Detailed definition
Androgens are C19 steroid hormones synthesized from cholesterol via pregnenolone. The major endogenous androgens are testosterone, dihydrotestosterone (DHT, the more potent form generated by 5α-reductase), androstenedione, dehydroepiandrosterone (DHEA), and DHEA-sulfate (DHEA-S). In women, the ovaries and adrenal glands together produce androgens at roughly one-tenth to one-twentieth of male levels. A substantial fraction of premenopausal estrogen comes from peripheral aromatization of these androgens to estrogens. Androgens act through the nuclear androgen receptor (AR) and contribute to libido, muscle mass and tone, bone density, energy, and mood, in addition to driving acne and pattern hair growth at higher levels. After menopause, ovarian testosterone production gradually declines, and women who undergo surgical menopause (bilateral oophorectomy) lose roughly half their circulating testosterone abruptly.
Why it matters in menopause
In hormone therapy, androgens enter the conversation in three places: (1) postmenopausal hypoactive sexual desire disorder, where low-dose testosterone has the best evidence; (2) intravaginal DHEA (prasterone), which is locally converted to androgens and estrogens to treat GSM; and (3) the marketing of testosterone pellets, which often produce supraphysiologic androgen levels with side effects (acne, voice change, facial hair) and no proven benefit beyond libido.
Related terms
Sources
External references: Wikipedia.