It is unclear why this variable pattern occurs. Lack of estrogen often results in symptoms of vaginal dryness, dyspareunia, dysuria, and vaginal discharge. Depression, anxiety, and irritability can be a result. Estrogen replacement in these women results is shortened sleep latency, and more REM sleep. Trabecular bone is affected more than cortical bone, therefore, vertebral and distal radius fractures are the most common.
Transdermal preparations are also effective.
Testosterone derivatives are the most potent and androgenic.