Estrogen replacement therapy: effects on the endogenous androgen milieu.
OBJECTIVE
To review the impact of exogenous estrogen replacement therapy (ERT) on the production, binding, and metabolism of ovarian and adrenal androgens.


METHODS
Review of the scientific literature from January 1966 through June 2001 using MEDLINE.


CONCLUSIONS
Although no precipitous drop in androgen production is apparent at the time of the menopause, androgens decrease slowly and progressively from early adulthood until old age. The impact of aging and of estrogen replacement therapy, particularly oral ERT, significantly reduces androgen bioavailability after menopause. The combined effects of reduced production with aging and the pharmacologic effects of oral ERT dramatically reduce the endogenous bioavailable androgen milieu. These changes may have adverse clinical implications for susceptible individuals.
Simon
James A
JA
George Washington University School of Medicine, Washington, D.C., USA. jasimon@whrc.net
D000311:Adrenal Glands / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000728:Androgens / Q000096:biosynthesis / Q000097:blood / Q000378:metabolism*; D000735:Androstenedione / Q000097:blood / Q000378:metabolism; D003687:Dehydroepiandrosterone / Q000097:blood / Q000378:metabolism; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood / Q000378:metabolism; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000378:metabolism*; D013739:Testosterone / Q000097:blood / Q000378:metabolism
D000728:Androgens; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate