Androgeni e sindrome genitourinaria della menopausa. Perché, quando e per chi sono indicati
Direttrice del Centro di Ginecologia e Sessuologia Medica, H. San Raffaele Resnati, Milano
Fondazione Alessandra Graziottin per la cura del dolore nella donna – Onlus
Why androgens – testosterone and dehydroepiandrosterone (DHEA) – can play a role in the treatment of the Genitourinary Syndrome of the Menopause? What evidence supports this? Androgens are essential sex hormones for women’s health. Biological evidence (“bio-evidence”) indicates the following: androgens reach high plasma levels in childbearing age; have cell receptors in major organs; the hormone-receptor interaction mediates androgen-mediated, somatic (brain, muscle, bone), sexual and reproductive functions; their deficiency causes symptoms of androgenic insufficiency. They have a trophic, sexual, anti-inflammatory, and reconstructive functions. DHEA launches puberty (adrenarche). Androgens reach their plasma peak at twenty years of age, then they undergo an age-dependent gradual fall. At the age of fifty, women have lost about 50% of testosterone and 60-70% of DHEA. Bilateral ovariectomy reduces testosterone by 80%. Their age-
dependent reduction, worsened by estrogen deficiency, contributes to systemic and genital aging and to the “low grade inflammation” typical of post-menopause. Genitourinary Syndrome of the Menopause includes vulvo-vaginal symptoms.
Keywords: androgens; prasterone; testosterone; genitourinary syndrome of the menopause (GSM).
Presente in LRIOG Nr.1 – 2021