Uso de testosterona en mujeres: un comentario sobre el consenso global sobre el uso de la terapia de testosterona para mujeres / Global consensus position statement on the use of testosterone therapy for women

Las mujeres han sido tratadas por décadas con testosterona intentando aliviar una gran variedad de síntomas con riesgos y beneficios inciertos. En la mayoría de los países, la testosterona se prescribe "off-label", de modo que las mujeres están utilizando compuestos y dosis ideadas para tratamientos en hombres. En este sentido, varias sociedades médicas de distintos continentes adoptaron recientemente por consenso una toma de posición sobre los beneficios y potenciales riesgos de la terapia con testosterona en la mujer, explorar las áreas de incertidumbre e identificar prácticas de prescripción con potencial de causar daño. Las recomendaciones con respecto a los beneficios y riesgos de la terapia con testosterona se basan en los resultados de ensayos clínicos controlados con placebo de al menos 12 semanas de duración. A continuación se comentan las recomendaciones. (AU)

There are currently no clear established indications for testosterone replacement therapy for women. Nonetheless, clinicians have been treating women with testosterone to alleviate a variety of symptoms for decades with uncertainty regarding its benefits and risks. In most countries, testosterone therapy is prescribed off-label, which means that women are using testosterone formulations or compounds approved for men with a modified dose for women. Due to these issues, there was a need for a global Consensus Position Statement on testosterone therapy for women based on the available evidence from placebo randomized controlled trials (RCTs). This Position Statement was developed to inform health care professionals about the benefits and potential risks of testosterone therapy intended for women. The aim of the Consensus was to provide clear guidance as to which women might benefit from testosterone therapy; to identify symptoms, signs, and certain conditions for which the evidence does not support the prescription of testosterone; to explore areas of uncertainty, and to identify any prescribing practices that have the potential to cause harm. (AU)

Are 2D: 4D finger-length ratios an indicator of androgenetic alopecia in males?

Abstract BACKGROUND: Although the pathogenesis of androgenetic alopecia is not completely understood, the roles of genetic susceptibility and androgens are well-known. A lower ratio of the second digit (index finger = 2D) to the fourth digit (ring finger = 4D) length has been hypothesized to reflect prenatal androgen exposure and/or higher sensitivity to androgens. OBJECTIVES: To determine the relationship between the second to fourth digit length ratio and androgenetic alopecia. METHODS: Finger length measurements were made by a digital vernier calliper. Androgenetic alopecia severity was assessed using the Hamilton-Norwood scale. Subjects with an androgenetic alopecia score of grade III or more were included in the study. RESULTS: A total of 189 males with androgenetic alopecia and 171 healthy controls were enrolled in the study. The age range of participants was 19-65 years. The 2D:4D ratios in patients with androgenetic alopecia were significantly lower than those of healthy controls for the right hand; however, no significant difference was found for the left hand. Average 2D:4D ratios in androgenetic alopecia patients were also lower than in controls. No significant relationship was observed between androgenetic alopecia severity and 2D:4D ratios. CONCLUSION: Our data support the anatomical evidence of in utero androgen exposure and/or an individual’s sensitivity to androgens in patients with androgenetic alopecia. Furthermore, the right hand 2D:4D ratio might be an indicator of androgenetic alopecia development.

Family care of people with severe mental disorders: an integrative review / Cuidado familiar de pessoas com doenças mentais graves: uma revisão integrativa / Cuidado familiar de la persona con trastorno mental grave: una revisión integradora

OBJECTIVE: to analyze the scientific literature on home-based family care of people with severe mental illness. METHOD: integrative review of 14 databases (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI COnNECT, LILACS, PsycINFO, PubMed, SciELO, and Scopus) searched with the key words "family caregivers", "severe mental illness", and "home" between 2003 and 2013. RESULTS: of 787 articles retrieved, only 85 met the inclusion criteria. The articles appeared in 61 journals from different areas and disciplines, mainly from nursing (36%). The countries producing the most scientific literature on nursing were Brazil, the UK, and the US, and authorship predominantly belonged to university centers. A total of 54.12% of the studies presented quantitative designs, with descriptive ones standing out. Work overload, subjective perspectives, and resources were the main topics of these papers. CONCLUSIONS: the international scientific literature on home-based, informal family care of people with severe mental disorder is limited. Nursing research stands out in this field. The prevalent topics coincide with the evolution of the mental health system. The expansion of the scientific approach to family care is promoted to create evidence-based guidelines for family caregivers and for the clinical practice of professional caregivers. .

