant decline in circulating androgen concentrations after bilateral oophorectomy. Despite several limitations, studying women after oophorectomy remains a good model for investigating the effects of both androgen deficiency and androgen replacement. Current data show that most women experience satisfying sexual lives after hysterectomy and bilateral oophorectomy. This is reassuring since elective oophorectomy at the time of hysterectomy is an appropriate option for many women. Oophorectomized women, however, are more likely to report a worsening of sexual function after hysterectomy compared with women who retain their ovaries. Specifically, adverse changes in libido and orgasmic response are more likely in oophorectomized women. After bilateral oophorectomy, women also appear more likely to experience decreased positive psychological well-being. Studies of both the consequences of oophorectomy and the effects of testosterone replacement are consistent with an important role for androgens in female sexual function and psychological well-being.