New statement defines androgen insufficiency. (Provides Management Algorithm).

LOS ANGELES -- A newly published consensus statement on female androgen insufficiency offers a working definition of the condition and an algorithm for its management.

It also emphasizes an urgent need for development of a practical, affordable assay for assessment of bioavailable testosterone in women. "Current androgen assays are unsatisfactory primarily because of their lack of [either] sensitivity or reliability at the lower ranges of normal," the document states (Fertil. Steril. 77[4]:66065, 2002).

Dr. Irwin Goldstein, director of the Center for Sexual Medicine arid professor of urology at Boston University, hailed the new guidelines as a "bible," offering perspective on a topic that has long been underappreciated. His remarks came during a session on female sexuality at the annual meeting of the American College of Obstetricians and Gynecologists.

The panel that wrote the statement consisted of experts in the field from throughout the United States and Australia.

Panelist Dr. Goldstein said that the document may specifically spur interest among ob.gyns. in treating the 60 million women in America who have sexual dysfunction. To date, less than 5% of ob.gyns have indicated an enthusiasm to get involved in the field, perhaps because it has been marked by a lack of good research to guide their practice.

"Historically androgens have been identified with masculinity or male sexual function, which has undoubtedly contributed to a lack of recognition of androgen effects in women," according to the consensus statement, which was written by 19 panelists who attended a conference in June 2001 at the Robert Wood Johnson Medical School in Piscataway, N.J.

"In fact," the statement continued, "androgens are necessary not only for the development of reproductive function and hormonal homeostasis in women, but they also represent the immediate precursors for the biosynthesis of estrogen. Androgens affect sexual desire, bone density, muscle mass and strength, adipose tissue distribution, mood, energy, and psychological well-being."