OBJETIVO: analisar a produção científica sobre o cuidado familiar de pessoas com transtorno mental grave em casa. MÉTODO: revisão integrativa de 14 bases de dados (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, EMI, ISOC, JBI Connect, LILACS, PsycInfo e PubMed, SciELO, e Scopus), com as palavras-chave "cuidadores familiares", "TMG" (transtornos mentais graves ) e "casa", realizada entre 2003 e 2013. RESULTADOS: dos 787 artigos retornados, somente 85 atenderam os critérios de inclusão. Os artigos vieram de 61 periódicos de diferentes áreas e disciplinas, principalmente de enfermagem (36%). Os países com maior produção científica sobre enfermagem foram o Brasil, o Reino Unido e os Estados Unidos, e a autoria era predominantemente de centros universitários. Um total de 54,12% dos estudos apresentou delineamento quantitativo, e os descritivos se destacaram. Os principais temas desses trabalhos foram sobrecarga de trabalho, perspectivas subjetivas e recursos. CONCLUSÕES: a produção cientifica internacional sobre o cuidado familiar informal de pessoas com doenças mentais graves em casa é limitada. A pesquisa em enfermagem se destaca nesse campo. Os temas prevalentes coincidem com a evolução do sistema de saúde mental. Estimula-se a expansão da abordagem científica do cuidado familiar de modo a encontrar evidências para criar guias para cuidadores familiares e para a prática clínica de cuidadores profissionais. .

OBJETIVO: analizar la producción científica sobre el cuidado familiar de la persona con trastorno mental grave en el hogar familiar. MÉTODO: revisión integradora en 14 bases de datos (CINALH, Cochrane Plus, Cuidatge, CUIDEN, Eric, IBECS, IME, ISOC, JBI ConNECT, LILACS, PsycInfo, PubMed, SciELO y Scopus), con las palabras clave "cuidadores familiares", "TMG" y "hogar"; realizada entre 2003 y 2013. RESULTADOS: de 787 artículos recuperados, sólo 85 cumplieron con los criterios de inclusión. Los artículos procedieron de 61 revistas de diferentes áreas y disciplinas destacando la disciplina de enfermería (36%). Los países con mayor producción científica sobre enfermería fueron Brasil, Reino Unido y EEUU. En la autoría predominaron los centros universitarios. El 54,12% de los estudios presentó diseño cuantitativo, sobresaliendo los descriptivos. Las temáticas destacadas fueron sobrecarga, perspectivas subjetivas y recursos. CONCLUSIONES: la producción científica internacional sobre el cuidado informal familiar de la persona con trastorno mental grave, en el contexto del hogar familiar, es limitada. En este campo, destaca la investigación de enfermería. Las temáticas prevalentes coinciden con la evolución del sistema de salud mental. Se estimula la ampliación del abordaje científico del cuidado familiar con el fin de encontrar evidencias para la elaboración de guías de cuidadores familiares y para la práctica clínica de cuidadores profesionales. .

Aspectos moleculares dos esteroides sexuais sobre a cartilagem e os ossos / Molecular features of sexual steroids on cartilage and bone

No Brasil, o crescimento dos casos registrados de doenças degenerativas das cartilagens articulares por ano é de 20%, o que representa, anualmente, que mais de 200 mil brasileiros desenvolvem doenças degenerativas das articulações e, com repercussões negativas sobre a massa óssea. Este trabalho mostra evidências que a produção hormonal de esteroides sexuais (estrogênios, progestagênios e androgênios) têm influência na qualidade da cartilagem, bem como na massa óssea. Portanto, o objetivo dessa revisão foi o de analisar os dados da literatura sobre a ação molecular e gênica dos esteroides sexuais na fisiologia da cartilagem hialina e do osso, bem como a interferência da osteoartrite na qualidade dessas estruturas.

In Brazil, the increase in the reported cases of degenerative diseases of articular cartilage is 20% per year, meaning that 200,000 Brazilians develop degenerative joint diseases every year, which have a negative impact on bone mass. This study shows evidence that hormone production of sexual steroids (estrogens, progestogens, and androgens) have an influence on cartilage quality, as well as on bone mass. Therefore, this review aimed to analyze literature data on the molecular and genic action of sexual steroids on hyaline cartilage and bone physiology, as well as osteoarthritis interference on the quality of these structures.

