女性的雄激素治疗

S. Kalantaridou, K. Calis
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摘要

尽管存在争议,但睾酮治疗对女性,尤其是自然或手术绝经的女性,正变得越来越普遍。这篇综述介绍了关于内源性雄激素作用的最新数据,并检查了在女性中使用睾酮治疗的最新发现。目前的证据表明,雄激素对女性有重要的生物学作用,直接通过骨骼、皮肤成纤维细胞、毛囊和皮脂腺等组织中的雄激素受体起作用。它们还通过睾丸激素与雌激素在卵巢、骨骼、大脑、心脏和脂肪组织等不同部位的芳香化间接起作用。随机对照试验的数据表明,外源性睾酮治疗可改善雄激素不足女性的性功能、情绪和骨密度。总结:对于精心挑选的雄激素功能不全的女性,雄激素治疗是必要的。自然绝经或手术绝经的女性,如果性欲下降且没有其他可确定的原因导致性欲下降,可能是睾酮治疗的候选者。需要从调查睾酮治疗对雄激素不足的年轻女性的影响的研究中获得数据。睾酮治疗常见的不良反应包括多毛症和痤疮,这些不良反应在停止治疗后会逆转。目前缺乏评估女性睾酮治疗安全性和有效性的长期试验。
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Androgen treatment in women
Purpose of reviewTestosterone therapy for women, particularly those with natural or surgically induced menopause, albeit controversial, is becoming more widespread. This review presents current data regarding the effects of endogenous androgen and examines recent findings using testosterone therapy in women. Recent findingsCurrent evidence indicates that androgens have important biological effects in women, acting directly via androgen receptors in tissues, such as bone, skin fibroblasts, hair follicles and sebaceous glands. They also act indirectly via the aromatization of testosterone to estrogen on various sites, such as the ovaries, bone, brain, heart and adipose tissue. Data from randomized controlled trials suggest that exogenous testosterone therapy improves sexual function, mood, and bone mineral density in women with androgen insufficiency. SummaryAndrogen therapy may be necessary for the management of carefully selected women with androgen insufficiency. Women with natural or surgically induced menopause may be candidates for testosterone therapy if they have decreased sexual desire and no other identifiable cause for decreased libido. Data from studies investigating the effects of testosterone therapy in young women with androgen insufficiency are needed. Common adverse effects of testosterone therapy include hirsutism and acne, which reverse with discontinuation of treatment. Long-term trials evaluating safety and effectiveness of testosterone therapy in women are lacking.
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