Male and female hormones play a vital role because they aid in development and maintenance of secondary sex characteristics and are necessary for human reproduction. Although hormones are naturally produced by the body, administration of a male or female hormone may be indicated in the treatment of certain disorders,such as inoperable breast cancer, male hypogonadism,and male or female hormone deficiency. Hormones also are used as contraceptives and for treating the symptoms of menopause.
MALE HORMONES
MALE HORMONES
Male hormones—testosterone and its derivatives—are collectively called androgens. Androgen secretion is
under the influence of the anterior pituitary gland.Small amounts of male and female hormones are also
produced by the adrenal cortex. The anabolic steroids are closely related to the androgen
testosterone and have both androgenic and anabolic (stimulate cellular growth and repair) activity.
Androgen hormone inhibitors inhibit the conversion of testosterone into a potent androgen.
ACTIONS
Androgens
The male hormone testosterone and its derivatives actuate the reproductive potential in the adolescent boy.From puberty onward, androgens continue to aid in the development and maintenance of secondary sex characteristics: facial hair, deep voice, body hair, body fat distribution, and muscle development. Testosterone also stimulates the growth in size of the accessory sex organs (penis, testes, vas deferens, prostate) at the time of puberty. The androgens also promote tissue-building processes (anabolism) and reverse tissue-depleting processes (catabolism). Examples of androgens are fluoxymesterone (Halotestin), methyltestosterone (Oreton Methyl), and testosterone.
Anabolic Steroids
The anabolic steroids are synthetic drugs chemically related to the androgens. Like the androgens,
related to the androgens. Like the androgens,
they promote tissue-building processes.
Given in normal doses,they have a minimal effect
on the accessory sex organs and secondary
sex characteristics.
Androgen Hormone Inhibitor
The androgen hormone inhibitor finasteride (Proscar) is a synthetic compound drug that inhibits the conversion of testosterone into the potent androgen 5 alpha dihydrotestosterone
into the potent androgen 5 alpha-dihydrotestosterone (DHT) The development of the prostate gland is dependent on DHT. The lowering of serum levels of DHT reduces the effect of this hormone on the prostate gland, resulting in a decrease in the size of the gland and the symptoms associated with prostatic gland enlargement.
USES
Androgens
In the male patient, androgen therapy may be given as replacement therapy for testosterone deficiency.
Deficiency states in male patients, such as hypogonadism (failure of the testes to develop), selected cases
of delayed puberty, and the development of testosterone deficiency after puberty may be treated with androgens.The transdermal testosterone system is used as replacement therapy when endogenous testosterone is deficient or absent.In the female patient, androgen therapy may be used as part of the treatment for inoperable metastatic breast carcinoma in women who are 1 to 5 years past
menopause. In addition, some breast carcinomas in women are “hormone-dependent” tumors, that is, their growth and spread are influenced by the female hormone estrogen. Administration of an androgen to patients with this type of malignant breast tumor counteracts the effect of estrogen on these tumors.
Androgens may also be administered to premenopausal women with metastatic breast carcinoma that is
believed to be hormone dependent and whose tumor growth and spread have been slowed after an oophorectomy (removal of the ovaries).
Anabolic Steroids
The uses of the various anabolic steroids include management of anemia of renal insufficiency, control of
metastatic breast cancer in women, and promotion ofweight gain in those with weight loss after surgery,
trauma, or infections. Stanozolol is used prophylactically to decrease the frequency and severity of hereditary angioedema (a condition characterized by urticaria and edematous areas of the skin, mucous membranes, orviscera).
Androgen Hormone Inhibitor
Finasteride is used in the treatment of the symptoms associated with benign prostatic hypertrophy (BPH),
such as difficulty starting the urinary stream, frequent passage of small amounts of urine, and having to urinate during the night (nocturia). Several months of therapy may be required before a significant improvement is noted and symptoms of BPH decrease. Finasteride is also used for the prevention of male pattern baldness in men with early signs of hair loss.
ADVERSE REACTIONS
Androgens
In men, administration of an androgen may result in breast enlargement (gynecomastia), testicular atrophy,inhibition of testicular function, impotence, enlargement of the penis, nausea, jaundice, headache, anxiety,male pattern baldness, acne, and depression. Fluid and electrolyte imbalances, which include sodium, water,chloride, potassium, calcium, and phosphate retention,
may also be seen. In women receiving an androgen preparation for breast carcinoma, the most common adverse reactions are amenorrhea, other menstrual irregularities, and virilization (acquisition of male sexual characteristics by a woman). Virilization produces facial hair, a deepening of the voice, and enlargement of the clitoris. Male pattern baldness and acne may also be seen.
Androgens
In the male patient, androgen therapy may be given as replacement therapy for testosterone deficiency.
