Somboonporn Woraluk
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Semin Reprod Med. 2006 Apr;24(2):115-24. doi: 10.1055/s-2006-939570.
The treatment of postmenopausal women with a variety of androgen formulations is increasing, despite the lack of clear guidelines regarding the diagnosis of androgen insufficiency. This review summarizes evidence on the efficacy and safety of adding testosterone to hormone therapy in postmenopausal women. Fair to good evidence exists that the use of testosterone in combination with hormone therapy has both benefits and risks. The benefits are an improvement in sexual function with various regimens of testosterone use (good evidence), an improved sense of well-being with transdermal testosterone (fair evidence), and a reduction in triglyceride levels with methyl testosterone (fair evidence). The most consistent risk is a reduction in high-density lipoprotein (HDL) cholesterol, particularly with methyl testosterone (good evidence). There has been insufficient reporting of other side effects; hence, testosterone therapy should be used with caution. The use of testosterone may be justified in specific clinical circumstances and should be limited to short-term use; long-term studies are not available. Close surveillance for HDL cholesterol and other side effects is necessary.
尽管缺乏关于雄激素不足诊断的明确指南，但使用各种雄激素制剂治疗绝经后女性的情况正在增加。本综述总结了在绝经后女性激素治疗中添加睾酮的疗效和安全性证据。有相当充分的证据表明，睾酮与激素治疗联合使用既有益处也有风险。益处包括：使用各种睾酮方案可改善性功能（充分证据），经皮睾酮可改善幸福感（中等证据），甲基睾酮可降低甘油三酯水平（中等证据）。最一致的风险是高密度脂蛋白（HDL）胆固醇降低，尤其是甲基睾酮（充分证据）。关于其他副作用的报告不足；因此，应谨慎使用睾酮治疗。在特定临床情况下使用睾酮可能是合理的，且应限于短期使用；目前尚无长期研究。有必要密切监测HDL胆固醇和其他副作用。