Localización extra nuclear de receptores esteroides y activación de mecanismos no genómicos / Extra nuclear localization of steroid receptors and non genomic activation mechanisms

Los receptores de hormonas esteroides han sido considerados históricamente como factores de transcripción nucleares. Sin embargo, en los últimos años surgieron evidencias que indican que su activación desencadena eventos rápidos, independientes de la transcripción y que involucran a diferentes segundos mensajeros; muchos de estos receptores han sido localizados en la membrana celular. Por otra parte, se han caracterizado varios receptores de hormonas esteroides noveles, de estructura molecular diferente al receptor clásico, localizados principalmente en la membrana celular. Esta revisión enfoca los diferentes efectos iniciados por los glucocorticoides, mineralocorticoides, andrógenos, estrógenos y progesterona, y los posibles receptores involucrados en los mismos.

Steroid hormone receptors have been historically considered as nuclear transcription factors. Nevertheless, in the last years, many of them have been detected in the cellular membrane. It has been postulated that their activation can induce transcription independent rapid events involving different second messengers. In addition, several novel steroid hormone receptors, showing a different molecular structure than the classical ones, have also been characterized and most of them are also located in the plasmatic membrane. This review focuses on the variety of effects initiated by glucocorticoids, mineralocorticoids, androgens, estrogens and progesterone, and the possible receptors involved mediating these effects.

Modulação androgênica e estrogênica na próstata: uma abordagem em modelos experimentais de roedores com enfoque na biologia estrutural: [revisão] / Androgenic and estrogenic modulation in the prostate: an approach in rodent experimental models with emphasis on structural biology: [review]

O sistema endócrino é uma complexa rede de glândulas e hormônios que regulam muitas das funções do corpo, incluindo crescimento, desenvolvimento e maturação, como as vias de ação de muitos órgãos. A próstata é um importante alvo dos hormônios e sua maturidade funcional e seu desenvolvimento são influenciados pelos níveis de esteroides. O presente grupo de pesquisa tem estudado os potenciais efeitos dos agentes esteroides sobre a próstata masculina e feminina do gerbilo da Mongólia (Meriones unguiculatus), utilizando métodos morfológicos e imuno-histoquímicos. Os resultados têm revelado a próstata do gerbilo da Mongólia como uma importante ferramenta para estudos da ação dos hormônios esteroides e seus antagonistas.

The endocrine system is a complex network of glands and hormones that regulates many of the body's functions; including growth, development and maturation, as well as the way several organs operate. The prostate is an important target of hormones and its functional maturity and development are influenced by steroids levels. Our research group has been evaluating the potential effects of the steroidal agents on the Mongolian gerbil (Meriones unguiculatus) male and female prostate using different morphological and immunohistochemical methods. Our results have revealed the Mongolian gerbil prostate as an important tool for the morphofunctional studies of steroid hormones and its antagonist actions.

Androgenoterapia en la mujer / Androgen therapy in women

El objetivo de esta presentación es revisar la terapia androgénica en la mujer, para lo cual consideramos esencial revisar previamente la fisiología de los andrógenos. Estos son producidos por los ovarios y las glándulas suprarrenales y circulan unidos a proteínas transportadoras o en forma libre (activos). En los tejidos periféricos los andrógenos débiles pueden transformarse en andrógenos más potentes y aún en estrógenos. Los receptoresandrogénicos son activados sólo por la testosterona y la dihidrotestosterona y la respuesta del receptor varía según el número de repeticiones CAG del dominio N-terminal. Actúan principalmente a nivel muscular, óseo, piel y sistema nervioso central (libido). Las situaciones que cursan con déficit de andrógenos son la insuficiencia ovárica, la insuficiencia adrenal primaria o secundaria, la administración exógena de corticoides y de anticonceptivos orales, la anorexia nerviosa, los pacientes HIV de bajo peso y ¿el envejecimiento? La sospecha de insuficiencia androgénica en la mujer no se puede confirmar por laboratorio, siendo el síntoma más publicado y aceptado en el consenso de Princeton la disminución de la libido y del placer sexual. Los mayores esfuerzos para incorporar el tratgamiento androgénico en la mujer se han observado con la administración de dehidroepiandrosterona en la insuficiencia adrenal y en el hipopituitarismo y con la administración de testosterona en las mujeres con ooforectomía bilateral. La administración de DHEA oscila entre 25-50 mg/día en pacientes con insuficiencia suprarrenal e hipopituitarismo. La administración de testosterona por vía transdérmica presenta buenos resultados sobre libido y placer sexual con pocas manifestaciones adversas referidas sólo a la piel. Sin embargo, no disponemos en nuestro país de preparados farmacéuticos para su empleo en la mujer.

Polymorphic [CAG]n repeats in the androgen' receptor gene: a risk marker for endometriosis and uterine leiomyomas

Endometriosis and uterine leiomyomas are leading hormone responsive, benign uterine disordders responsible for high morbidity in women of reproductive age group. A polymorphic [CAG]n repeat length located in exon 1 of the androgen receptor [AR] gene has been proposed as a risk marker for both endometriosis and leiomyomas in some ethnic groups. The present study was carried out to assess the frequency of AR [CAG]n repeat polymorphism as a risk marker for endometriosis and uterine leiomyomas in Asian Indian women. DNA was isolated from peripheral blood samples of 331 subjects, which include 90 endometriosis cases, 140 cases of leiomyomas and 101 healthy age- and sex-matched controls. PCR was carried out to amplify exon 1 of the AR gene. All the PCR amplicons were analysed initially on 2% agarose gel electrophoresis, folllowed by bidirectional sequencing to calculate the number CAG repeats in individuals. The CAG repeat ranges detected in endometriosis cases were 4-33 [Mode-19] and in leiomyomas cases 5-34 [Mode-20], whereas in controls it was 5-34 [Mode-22]. A distinct variation was observed in the three groups at 14, 18, 19, 20 and 22 [CAG]n repeats, which were statistically analyzed using chi-square and odds ratio tests. 19 CAG repeats were found to be higher in endometriosis cases [19.09%] when compared with conttrols [9.04%], while 20 CAG repeats were higher in leiomyomas cases [14.02%] compared to controls [6.14%]. A statistically significant [P < 0.05] association was observed in 19 and 20 CAG repeats in endometriosis and leiomyomas, respectively. This is the first report from an Asian Indian population proposing that 19 and 20 CAG repeats of the AR gene are associated with endometriosis and leiomyoma and can be regarded as high-risk markers

Mulheres adultas com acne: aspectos comportamentais, perfis hormonal e ultra-sonográfico ovariano / Acne in adult women: behavior, hormone and ovarian ultrasonographic profile

OBJETIVOS: abordar os aspectos comportamentais, o perfil androgênico e as alterações ultra-sonográficas ovarianas de uma amostra de mulheres adultas com acne. MÉTODOS: estudo de série de casos envolvendo uma amostra de 60 mulheres, escolhidas por conveniência. As pacientes foram submetidas a exame clínico, dosagens hormonais e ultra-sonografia para avaliação da morfologia ovariana. Na análise estatística, foi aplicado o Teste de Fischer para análise de correlação entre as variáveis. RESULTADOS: a média de idade foi de 26,5 anos. Todas as pacientes referiram atitudes e sentimentos negativos em relação à acne, sendo os mais freqüentes ansiedade (88,3 por cento) e manipulação constante das lesões (88,3 por cento). O grau de acne mais observado foi o grau II (48,3 por cento). Foram identificados níveis de androgênios fora da faixa de normalidade em 63,3 por cento, com elevação mais freqüente do, dehidroepiandrosterona (57,6 por cento). O padrão ultra-sonográfico mais observado foi o microcístico (74,6 por cento). CONCLUSÕES: as formas clínicas leves de acne predominaram nas mulheres estudadas. Ainda assim, essas apresentaram, com grande freqüência, atitudes e sentimentos negativos em relação à doença. Foram identificados, ainda, modificação dos níveis séricos dos androgênios, bem como do padrão de normalidade do exame ultra-sonográfico.

OBJECTIVES: to assess behavior, androgenic profile and ovarian ultrasound alterations in a sample of adult women with acne. METHODS: case study involving a serie of 60 women selected for convenience. Patients were submitted to clinical exam, hormonal dosages and ultrasound to assess ovarian morphology. Fischer's test for variables correlation analysis was applied. RESULTS: age median was 26.5 years old. All patients attitudes were negative in relation to acne, the more frequent ones were anxiety (88.3 percent) and frequent manipulation of the lesions (88.3 percent). Degree II was the most frequent acne classification determined (48.3 percent). Abnormal androgen levels were identified(63,3 percent), with frequent dehydroepiandrosterone elevation (57 percent.6 percent). The more frequent ultrasound level observed was the monocystic one (74.6 percent). CONCLUSIONS: mild clinical acne was prevalent in the women studied. Nevertheless, they frequently had negative attitudes and feelings related to the disease. Modifications on the circulating androgen levels, as well as on the ovarian ultrasonographic pattern were identifield.

