Androgen deficiency in hypopituitary women: its consequences and management.

IF 6.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Reviews in Endocrine & Metabolic Disorders Pub Date : 2024-06-01 Epub Date: 2024-01-19 DOI:10.1007/s11154-024-09873-1
Daniela Esposito, Åsa Tivesten, Catharina Olivius, Oskar Ragnarsson, Gudmundur Johannsson
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Abstract

Women with hypopituitarism have various degrees of androgen deficiency, which is marked among those with combined hypogonadotrophic hypogonadism and secondary adrenal insufficiency. The consequences of androgen deficiency and the effects of androgen replacement therapy have not been fully elucidated. While an impact of androgen deficiency on outcomes such as bone mineral density, quality of life, and sexual function is plausible, the available evidence is limited. There is currently no consensus on the definition of androgen deficiency in women and it is still controversial whether androgen substitution should be used in women with hypopituitarism and coexisting androgen deficiency. Some studies suggest beneficial clinical effects of androgen replacement but data on long-term benefits and risk are not available. Transdermal testosterone replacement therapy in hypopituitary women has shown some positive effects on bone metabolism and body composition. Studies of treatment with oral dehydroepiandrosterone have yielded mixed results, with some studies suggesting improvements in quality of life and sexual function. Further research is required to elucidate the impact of androgen deficiency and its replacement treatment on long-term outcomes in women with hypopituitarism. The lack of transdermal androgens for replacement in this patient population and limited outcome data limit its use. A cautious and personalized treatment approach in the clinical management of androgen deficiency in women with hypopituitarism is recommended while awaiting more efficacy and safety data.

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垂体功能减退妇女的雄激素缺乏症:其后果和处理方法。
患有垂体功能减退症的女性会出现不同程度的雄激素缺乏,其中以合并性腺功能减退症和继发性肾上腺功能不全的女性最为明显。雄激素缺乏的后果和雄激素替代疗法的效果尚未完全阐明。虽然雄激素缺乏对骨矿物质密度、生活质量和性功能等结果的影响是可信的,但现有证据有限。目前,关于女性雄激素缺乏症的定义尚未达成共识,对于垂体功能减退症合并雄激素缺乏症的女性是否应使用雄激素替代治疗仍存在争议。一些研究表明,雄激素替代可产生有益的临床效果,但有关长期益处和风险的数据尚缺。经皮睾酮替代疗法对垂体功能减退妇女的骨代谢和身体组成有一些积极影响。口服脱氢表雄酮治疗的研究结果不一,一些研究表明生活质量和性功能有所改善。要阐明雄激素缺乏及其替代治疗对垂体功能减退症女性患者长期疗效的影响,还需要进一步的研究。在这一患者群体中,由于缺乏用于替代治疗的透皮雄激素,且疗效数据有限,因此限制了透皮雄激素的使用。在等待更多疗效和安全性数据的同时,建议对患有垂体功能减退症的女性患者在雄激素缺乏的临床治疗中采取谨慎和个性化的治疗方法。
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来源期刊
Reviews in Endocrine & Metabolic Disorders
Reviews in Endocrine & Metabolic Disorders 医学-内分泌学与代谢
CiteScore
14.70
自引率
1.20%
发文量
75
审稿时长
>12 weeks
期刊介绍: Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.
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