Safety and adverse effects of androgens: how to counsel patients.

Recently, interest has grown in the use of androgen replacement therapy for postmenopausal women. Androgen replacement in women improves libido, bone density, and body composition. The adverse effects, like hirsutism, are generally mild, and the safety profile of transdermal testosterone replacement is more favorable than that of other modes of androgen therapy. Further studies may help to determine the effect of lipid changes on cardiac outcomes. We believe that long-term studies are necessary to observe the potential effect of androgen replacement on cardiovascular mortality, breast and endometrial tissues, and mood and anger before this therapy can be used routinely in women.