Andrôgenos em mulheres: uma revisão / Androgens in women: a review

A prática da ooforectomia profilática tem sido comumente utilizada em mulheres de meia idade que são submetidas a histerectomia por patologia benigna do útero. A redução que ocorre na produção dos androgênios gonadais não tem sido alvo de muitas pesquisas, assim como as consequências que a deficiência de androgênios pode causar a longo prazo na saúde feminina. A presente revisão tem como objetivo ressaltar as principais ações dos androgênios em diferentes aspectos da saúde feminina.

Interrelationship among testicular cells in wall lizard Hemidactylus flaviviridis (Rüppell): an ultrastructural seasonal and experimental study.

The present study was aimed at investigating ultrastructure of different testicular cells and their interactions through various junctional specializations during different phases of reproductive cycle in wall lizard H. flaviviridis to develop an integrated approach of cell-cell interaction in control of testicular functions. Specialized steroid synthesizing cell organelles such as smooth endoplasmic reticulum (SER) and long slender mitochondria with tubulo-vesicular cristae were predominantly seen in Leydig as well as Sertoli cells during spermatogenically active phase, suggesting their active involvement in steroid biosynthesis. Peritubular cells also exhibited marked seasonal variations. Multi-layered fibroblast-like peritubular cells during regressed phase became single layered myoid-like during spermatogenically active phase. The presence of various types of junctions, including gap and tight junctions (occluding junctions) and adhering junctions such as desmosomes, septate-like junction, ectoplasmic specializations and tubulo-bulbar complexes, were demonstrated among testicular cells in wall lizard H. flaviviridis. However, the nature and degree of junctional (environmental) interaction varied with the reproductive state of the wall lizard. Further, administration of dihydrotestosterone in wall lizards during regressed phase resulted in increase of lipid droplets in Leydig cells and accumulation of germ cell debris in seminiferous tubules. Some of the Sertoli cells were seen darker in response to testosterone treatment probably due to its inhibitory effect on lipid metabolism. These results suggest that testosterone either directly or via inhibiting pituitary basal gonadotropin secretion has suppressive effect on testicular cells.

Thymic structural changes in relation to seasonal cycle and testosterone administration in wall lizard Hemidactylus flaviviridis (Ruppell).

Light microscopic and ultrastructural studies of thymus in wall lizard showed remarkable season dependent structural changes. In winter, the thymus was involuted and its cortico-medullary differentiation was not distinct. Thymocytes were sparsely distributed. The epithelial cells exhibited atrophic features such as an appreciable decrease in the nuclear-cytoplasmic ratio and accordingly reduction in cell organelles. The reconstruction of thymus commenced during spring and it became fully developed with marked delineation of cortico-medullary regions during summer. The thymus was then densely populated with thymocytes and epithelial cells showed voluminous cytoplasm having numerous cell organelles. The thymus regression started again by the beginning of autumn. The results suggest that the thymic development in wall lizard have inverse relationship with the androgen level, as the testicular steroidogenic activity was seen maximum during winter and least in summer. This assumption gets support by castration and testosterone replacement experiments. Castration of lizards during winter resulted in profound development of thymus with an appreciable increase in thymocytes mainly in the cortex region . The cortex became delineated from the medulla. Following testosterone treatment, the thymus underwent regression and was comparable to testis-intact lizard's thymus during winter season. After withdrawal of testosterone treatment, the thymus exhibited dense lymphoid and thymocyte population with a demarcation of cortico-medullary regions and sub-cortical region was regenerated.

