The functional status of pituitary-gonads axis in women on fertile age with deficiency of testosterone

Relevance. In 1999, it was reported that the proportion of women in the United States between the ages of 18 and 59 with sexual dysfunction was 43%. [1].However, because little attention has been paid publicly to female sexual dysfunction, this area has remain neglected, and only now is there understanding of such disorders in women. [6].The percentage of women, categorized by age, education, and ethnic background, who complained of decreased sexual desire in the different categories ranged from 22% to 44%, with a mean of 32%.[ 2]. This would put the number of women with decreased libido in the tens of millions in this country alone. How many of these women have decreased androgens is unknown, but the number is estimated to be between 10 and 15 million [3, 7].

The symptoms of androgen deficiency in women may very closely resemble other conditions. [4].The chief complaint of androgen-deficient women is decreased sexual desire, which is often characterized by a decrease in sexual thoughts and fantasies, as well as actions. [5].

Aim – to study the functional status of pituitary-gonades (PG) axis in women with deficiency of testosterone.

Materials and methods. We evaluated 60 women with deficiency of testosterone without other associated pathology. Mean age of patients was 28,3 years-old. Control group constituted by 20 healthy women with different age. The patients were divided by BMI into 3 groups:

Group 1 - 20 women with pre-obesity

Group 2 - 20 women-with grade I obesity

Group 3 - 20 women with grade II obesity.

The control group consisted of 20 women of the same age without menstrual disorders and with a normal body weight.

All patients underwent clinical and biochemical evaluations including endocrine check, lipids profile, hormonal profile in 14 day of menstrual cycle (LH, FSH, prolactin, free testosterone, estradiol, progesterone, etc), genitalia ultrasonography, height (sm), weight (kg), BMI, waist circumference (WC), hip circumference (HC), waist-hip ratio, questioning and other studies.

Results. The patients complained of a feeling of loss of energy, severe muscle weakness, depression, lack of sex drive, irregular menstrual cycle, hair loss all over the body, being overweight oe even obese, dry skin, sleep disturbance.

Hormonal profile showed anovulation in 19 patients (76%) (mean LH ranged 8,7±1, 2 mIU/L, FSH 6,4±1,5 mIU/L) and low range of free testosterone levels (mean 1,6±0,3 ng/ml).

Most of the patients had central obesity with BMI > 35 kg/m2. WC was in normal range 104,3 ± 7, 4 cm, HC = 85, 6 ± 5,3 cm, whereas waist-hip ratio > 1, 22. Blood tests showed dyslipidemia in all patients (100%).

Direct correlation of testosterone deficiency with the degree of obesity. Thus, the lowest values of testosterone were found in patients of group 3 (< 0.05 nmol/l) (with a norm of 0.31-3.78 nmol, l), while in patients of groups 1 and 2, testosterone levels were also significantly reduced-from 0, 1 to 0, 2 nmol/l and from 0, 05 to 0, 1 nmol/l, respectively

Conclusions. 1) Most fertile women with deficiency of testosterone (76%) have anovulation with low range of free testosterone in all patients with partial decrease of estradiolum, progesterone (secondary hypogonadism). 2) We found the dysfunction of middle structures of the brain in EEG in all patients.

List of references

  1. Basson R. Report of the international consensus development conference on female sexual dysfunction:definitions and classifications // J Urol. 2000 Mar;163(3):888–93
  2. Berman J., Almeida F., Jolin J. Correlation of androgen receptors,aromatase, and 5-alpha reductase in the human vagina with menopausal status // Fertil. Steril. 2003. Vol. 79. N 4. Р. 925–931.,
  3. By André Guay and Susan R. Davis. Testosterone insufficiency in women: fact or fiction?//Excerpt from World Journal of Urology 2002. 20:106-110
  4. .Bachmann G., Bancroft J., Braunstein G. et al. Female androgen insufficiency: the Princeton consensus statement on definition, classification, and assessment // Fertil. Steril. — 2002. — Vol. 77. — P. 660-665.
  5. Калинченко С.Ю., Тюзиков И.А., Тишова Ю.А., Ворслов Л.О. Роль тестостерона в женском организме. Общая и возрастная эндокринология тестостерона у женщин. //Международный Эндокринологический журнал Номер: 14 (115) Год: 2015 Страницы: 59-64
  6. С.Ю. Калинченко, Аркадий Верткин. Приобретенный возрастной дефицит андрогенов. Конспект врача. //Международный Эндокринологический журнал 2(4) 2006, стр. 28-33
  7. Тюзиков И. А., Калинченко С. Ю., Апетов С. С. Дефицит андрогенов у женщин к урогинекологической практике: патофизиологические механизмы, клинические «маски» и фармакотерапия трансдермальными формами тестостерона // Рос. вестн.акушера-гинеколога. 2014. № 1. С. 33–43.
Year: 2020
City: Shymkent
Category: Medicine