This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Santoro, N. Articles by Weiss, G. Search for Related Content PubMed PubMed Citation Articles by Santoro, N. Articles by Weiss, G. Related Collections Female Endocrinology Metabolism

Correlates of Circulating Androgens in Mid-Life Women: The Study of Women’s Health Across the Nation

Department of Obstetrics, Gynecology and Women’s Health (N.S.), Albert Einstein College of Medicine, Bronx, New York 10461; Massachusetts General Hospital (J.S.F.), Boston, Massachusetts 02114; Rush University, Rush-Presbyterian-St. Luke’s Medical Center (J.L.L.), Chicago, Illinois 60612; University of California, Davis/Kaiser (E.B.G., W.L.L.), Davis, California 95616; University of California, Los Angeles (S.K.), Los Angeles, California 90095; University of Medicine and Dentistry/New Jersey Medical School (N.S., J.T., G.W.), Newark, New Jersey 07103; Laboratory: University of Michigan (D.M., M.F.S.), Ann Arbor, Michigan 48104; and New England Research Institutes (S.C., J.E.A.), Watertown, Massachusetts 02472

Address all correspondence and requests for reprints to: Nanette Santoro, M.D., Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Women’s Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer 316, Bronx, New York 10461. E-mail: glicktoro{at}aol.com.

Context: Androgens influence sexual differentiation and behavior, body composition, and physical functioning in men, but their role in women is less well understood. Because circulating androgens decline with age, the use of androgen supplementation for women to improve health and well-being has been increasing.

Objective: The aim of this study was to assess the association between androgens and a variety of end points thought to be affected by androgens.

Design: In a community-based baseline cohort of women aged 42–52 yr from the Study of Women’s Health Across the Nation, we measured circulating testosterone (T), dehydroepiandrosterone sulfate, and SHBG, and calculated a free androgen index (FAI) in 2961 women.

Main Outcome Measures: Correlations of androgen measures with each other and with body mass index, waist circumference, and waist-hip ratio were computed, and odds ratios (OR) were estimated for the categorical outcomes of functional limitations, functional status, self-reported health, scores indicative of depressed mood, quality of life, sexual desire and arousal, and the presence of the metabolic syndrome.

Results: Androgens, and particularly SHBG, were associated most strongly with body mass index, waist circumference, and waist-hip ratio. SHBG was associated prominently inversely with the metabolic syndrome (OR = 0.32; 95% confidence interval = 0.26–0.39), which was present in 17% of women at baseline. Dehydroepiandrosterone sulfate was associated modestly with functional status and self-reported health. T was associated minimally with increased sexual desire (OR = 1.09; 95% confidence interval = 1.00–1.18). The association of FAI with self-reported health and depressive symptomatology based on the Center for Epidemiologic Studies Depression Scale score was explained more by T than by SHBG, whereas the association of FAI with sexual arousal and metabolic syndrome was due more to SHBG than to T.

Conclusions: Circulating SHBG and androgens are most strongly associated with physical characteristics and the metabolic syndrome in women in this community-based cohort. Androgens are related weakly to physical functioning and other symptoms to which they commonly are attributed, such as sexual desire, sexual arousal, and well-being.

This article has been cited by other articles:

				F. Laghi, N. Adiguzel, and M. J. Tobin Endocrinological derangements in COPD Eur. Respir. J., October 1, 2009; 34(4): 975 - 996. [Abstract] [Full Text] [PDF]

				D. Kronawitter, L. J Gooren, H. Zollver, P. G Oppelt, M. W Beckmann, R. Dittrich, and A. Mueller Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study Eur. J. Endocrinol., August 1, 2009; 161(2): 363 - 368. [Abstract] [Full Text] [PDF]

				G. D. Braunstein, B. D. Johnson, F. Z. Stanczyk, V. Bittner, S. L. Berga, L. Shaw, T. K. Hodgson, M. Paul-Labrador, R. Azziz, and C. N. B. Merz Relations between Endogenous Androgens and Estrogens in Postmenopausal Women with Suspected Ischemic Heart Disease J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4268 - 4275. [Abstract] [Full Text] [PDF]

				H. Kumar, J. Muthukrishnan, and K. D. Modi Effect of Testosterone Therapy versus Other Factors on the Self-reported Sexual Satisfaction of Premenopausal Women Ann Intern Med, September 2, 2008; 149(5): 361 - 361. [Full Text] [PDF]

				M. Demissie, M. Lazic, E. M. Foecking, F. Aird, A. Dunaif, and J. E. Levine Transient prenatal androgen exposure produces metabolic syndrome in adult female rats Am J Physiol Endocrinol Metab, August 1, 2008; 295(2): E262 - E268. [Abstract] [Full Text] [PDF]

				I. Janssen, L. H. Powell, S. Crawford, B. Lasley, and K. Sutton-Tyrrell Menopause and the Metabolic Syndrome: The Study of Women's Health Across the Nation Arch Intern Med, July 28, 2008; 168(14): 1568 - 1575. [Abstract] [Full Text] [PDF]

