Androgens and cardiovascular risk1)

Abstract

Abstract Testosterone concentrations in men gradually decrease with age. Whether this reduction in androgen levels is a pathological process or a physiological event remains to be determined. The age-related decrease in testosterone levels is, however, frequently accompanied by adverse health consequences including low bone and muscle mass, increased fat mass, type 2 diabetes mellitus and the metabolic syndrome. Moreover, low androgen levels are associated with increased mortality. Testosterone treatment should be performed in men with low androgen levels as well as clinical signs and symptoms of hypogonadism. In premenopausal women, hyperandrogenemia is associated with several cardiovascular risk factors. The most common cause of hyperandrogenemia in women is polycystic ovary syndrome (PCOS). PCOS women are affected by hyperandrogenism, infertility and metabolic disturbances, such as insulin resistance, central obesity and dyslipidemia. Androgen levels decrease with menopausal transition in women. Hyperandrogenemia is associated with insulin resistance and type 2 diabetes in postmenopausal women. Whether this hyperandrogenemia results in increased mortality is, however, less clear. Moreover, the impact of androgen supplementation in postmenopausal women with hypoandrogenemia is open.