Estrogen-androgen for hormone replacement. A review.

OBJECTIVE

To critically examine the role of androgens as part of postmenopausal hormone replacement therapy.

STUDY DESIGN

Examination of original reports and reviews obtained by electronic database searches and supplemented by manual search of bibliographies.

RESULTS

As compared to estrogens alone, estrogen-androgen therapy may better protect against osteoporosis and increase libido, energy levels and general sense of well-being. However, estrogen-androgen replacement also reduces the beneficial increases in high-density lipoprotein induced by estrogens alone, although this effect may be offset at least partially by decreases in atherogenic triglycerides. The long-term net effect of estrogen-androgen replacement on cardiovascular disease remains unknown.

CONCLUSION

Although the literature includes relatively few clinical trials or well-controlled studies and is further limited by the subjective nature of outcomes, such as sexual and psychological function, the available data suggest that for many postmenopausal women, estrogen-androgen replacement may provide benefits beyond those provided by estrogen-only replacement therapy.