Hormonal changes in menopause and implications on sexual health.
BACKGROUND
The menopause is characterized by an array of changes to the female body caused by modulations which occur in the production of estrogens and androgens. The ovaries are important sites of testosterone production in the peri- and postmenopausal women, but the contribution of testosterone pro-hormones from the adrenal glands falls precipitously to the extent where the ovaries cannot correct the deficit. This results in a net decline in circulating testosterone levels.


OBJECTIVE
This paper gives an overview of this interesting subject area. Researchers have cogitated on the relationship between the physical effects of the menopause and the observed declines in testosterone levels, but it is now much clearer that falling testosterone levels cannot explain all of these changes.


METHODS
The cessation of follicular functioning results in a steep decline in the production of estrogens. This modulation is responsible for the physical manifestations of the menopause--hot flushes, sleep disturbances, mood changes, bleeding problems, local urogenital problems, vaginal changes, etc.


METHODS
A review of the pertinent literature was conducted to investigate hormonal changes around the menopause. A précis of the salient information is presented here.


RESULTS
Although the most obvious and well-known effects of the menopause are due to the decline of estrogen levels, the effects of falling testosterone levels are subtle, but by no means less significant. Reductions in sexual motivation, sexual arousal, vaginal lubrication, etc. are all associated with plummeting androgen levels.


CONCLUSIONS
Today, several options exist for the treatment of the endocrinological changes associated with the menopause. Estrogen deficiency can be corrected with hormone replacement therapy and topical preparations for the genitalia. A new transdermal system for the administration of testosterone shows a great deal of potential for the treatment of androgen deficiency.
Schwenkhagen
Anneliese
A
Gynaekologicum Hamburg, Hamburg, Germany. schwenkhagen@hormone-hamburg.de
D000328:Adult; D000367:Age Factors; D000728:Androgens / Q000378:metabolism; D005260:Female; D042341:Gonadal Hormones / Q000378:metabolism*; D006304:Health Status; D006801:Humans; D008593:Menopause / Q000378:metabolism* / Q000523:psychology; D008875:Middle Aged; D012735:Sexual Dysfunction, Physiological / Q000378:metabolism* / Q000503:physiopathology / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000378:metabolism* / Q000469:parasitology / Q000503:physiopathology; D016387:Women's Health
D000728:Androgens; D042341:Gonadal Hormones