title: Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment.
abstract: OBJECTIVE
  To evaluate the evidence for and against androgen insufficiency as a cause of sexual and other health-related problems in women and to make recommendations regarding definition, diagnosis, and assessment of androgen deficiency states in women.
  
  
  METHODS
  Evaluation of peer-review literature and consensus conference of international experts.
  
  
  METHODS
  Multinational conference in the United States.
  
  
  METHODS
  Premenopausal and postmenopausal women with androgen deficiency.
  
  
  METHODS
  Evaluation of peer-review literature and development of consensus panel guidelines.
  
  
  RESULTS
  The term "female androgen insufficiency" was defined as consisting of a pattern of clinical symptoms in the presence of decreased bioavailable T and normal estrogen status. Currently available assays were found to be lacking in sensitivity and reliability at the lower ranges, and the need for an equilibrium dialysis measure was strongly emphasized. Causes of androgen insufficiency in women were classified as ovarian, adrenal, hypothalamic-pituitary, drug-related, and idiopathic. A simplified management algorithm and clinical guidelines were proposed to assist clinicians in diagnosis and assessment. Androgen replacement is currently available in several forms, although none has been approved for treatment of sexual dysfunction or other common symptoms of female androgen insufficiency. Potential risks associated with treatment were identified, and the need for informed consent and careful monitoring was noted. Finally, the panel identified key goals and priorities for future research.
  
  
  CONCLUSIONS
  A new definition of androgen insufficiency in women has been proposed along with consensus-based guidelines for clinical assessment and diagnosis. A simplified management algorithm for women with low androgen in the presence of clinical symptoms and normal estrogen status has also been proposed.
authors.affiliation: Robert Wood Johnson Medical School, Women's Health Institute, New Jersey, New Brunswick, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: Bachmann
authors.forename: John
authors.initials: J
authors.lastname: Bancroft
authors.forename: Glenn
authors.initials: G
authors.lastname: Braunstein
authors.forename: Henry
authors.initials: H
authors.lastname: Burger
authors.forename: Susan
authors.initials: S
authors.lastname: Davis
authors.forename: Lorraine
authors.initials: L
authors.lastname: Dennerstein
authors.forename: Irwin
authors.initials: I
authors.lastname: Goldstein
authors.forename: Andre
authors.initials: A
authors.lastname: Guay
authors.forename: Sandra
authors.initials: S
authors.lastname: Leiblum
authors.forename: Rogerio
authors.initials: R
authors.lastname: Lobo
authors.forename: Morris
authors.initials: M
authors.lastname: Notelovitz
authors.forename: Raymond
authors.initials: R
authors.lastname: Rosen
authors.forename: Philip
authors.initials: P
authors.lastname: Sarrel
authors.forename: Barbara
authors.initials: B
authors.lastname: Sherwin
authors.forename: James
authors.initials: J
authors.lastname: Simon
authors.forename: Evan
authors.initials: E
authors.lastname: Simpson
authors.forename: Jan
authors.initials: J
authors.lastname: Shifren
authors.forename: Richard
authors.initials: R
authors.lastname: Spark
authors.forename: Abdul
authors.initials: A
authors.lastname: Traish
mesh_terms: D000728:Androgens / Q000008:administration & dosage / Q000096:biosynthesis / Q000097:blood / Q000172:deficiency*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006292:Health Priorities; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D006801:Humans; D012106:Research; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D016387:Women's Health
chemical_list: D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate