Therapeutic Use of Androgens in Women

Because of the antagonistic action of androgens in many estrogen-sensitive tissues, it would seem logical that androgens might be effective therapeutic agents in clinical situations of estrogen excess or in the presence of estrogen-dependent neoplasms. However, the viriliz-ing side effects of these compounds have limited their clinical use. Selective protein anabolic forms of andro-gens have been used in certain clinical situations.

Endometriosis

Endometriosis is abnormal growth of endometrial tissue in the peritoneal cavity. Women with this disorder have dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Danazol (Danocrine) is a 2,3-isoxazol derivative of 17a-ethynyl testosterone (ethisterone) that has weak virilizing and protein anabolic properties. It is effective in endometriosis through its negative feedback inhibition of LH and FSH release, which in turn results in decreased ovarian steroidogenesis and regression of endometriomas. Because of the virilizing side effects of danazol, causing acne and hirsutism, its use in en-dometriosis has been largely supplanted by the use of GnRH analogues. Danazol is also approved for use in fi-brocystic breast disease and hereditary angioneurotic edema.

Female Hypogonadism

Female hypogonadism, especially prepuberal, may be an indication for androgen therapy. Androgens are necessary for normal pubic hair induction and long bone growth in both sexes. In prepuberal females with hy-popituitarism in whom all other hormonal deficiencies (estrogen, progesterone, thyroid, adrenal, and growth hormone) have been corrected, normal sexual development and long bone growth are not complete without androgen hormone replacement. Estrogen administration during adolescence is necessary for the development of the breast, the gynecoid pelvis, and other female characteristics. However, maximal long bone growth and development of axillary and pubic hair will not occur without small amounts of androgen replacement. The use of methyltestosterone (Android) and di-ethylstilbestrol in combination has been demonstrated to be very effective in inducing complete secondary sexual development in these females. Finally, low doses of androgens have been used to facilitate impaired libido in postmenopausal women when combined with estrogen replacement therapy.

51 Tips for Dealing with Endometriosis

51 Tips for Dealing with Endometriosis

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