Resistência à insulina na pubarca precose: relaçäo com os androgênios / Insulin resistance in early puberty: relation with the androgens

O objetivo deste estudo foi descrever o perfil da insulina e determinar sua relação com o hiperandrogenismo na pubarca precoce. (PP). Avaliamos 23 meninas com PP devido à adrenarca precoce e 5 controles (C) pré-puberais normais (7,3 +/- 1,1 x 7,1 +/- 1,8 anos). Os níveis de sulfato de deidroepiandrosterona (SDHEA), testosterona (T) e globulina ligadora dos hormônios sexuais (SHBG) foram medidos. 0 índice de massa corporal (IMC) e o índice do androgênio livre (IAL) foram calculados. 0 teste oral de tolerância à glicose (G) foi realizado; sendo calculadas a relação de jejum da insulina (I) pela G (FIGR= I/G) e as áreas abaixo das curvas da G e I (AACG e AACI). A FIGR > 22 foi considerada como sugestiva de resistência a I (RI). 0 IMC foi maior na PP do que nos C: 18,8 +/- 3,0 x 15,5 +/- 1,6, p= 0,03. Os níveis de SDHEA (71,7 +/- 40,6 x 34,2 +/- 6,9ng/dl, p= 0,02), T (0,41 +/- 0,4 x 0, 17 +/- 0,1 nmol/L p= 0,02) e IAL (0,73 +/- 0,7 x 0,17 +/- 0,04, p= 0,001) foram maiores na PP, enquanto a SHBG (63,7 +/- 23,1 x 110,2 +/- 23,9nmol/L p= 0,0006) foi menor. A FIGR foi sugestiva de RI em 44 por cento dos casos de PP, mas os níveis de G, I, a AACG, a AACI e a FIGR foram semelhantes aos C. Na PP foi observada correlação inversa entre SDHEA e I (r = -0,43, p= 0,04) e entre SHBG e IMC (r = -0,74, p = 0,0001) e AACI (r=-0,36, p= 0,09). A AACI mostrou uma correlação positiva com o IMC (r=0,56, p= 0,006) e a FIGR (r= 0,86, p= 0,0001). Embora o hiperandrogenismo adrenal possa não ter um efeito adverso sobre a sensibilidade à I na infância, como demonstrado pela correlação inversa entre o SDHEA e a I em meninas com PP, a presença da FIGR sugestiva de RI foi relativamente comum, permanecendo incerta a relação entre os níveis dos androgênios adrenais e a sensibilidade à insulina.

Epididymal protein secretion and its androgenic control in wall lizards Hemidactylus flaviviridis (Ruppell).

The total protein level in different segments of epididymis of normal lizard exhibited noticeable increase from early February to late March of a same reproductive phase. Comparison among the protein level of different epididymal segments showed insignificant variation from anterior to posterior part in early February but in late March, the protein level in posterior segment was appreciably higher than in anterior and middle segments. Further, testosterone-induced epididymal protein did not exhibit any significant quantitative variation among different regions. The electrophoretic pattern of luminal fluid from different epididymal regions of normal lizard showed 28 protein bands without any marked regional difference. However, only 16 protein bands could be demonstrated in the epididymal fluid of any region. Unlike molecular size, isoelectric focussing of testosterone induced epididymal proteins revealed that three regions of epididymis differ in their nature of protein. The number of proteins having alkaline pH range in anterior and middle regions were 4 and 3, respectively which increased upto 6 in posterior region.

Síndrome de feminización testicular, reporte de tres casos en la misma familia / Testicular feminization syndrome. A report of three cases in the same family

En este artículo se comunican tres casos de alteraciones en la diferenciación sexual fenotípica ocurridos en una familia. Esta alteración se conoce como síndrome de feminización testicular completa. Se realizó una revisión de los aspectos básicos de este padecimiento, así como de su diagnóstico y tratamiento, y de los métodos auxiliares usados para llegar a un diagnóstico preciso.

Fatores hormonais e genéticos na próstata normal e neoplásica / Hormonal and genetics factors in normal and neoplasic prostate

Recentemente, tem sido dada muita atenção para os efeitos proliferativos dos andrógenos nas células prostáticas. Isso tem despertado grande interesse no papel desses hormônios esteróides no desenvolvimento e manutenção tanto da próstata normal quanto maligna. Entretanto, até o presente, não tem sido identificada a relação exata entre os níveis hormonais e o risco de neoplasia. O complexo andrógeno-receptor, após associação com elementos no DNA que respondem ao hormônio, promove especificamente o crescimento da glândula. Já foi reconhecido que existe uma estreita ligação entre o seu padrão de sinalização citoplasmática e aquele desencadeado pelos fatores de crescimento. Muito progresso tem sido obtido a partir do estudo dessas interações o que pode levar ao desenvolvimento de novas e eficientes abordagens terapêuticas no câncer de próstata.