Intervention: Androgens

Testosterone levels in women fall substantially during the reproductive years, with little further change at the time of spontaneous menopause. A major fall in circulating testosterone occurs following bilateral oophorectomy. There is increasing interest in the contribution of androgen insufficiency to low libido and a variety of other symptoms. A substantial body of evidence indicates that testosterone is an important determinant of female sexuality and that androgen therapy enhances certain aspects of sexual function, particularly in women who have undergone oophorectomy. Many women are uneasy discussing their loss of sexual desire, particularly those who have undergone chemotherapy. Also, the symptoms of iatrogenic menopause can easily be attributed to side effects of chemotherapy or to other psychosocial factors in premenopausal women or in those who have undergone a premature menopause. Therefore, it is the treating physician's responsibility to facilitate discussion of sexuality in all affected women. Potential etiologic factors such as depression, poor relationship, and stress as well as other medical conditions should be addressed. The possibility of low androgen production as an underlying cause might then be considered.