Síndrome de insuficiencia androgénica en la mujer
Palabras clave:
ANDRÓGENOS, POSMENOPAUSIAResumen
Los andrógenos cumplen importantes funciones fisiológicas en la mujer, sin embargo un síndrome de deficiencia androgénica es difícil de caracterizar y su tratamiento motivo de controversia. Generalmente se considera a los andrógenos como un elemento "nocivo" sobre la belleza y salud femeninas. Aunque cumplen importantes roles y en la posmenopausia constituyen el principal sustrato a partir del cual se sintetizan los estrógenos. Los escasos o antiguos conocimientos, o ambos, sobre el rol de los andrógenos en la mujer son uno de los problemas para optimizar el diagnóstico y el tratamiento. El presente artículo busca realizar una revisión de los conocimientos sobre los cambios del nivel de andrógenos con la edad y el uso de medicación, los caracteres de la insuficiencia androgénica en la mujer y las bases de la sustitución androgénica. Se busca optimizar el diagnóstico y el tratamiento del déficit androgénico en la mujer.
Citas
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4) Burger HG, Dudley EC, Cui J, Dennerstein L, Hopper JL. A prospective longitudinal study of serum testosterone dehydroepiandrosterone sulphate and sex hormone binding globulin levels through the menopause transition. J Clin Endocrinol Metab 2000; 85(8): 2832-938.
5) Carlstrom K, Brody S, Lunell NO, Lagrelius G, Mollerstrom A, Pousette G, et al. Dehydroepiandrosterone sulphate and dehydroepiandrosterone in serum: differences related to age and sex. Maturitas 1988; 10(4): 297-306.
6) Ravaglia G, Forti P, Maioli F, Boschi F, Bernardi M, Pratelli L, et al. The relationship of dehydroepiandrosterone sulphate (DHEAS) to endocrine-metabolic parameters and functional status in the oldest-old. Results from an Italian study on healthy free-living over ninety-year-olds. J Clin Endocrinol Metab 1996; 81(3): 1173-8.
7) Longcope C. Adrenal and gonadal androgen secretion in normal females. Clin Endocrinol Metab 1986; 15(2): 213-27.
8) Vermeulen A, Verdonck L. Plasma androgen levels during the menstrual cycle. Am J Obstet Gynecol 1976; 125(4): 491-4.
9) Mushayandebvu T, Castracane DV, Gimpel T, Adel T, Santoro N. Evidence for diminished midcycle ovarian androgen production in older reproductive aged women. Fertil Steril 1996; 65(4): 721-3.
10) Vermeulen A. The hormonal activity of the postmenopausal ovary. J Clin Endocrinol Metab 1976; 42(2): 247-53.
11) Lobo RA. Androgens in postmenopausal women: production, possible role, and replacement options. Obstet Gynecol Surv 2001; 56(6): 361-76.
12) Roger M, Nahoul K, Scholler R, Bagrel D. Evolution with ageing of four plasma androgens in postmenopausal women. Maturitas 1980; 2(3): 171-7.
13) Keller ET, Ershler W, Chang C. The androgen receptor: a mediator of diverse responses. Front Biosci 1996; 1: d59-71.
14) Maclean HE, Warne GL, Zajac JD. Localization of functional domains in the androgen receptor. J Steroid Biochem Mol Biol 1997; 62(4): 233-42.
15) Moghissi E, Ablan F, Horton R. Origin of plasma androstanediol glucuronide in man. J Clin Endocrinol Metab 1984; 59(3): 417-21.
16) Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80(4): 1429-30.
17) Longcope C. Hormone dynamics at the menopause. Ann NY Acad Sci 1990; 592: 21-30. Discussion 44-51.
18) Judd HL, Judd GE, Lucas WE, Yen SSC. Endocrine function of the postmenopausal ovary: concentrations of androgens and estrogens in ovarian and peripheral vein blood. J Clin Endocrinol Metab 1974; 39(6): 1020-4.
19) Labrie F, Belanger A, Cusan L, Gomez JL. Candas B. Marked decline in serum concentrations of adrenal C19 sex steroid precursors and conjugated androgen metabolites during aging. J Clin Endocrinol Metab 1997; 82(8): 2396-02.
20) Simpson ER, Rubin G, Clyne C, Robertson K, O’Donnell, L, Jones M, et al. The role of local estrogen biosynthesis in males and females. Trends Endocrinol Metab 2000; 11(5): 184-8.
21) Longcope C. Metabolism clearance and blood production rates of estrogen in postmenopausal women. Am J Obstet Gynecol 1971; 111(6): 779-85.
22) Judd HL, Lucas WE, Yen SCS. Effect of oophorectomy on circulating testosterone and androstenedione levels in patients with endometrial cancer. Am J Obstet Gynecol 1974; 118(6): 793-8.
23) Laughlin GA, Barrett-Connor E, Kritz-Silverstein D, Von-Muhlen D. Hysterectomy, oophorectomy, and endogenous sex hormone levels in older women: the Rancho Bernardo Study. J Clin Endocrinol Metab 2000; 85(2): 645-51.
24) Oldenhave A, Jaszmann LJB, Everaerd WTAM, Haspels AA. Hysterectomized women with ovarian conservation report more severe climacteric complaints than do normal climacteric women of similar age. Am J Obstet Gynecol 1993; 168(3 Pt 1): 765-71.
25) Centerwall BS. Premenopausal hysterectomy and cardiovascular disease. Am J Obstet Gynecol 1981; 139(1): 58-61.
26) Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. JAMA 1992; 267(1): 64-9.
27) Sherwin BB, Gelfand MM. The role of androgen in the maintenance of sexual functioning in oophorectomized women. Psychosom Med 1987; 49(4): 397-409.
28) Roos NP. Hysterectomies in one Canadian province: a new look at risks and benefits. Am J Public Health 1984; 74(1): 39-46.
29) Tazuke S, Shaw K-T, Barrett-Connor E. Exogenous estrogen and endogenous sex hormones. Medicine (Baltimore) 1992; 71(1): 44-51.
30) Simon JA, Klaiber E, Wiita B, Bowen A, Yang HM. Differential effects of estrogen-androgen and estrogen-only therapy on vasomotor symptoms, gonadotropin secretion, and endogenous androgen bioavailability in postmenopausal women. Menopause 1999; 6(2): 138-46.
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2005-10-31
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Cóppola F, Nader J, Aguirre R. Síndrome de insuficiencia androgénica en la mujer. Rev. Méd. Urug. [Internet]. 31 de octubre de 2005 [citado 21 de noviembre de 2024];21(3):174-85. Disponible en: https://revista.rmu.org.uy/index.php/rmu/article/view/801
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