Deficiency states in male patients, such as hypogonadism (failure of the testes to develop), selected cases
of delayed puberty, and the development of testosterone deficiency after puberty may be treated with androgens.The transdermal testosterone system is used as replacement therapy when endogenous testosterone is deficient or absent.In the female patient, androgen therapy may be used as part of the treatment for inoperable metastatic breast carcinoma in women who are 1 to 5 years past
menopause. In addition, some breast carcinomas in women are “hormone-dependent” tumors, that is, their growth and spread are influenced by the female hormone estrogen. Administration of an androgen to patients with this type of malignant breast tumor counteracts the effect of estrogen on these tumors.
Androgens may also be administered to premenopausal women with metastatic breast carcinoma that is
believed to be hormone dependent and whose tumor growth and spread have been slowed after an oophorectomy (removal of the ovaries).
Anabolic Steroids
The uses of the various anabolic steroids include management of anemia of renal insufficiency, control of
metastatic breast cancer in women, and promotion ofweight gain in those with weight loss after surgery,
trauma, or infections. Stanozolol is used prophylactically to decrease the frequency and severity of hereditary angioedema (a condition characterized by urticaria and edematous areas of the skin, mucous membranes, orviscera).
Androgen Hormone Inhibitor
Finasteride is used in the treatment of the symptoms associated with benign prostatic hypertrophy (BPH),
such as difficulty starting the urinary stream, frequent passage of small amounts of urine, and having to urinate during the night (nocturia). Several months of therapy may be required before a significant improvement is noted and symptoms of BPH decrease. Finasteride is also used for the prevention of male pattern baldness in men with early signs of hair loss.
ADVERSE REACTIONS
Androgens
In men, administration of an androgen may result in breast enlargement (gynecomastia), testicular atrophy,inhibition of testicular function, impotence, enlargement of the penis, nausea, jaundice, headache, anxiety,male pattern baldness, acne, and depression. Fluid and electrolyte imbalances, which include sodium, water,chloride, potassium, calcium, and phosphate retention,
may also be seen. In women receiving an androgen preparation for breast carcinoma, the most common adverse reactions are amenorrhea, other menstrual irregularities, and virilization (acquisition of male sexual characteristics by a woman). Virilization produces facial hair, a deepening of the voice, and enlargement of the clitoris. Male pattern baldness and acne may also be seen.
Anabolic Steroids
Virilization in the woman is the most common reaction associated with anabolic steroids, especially when
higher doses are used. Acne occurs frequently in all age groups and both sexes. Nausea, vomiting, diarrhea, fluid and electrolyte imbalances (the same as for the androgens, discussed previously), testicular atrophy,jaundice, anorexia, and muscle cramps may also be seen. Blood-filled cysts of the liver and sometimes the spleen, malignant and benign liver tumors, an increased risk of atherosclerosis, and mental changes are the most serious adverse reactions that may occur during prolonged use.
Many serious adverse drug reactions are being reported in healthy individuals using anabolic steroids.
There is some indication that prolonged high-dose use has resulted in psychological and possibly physical
addiction, and some individuals have required treatment in drug abuse centers. Severe mental changes,
such as uncontrolled rage, severe depression, suicidaltendencies, malignant and benign liver tumors, aggressive behavior, increased risk of atherosclerosis, inability to concentrate, and personality changes are not uncommon. In addition, the incidence of the severe adverse reactions cited earlier appears to be increased in those using anabolic steroids for this purpose.
Androgen Hormone Inhibitor
Adverse reactions with finasteride usually are mild and do not require discontinuing use of the drug. Adverse reactions, when they occur, are related to the sexual drive and include impotence, decreased libido, and a decreased volume of ejaculate.
CONTRAINDICATIONS, PRECAUTIONS
AND INTERACTIONS
Androgens
The androgens are contraindicated in patients with known hypersensitivity to the drugs, liver disorders, or
serious cardiac disease, and in men with prostate gland disorders (eg, prostate carcinoma and prostate enlargement). The androgens are classified as Pregnancy Category X drugs and should not be administered during pregnancy and lactation. When the androgens are administered with anticoagulants, the anticoagulant effect may be increased.
Anabolic Steroids
The anabolic steroids are contraindicated in patients with known hypersensitivity to the drugs, liver disor-
ders, or serious cardiac disease, and in men with prostate gland disorders (eg, prostate carcinoma and
prostate enlargement). The anabolic steroids are classified as Pregnancy Category X drugs and should not be administered during pregnancy and lactation. Anabolic steroids are contraindicated when used to enhance physical appearance or athletic performance.
Androgen Hormone Inhibitor
Finasteride is contraindicated in patients with hypersensitivity to the drug or any component of the drug, in women who are pregnant (Pregnancy Category X) or women who may potentially be pregnant (includes handling of crushed or broken tablets), and during lactation. The drug is used cautiously in patients with ver function impairment.
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Unknown - Monday 10 January 2011
