Effect of postmenopausal estrogen replacement on circulating androgens

Peter R. Casson, Karen E. Elkind-Hirsch, John E. Buster, Peter J. Hornsby, Sandra A. Carson, Michael C. Snabes

Research output: Contribution to journalArticle

126 Scopus citations

Abstract

Objective: To determine the effect of estrogen replacement therapy (ERT) on serum androgen levels in postmenopausal women. Methods: We measured serum dehydroepiandrosterone (DHEA), DHEA-sulfate, testosterone, estradiol (E2), LH, FSH, and sex hormone binding globulin in 8:00 AM fasting serum samples from a previous randomized, blinded, placebo-controlled crossover study in which 28 postmenopausal women (27 naturally menopausal) were given 2 mg/day of oral micronized estradiol. The treatment arms were 12 weeks with a 6-week washout. Results: Estrogen replacement therapy raised mean (± standard error of the mean [SEM]) serum E2 from 8.7 ± 1.0 to 117 ± 18.7 pg/mL (P < .001 from baseline). Concurrently, mean (±SEM) DHEA-sulfate fell from 67.3 ± 9.6 to 52.1 ± 6.4 μg/dL (P < .001), and mean (±SEM) testosterone fell from 16.1 ± 2.4 to 9.4 ± 1.4 ng/dL (P = .006). Both FSH and LH declined significantly. Sex hormone binding globulin increased by 160% with ERT (P < .001). Conclusion: Menopausal ERT decreases serum androgen levels, decreasing DHEA-sulfate and testosterone by 23% and 42%, respectively. Whereas the decline in testosterone is likely due to decreased LH-driven ovarian stromal steroidogenesis, the declining levels of DHEA-sulfate also may imply a direct adrenal effect of estrogen. Bioavailable testosterone likely is reduced even more profoundly because sex hormone binding globulin is increased 160% by estrogen. Thus, menopausal ERT may induce relative ovarian and adrenal androgen deficiency, creating a rationale for concurrent physiologic androgen replacement.

Original languageEnglish (US)
Pages (from-to)995-998
Number of pages4
JournalObstetrics and Gynecology
Volume90
Issue number6
DOIs
StatePublished - Dec 1 1997
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'Effect of postmenopausal estrogen replacement on circulating androgens'. Together they form a unique fingerprint.

  • Cite this

    Casson, P. R., Elkind-Hirsch, K. E., Buster, J. E., Hornsby, P. J., Carson, S. A., & Snabes, M. C. (1997). Effect of postmenopausal estrogen replacement on circulating androgens. Obstetrics and Gynecology, 90(6), 995-998. https://doi.org/10.1016/S0029-7844(97)00538-3