				N. Santoro, S. L. Crawford, W. L. Lasley, J. L. Luborsky, K. A. Matthews, D. McConnell, J. F. Randolph Jr., E. B. Gold, G. A. Greendale, S. G. Korenman, et al. Factors Related to Declining Luteal Function in Women during the Menopausal Transition J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1711 - 1721. [Abstract] [Full Text] [PDF]

				E. Elaut, G. De Cuypere, P. De Sutter, L. Gijs, M. Van Trotsenburg, G. Heylens, J.-M. Kaufman, R. Rubens, and G. T'Sjoen Hypoactive sexual desire in transsexual women: prevalence and association with testosterone levels Eur. J. Endocrinol., March 1, 2008; 158(3): 393 - 399. [Abstract] [Full Text] [PDF]

				O. P. Almeida, B. B. Yeap, G. J. Hankey, K. Jamrozik, and L. Flicker Low Free Testosterone Concentration as a Potentially Treatable Cause of Depressive Symptoms in Older Men Arch Gen Psychiatry, March 1, 2008; 65(3): 283 - 289. [Abstract] [Full Text] [PDF]

				D. P. Rose, S. M. Haffner, and J. Baillargeon Adiposity, the Metabolic Syndrome, and Breast Cancer in African-American and White American Women Endocr. Rev., December 1, 2007; 28(7): 763 - 777. [Abstract] [Full Text] [PDF]

				J. E. Potter A 60-Year-Old Woman With Sexual Difficulties JAMA, February 14, 2007; 297(6): 620 - 633. [Abstract] [Full Text] [PDF]

				A. R. Cappola, S. J. Ratcliffe, S. Bhasin, M. R. Blackman, J. Cauley, J. Robbins, J. M. Zmuda, T. Harris, and L. P. Fried Determinants of Serum Total and Free Testosterone Levels in Women over the Age of 65 Years J. Clin. Endocrinol. Metab., February 1, 2007; 92(2): 509 - 516. [Abstract] [Full Text] [PDF]

				W. Rosner, R. J. Auchus, R. Azziz, P. M. Sluss, and H. Raff Utility, Limitations, and Pitfalls in Measuring Testosterone: An Endocrine Society Position Statement J. Clin. Endocrinol. Metab., February 1, 2007; 92(2): 405 - 413. [Abstract] [Full Text] [PDF]

				L. Titomanlio, A. Verloes, J.-C. Mercier, A. Schlegel, A. J. Polotsky, J. Rieder, N. Santoro, A. G. Hoppin, and L. M. Kaplan Case 31-2006: A Girl with Severe Obesity N. Engl. J. Med., January 11, 2007; 356(2): 194 - 196. [Full Text] [PDF]

				S. Basaria and A. S. Dobs Controversies Regarding Transdermal Androgen Therapy in Postmenopausal Women J. Clin. Endocrinol. Metab., December 1, 2006; 91(12): 4743 - 4752. [Abstract] [Full Text] [PDF]

				M. E. Wierman, R. Basson, S. R. Davis, S. Khosla, K. K. Miller, W. Rosner, and N. Santoro Androgen Therapy in Women: An Endocrine Society Clinical Practice Guideline J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3697 - 3710. [Abstract] [Full Text] [PDF]

				I. Lambrinoudaki, G. Christodoulakos, D. Rizos, E. Economou, J. Argeitis, S. Vlachou, M. Creatsa, E. Kouskouni, and D. Botsis Endogenous sex hormones and risk factors for atherosclerosis in healthy Greek postmenopausal women. Eur. J. Endocrinol., June 1, 2006; 154(6): 907 - 916. [Abstract] [Full Text] [PDF]

				E. Codner, N. Soto, P. Lopez, L. Trejo, A. Avila, F. C. Eyzaguirre, G. Iniguez, and F. Cassorla Diagnostic Criteria for Polycystic Ovary Syndrome and Ovarian Morphology in Women with Type 1 Diabetes Mellitus J. Clin. Endocrinol. Metab., June 1, 2006; 91(6): 2250 - 2256. [Abstract] [Full Text] [PDF]

				R. Basson Sexual Desire and Arousal Disorders in Women N. Engl. J. Med., April 6, 2006; 354(14): 1497 - 1506. [Full Text] [PDF]

				W. Arlt Androgen therapy in women Eur. J. Endocrinol., January 1, 2006; 154(1): 1 - 11. [Abstract] [Full Text] [PDF]

				A. B. Singh, M. L. Lee, I. Sinha-Hikim, M. Kushnir, W. Meikle, A. Rockwood, S. Afework, and S. Bhasin Pharmacokinetics of a Testosterone Gel in Healthy Postmenopausal Women J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 136 - 144. [Abstract] [Full Text] [PDF]

				S. Bhasin Female Androgen Deficiency Syndrome--An Unproven Hypothesis J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4970 - 4972. [Full Text] [PDF]