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Endocrine Care: S. L. Davison, R. Bell, S. Donath, J. G. Montalto, and S. R. Davis Androgen Levels in Adult Females: Changes with Age, Menopause, and Oophorectomy J Clin Endocrinol Metab 2005; 90: 3847-3853 [Abstract] [Full text] [PDF]

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Letter to the Editor

Andre T. Guay, Abdulmaged Traish, Boston University School of Medicine   (3 October 2005)

Letter to the Editor 3 October 2005
Andre T. Guay, FACP, FACE Lahey Clinic Medical Center, Abdulmaged Traish, Boston University School of Medicine Send letter to journal: Re: Letter to the Editor andre.t.guay{at}lahey.org Andre T. Guay, et al.	We wish to congratulate Dr. Davison and her colleagues for their seminal paper on determining androgen levels in normal healthy women over a wide age range (1). The large number of women included in this study make the data highly significant. Studies of androgen metabolism and disorders in women have lagged behind those of men for two main reasons: a) the lack of sensitive assays for testosterone in women, and b) lack of normal ranges of testosterone based on significant numbers of women (2). We recently reported a normative range for androgens in 60 normal healthy women with a more limited age range (20-49 years) (4). The only point of direct comparison between our study and that of Davison et al. is the calculated free testosterone. We agree with Davison and colleagues in that it is the most sensitive measure and our data are quite similar, showing a sharp decline after the third decade of life. Our data suggests that the normal range is higher than defined by Davison. Our reported free androgen index in younger women was also higher at 5.0 compared to the suggested level of 4.5 in the Davison article. Our higher values may be attributed to the fact that we screened women for sexual dysfunction, eliminating 12%. We have early data suggesting that the androgen levels in women with sexual dysfunction were lower than the normal controls. There has been considerable debate about how much androgen is produced in the postmenopausal ovaries. Davison et al., have shown that the postmenopausal ovaries continue to produce androgens. In contrast, Couzinet, et al (3) found no or minimal androgen production by postmenopausal ovaries. The discrepancy between these findings might be related to the time after menopause in study subjects, which was later in the Couzinet study. Again, Davison, et al, are to be congratulated for their landmark paper in the area of female androgen metabolism. This is a great step towards being able to better define normal and abnormal androgen levels in women. Hopefully, this will lead to the validation of androgen deficiency as one possible etiology of female sexual dysfunction. References 1. Davison SL, Bell R, Donath S, Montalto JG, Davis SR 2005 Androgen levels in adult females: changes with age, menopause and oophorectomy. J Clin Endocrinol Metab 90:3847-3853. 2. Bachmann G, Bancroft J, Braunstein G, Burger H, Davis S, Dennerstein L, Goldstein I, Guay A, Leiblum S, Lobo R, Notelovitz M, Rosen R, Sarrel P, Sherwin B, Simon J, Simpson E, Shifren J, Spark R, Traish A 2002 Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment. Fert Steril 77:660-665. 3. Couzinet B, Meduri G, Lecce M, Young J, Brailly S, Loosfelt H. 2001 The postmenopausal ovary is not a major androgen producing gland. J Clin Endocrinol Metab 86:5060-5065. 4. Guay A, Munarriz R, Jacobson J, Talakoub L, Traish A, Quirk, Goldstein I, Spark R. 2004 Serum androgen levels in healthy premenopausal women with and without sexual dysfunction: Part A. Serum androgen levels in women aged 20-49 years with no complaints of sexual dysfunction. Int J Imp Res 16:112-120. 5. 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: 1429-1430.