Androgens and behavior in men and women

A growing body of medical evidence substantiates the popular notion that androgens regulate several aspects of behavior in men; in addition, recent studies suggest that androgens modulate certain behaviors in women as well. In hypogonadal men, androgen replacement leads to improved libido and other behaviors, but erectile responses to erotic stimuli do not seem to be affected. Similarly, in normal men, suppression of endogenous androgens to very low levels leads to decreases in a variety of sexual behaviors. Sexual function, however, may be maintained with lower androgen levels than are required for other target tissues. Although higher androgen levels lead to increased aggressive behaviors in animals, this relationship is probably not in men. In women, correlations between levels of circulating androgens and sexual behaviors are variable. In some naturally menopausal women with decreased libido, androgen replacement may be effective when estrogen replacement has failed, but few studies have examined this question. In contrast, several studies suggest that in some surgically menopausal women, replacement of estrogen and androgens may lead to better psychological and sexual functioning than replacement of estrogen alone. However, more data are needed before this approach can be recommended to every surgically menopausal woman.