Kalantaridou Sophia N, Calis Karim A
Department of Obstetrics and Gynecology; University of Ioannina School of Medicine, Panepistimiou Avenue, 45110 Ioannina, Greece.
Semin Reprod Med. 2006 Apr;24(2):106-14. doi: 10.1055/s-2006-939569.
Testosterone therapy for postmenopausal women and women with surgical menopause, albeit controversial, is becoming more widespread. However, only limited data are available to support its use in premenopausal women. Androgens have important biological roles in young women, influencing bone and muscle mass, mood and well-being, and libido. Pathophysiological states affecting ovarian and adrenal function or both may result in androgen deficiency in premenopausal women. Young women with hypothalamic amenorrhea, premature ovarian failure, oophorectomy, premenstrual syndrome, acquired immunodeficiency wasting syndrome, adrenal insufficiency, and hypopituitarism may have testosterone deficiency. Young women with loss of libido may also have testosterone deficiency. Medications that may lead to testosterone insufficiency include oral estrogen, oral contraceptives, and corticosteroids. Testosterone deficiency in young women may be underdiagnosed because the symptoms generally are nonspecific and the measurement of total and free testosterone is inaccurate with commonly used techniques. Only a few studies investigating the effects of testosterone therapy have been performed thus far in premenopausal women. Long-term trials evaluating safety and effectiveness of testosterone therapy in premenopausal women are lacking. Common adverse effects include hirsutism and acne, which reverse with discontinuation of treatment. The availability of testosterone regimens specifically designed for women is expected to help maintain testosterone levels within the normal range and clarify whether the apparent beneficial effects of testosterone therapy are physiological or pharmacological.
睾酮疗法用于绝经后女性及手术绝经女性，尽管存在争议，但正变得越来越普遍。然而，仅有有限的数据支持其在绝经前女性中的应用。雄激素在年轻女性中具有重要的生物学作用，影响骨量和肌肉量、情绪和幸福感以及性欲。影响卵巢和肾上腺功能或两者的病理生理状态可能导致绝经前女性雄激素缺乏。患有下丘脑性闭经、卵巢早衰、卵巢切除术、经前综合征、获得性免疫缺陷消耗综合征、肾上腺功能不全和垂体功能减退的年轻女性可能存在睾酮缺乏。性欲减退的年轻女性也可能存在睾酮缺乏。可能导致睾酮不足的药物包括口服雌激素、口服避孕药和皮质类固醇。年轻女性的睾酮缺乏可能未得到充分诊断，因为症状通常不具特异性，且常用技术对总睾酮和游离睾酮的测量不准确。迄今为止，在绝经前女性中仅进行了少数几项研究来调查睾酮疗法的效果。缺乏评估睾酮疗法在绝经前女性中的安全性和有效性的长期试验。常见的不良反应包括多毛症和痤疮，停药后这些症状会消失。专门为女性设计的睾酮治疗方案有望帮助将睾酮水平维持在正常范围内，并阐明睾酮疗法明显的有益效果是生理作用还是药理作用。
