Androgen insufficiency in women: summary of critical issues.

Critical issues concerning the role of androgens in the physical, sexual, and emotional health of women include the following:1. Which androgens best reflect the androgen status of women? 2. What form of T should be measured and how? 3. Do T levels fall after menopause? 4. What effect does oophorectomy have on T levels? 5. What is the relationship between T and sexual dysfunction? 6. What constitutes androgen insufficiency syndrome? 7. What conditions are associated with androgen insufficiency? 8. How should a patient with suspected androgen insufficiency be evaluated? 9. Does androgen replacement therapy improve sexual dysfunction? 10. Do androgens enhance the quality of life? 11. Is estrogen and androgen therapy superior to estrogen therapy alone for low bone mineral density? 12. What are the indications for androgen replacement therapy? 13. What is the best means for delivery of androgen therapy? 14. How should androgen replacement therapy be monitored? Based on our current knowledge, it is clear that some women develop symptomatic androgen insufficiency and that androgen replacement therapy has a beneficial effect on libido, sexual satisfaction, quality of life, and bone mineralization. Androgen replacement therapy should be given the same consideration that we give estrogen replacement therapy.