Results of February survey 2007

The androgen deficiency syndrome in women can be caused by an elevation of serum SHBG levels, that leads to low levels of bioavailable testosterone.
An increase of SHBG values can be caused by several factors, conditions and treatments. Which of the following treatment does NOT cause SHBG to increase:

1. Current assumption of oral contraceptive: Percentage of answers: 19%
2. Previous assumption of oral contraceptive, discontinued from 6 months: Percentage of answers: 27%
3. Previous assumption of contraceptive, discontinued form 4 weeks: Percentage of answers: 0%
4. Transdermal testosterone treatment: Percentage of answers: 36%
5. Anticonvulsants: Percentage of answers: 18%

Comments

Oral contraceptives increase the serum SHBG levels. This effect is reported not only during the assumption, but also long after the suspension of the treatment, and is still evident after 6 months. The underlying mechanism of this impact on SHBG it is not very clear yet, and further studies are required to identify whether oral contraceptives-dependent SHBG changes may be completely reversible after suspension of the treatment.[1]
Anticonvulsants use is known to increase SHBG serum levels, and is considered an exclusion criteria in many studies where the SHBG levels measurement is required.
Conversely, transdermal testosterone treatment can decrease SHBG levels in women.[2] This is a further mechanism through which transdermal testosterone can improve the androgen deficiency syndrome, when it is secondary to a SHBG elevation. Therefore this treatment is potentially effective in improving an androgen deficiency syndrome not only that cannot lead to secondary androgen deficiency syndrome. This answer has been correctly selected by 36% of responders.

References

Panzer C. et al. Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen levels: a Retrospective Study in Women with Sexual Dysfunction. J Sex Med 2006;3:104-113.
Guay A, Davis SR. Testosterone Insufficiency in women: Fact or Fiction? World J urol 2002; 20:106-10