Effects of parenteral administration of estrogen and androgen on plasma hormone levels and hot flushes in the surgical menopause.

In a prospective, double-blind, crossover study, it was found that surgically menopausal women who received an estrogen drug alone and those who were given a combined estrogen-androgen preparation reported a significantly reduced frequency of hot flushes compared to a placebo group (p less than 0.01) coincident with their higher total plasma estrogen levels (p less than 0.01). The administration of testosterone alone, however, was ineffective in alleviating hot flushes, even though these patients had plasma estrogen values that were not different from those of women with intact ovaries. It was proposed that, in women with very low levels of endogenous estrogens, changes in sex hormone-binding globulin (SHBG) concentrations induced by exogenous testosterone may reduce the amount of non-SHBG-bound estrogens, thereby obviating estrogenic effects on hot flushes.