Androgens in the etiology and treatment of desire disorders in women

Recent data support an emerging role of androgens in influencing women's health with particular regard to sexual function. Androgens secure libido by acting in the central nervous system throughout genomic and non-genomic mechanisms. In addition, androgens modulate vaginal and clitoral physiology by influencing the muscular tone of erectile tissue and vaginal walls. The production of androgens is dynamic over the menstrual cycle, is influenced by hormonal manipulations, and declines with age. Menopause, especially when induced surgically, may be accompanied by the so-called androgen-insufficiency syndrome, which has a great impact on mental and sexual sense of well-being. Several therapeutic strategies, including the addition of androgens to estrogen replacement preparations and the use of tibolone, have been considered to relieve desire disorders in order to improve postmenopausal women's sexual function and satisfaction.