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Androgens and Antiandrogens

by Pravin Shukle, MD
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    Let's move on to the androgens. The prototypical androgen is testosterone. It is produced in the testes, in the adrenal gland, in the ovary, and in the skin. In plasma, it is bound to sex hormone binding globulin or SHBG. It is converted to deoxy-testosterone, which is going to be the active compound in this system. Now, obviously, testosterone is going to give masculinizing characteristics. You will have an increased hematocrit, positive nitrogen balance, normalizing your increasing bone density, more virilization which includes facial hair. It is often used in men for replacement therapy. We’re starting to diagnose low testosterone levels more and more often in men and we’re starting to see that they have significant biomedical issues with low testosterone and we’re starting to treat them quite effectively. Rapid hepatic metabolism can sometimes occur with these medications and that's why oral medications aren't terribly effective. So, we tend to use injections and patches. The use of testosterone patches has resulted in a significant reduction in male – elderly male depression as well, as it seems that testosterone seems to keep men happy for some reason. In terms of toxicity, the worst of the issues is really cholestatic jaundice. We see that actually quite a bit. Transaminitis is going to be an issue and hepatocellular carcinoma is the most feared of the potential problems. Now, in women, who are on testosterone therapy, we see some virilization. We see hirsutism, which is increased facial hair; we see enlargement of the clitoris; and we see a deepening of the voice. We also see in women menstrual irregularities, more aggression, and rare episodes of hypersexuality. In terms of pregnant women, we will see virilization of the female fetus. In males, we can sometimes get a paradoxical feminization of the patient, and that's because...

    About the Lecture

    The lecture Androgens and Antiandrogens by Pravin Shukle, MD is from the course Reproductive Pharmacology. It contains the following chapters:

    • Androgens
    • Antiandrogens – Receptor Antagonists
    • 5-α-Reductase
    • Synthesis Inhibitors

    Included Quiz Questions

    1. Increased endogenous testosterone production
    2. Increased hematocrit
    3. positive nitrogen balance
    4. normalized bone density
    5. Virilization
    1. Paradoxical feminization
    2. Hirsutism
    3. Enlarged clitoris
    4. Deep voice
    5. Aggression
    1. Anabolic steroid use
    2. Psychotic episode
    3. Delayed puberty
    4. Glucocorticoid use
    5. Antisocial personality disorder
    1. Those tissues with dihydrotestosterone receptors such as the prostate and hair follicles.
    2. Those tissues with aldosterone receptors such as the kidney, colon, and heart.
    3. Those tissues with estrogen receptors such as the uterine lining and the breasts.
    4. Those tissues with progesterone receptors such as the uterine lining and anterior pituitary gland.
    5. Those tissues with glucocorticoid receptors in most cells of the body.

    Author of lecture Androgens and Antiandrogens

     Pravin Shukle, MD

    Pravin Shukle, MD


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