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Alerta (San Salvador) ; 5(2): 112-117, jul. 22, 2022. ilus
Article in Spanish | LILACS, BISSAL | ID: biblio-1379956


El síndrome de insensibilidad a los andrógenos (SIA), conocido también como un síndrome de feminización testicular, incluye un grupo variado de mutaciones que se relacionan con la disfunción de los receptores de andrógenos y la resistencia de los tejidos diana a la acción de las hormonas masculinas. Es causado por alteraciones genéticas localizadas en la secuencia de codificación de los receptores de andrógenos ligada al cromosoma Xq11 - 12, el gen que codifica al receptor de los andrógenos, de un individuo genéticamente masculino (46 XY). Las formas clínicas moderada, parcial o completa, dependen del grado de insensibilidad androgénica. Los avances en las causas genéticas han permitido que estas condiciones congénitas de desarrollo del sexo cromosómico, gonadal o anatómico atípico sean denominados trastornos de diferenciación sexual

Androgen insensitivity syndrome (AIS), also known as testicular feminization syndrome, includes a diverse group of mutations that are related to androgen receptor dysfunction and resistance of target tissues to the action of hormones masculine. It is caused by localized genetic alterations in the androgen receptor coding sequence linked to chromosome Xq11-12, the gene encoding the androgen receptor, of a genetically male (46 XY) individual. Moderate, partial, or complete clinical forms depend on the degree of androgen insensitivity. Advances in genetic causes have allowed these congenital conditions of atypical chromosomal, gonadal, or anatomical sex development to be called disorders of sexual differentiation

Androgen-Insensitivity Syndrome , Androgens , Disorders of Sex Development , Syndrome , Chromosomes , El Salvador , Hormones
Arch. endocrinol. metab. (Online) ; 66(1): 77-87, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364306


ABSTRACT Adrenal steroid biosynthesis and its related pathology are constant evolving disciplines. In this paper, we review classic and current concepts of adrenal steroidogenesis, plus control mechanisms of steroid pathways, distribution of unique enzymes and cofactors, and major steroid families. We highlight the presence of a "mineralocorticoid (MC) pathway of zona fasciculata (ZF)", where most circulating corticosterone and deoxycorticosterone (DOC) originate together with 18OHDOC, under ACTH control, a claim based on functional studies in normal subjects and in patients with 11β-, and 17α-hydroxylase deficiencies. We emphasize key differences between CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase) and the onset of a hybrid enzyme - CYP11B1/CYP11B2 -, responsible for aldosterone formation in ZF under ACTH control, in "type I familial hyperaldosteronism" (dexamethasone suppressible). In "apparent MC excess syndrome", peripheral conversion of cortisol to cortisone is impaired by lack of 11β-hydroxysteroid dehydrogenase type 2, permitting free cortisol access to MC receptors resulting in severe hypertension. We discuss two novel conditions involving the synthesis of adrenal androgens: the "backdoor pathway", through which dihydrotestosterone is formed directly from androsterone, being relevant for the fetoplacental setting and sexual differentiation of male fetuses, and the rediscovery of C19 11-oxygenated steroids (11-hydroxyandrostenedione and 11-ketotestosterone), active androgens and important markers of virilization in 21-hydroxylase deficiency and polycystic ovaries syndrome. Finally, we underline two enzyme cofactor deficiencies: cytochrome P450 oxidoreductase which partially affects 21- and 17α-hydroxylation, producing a combined clinical/hormonal picture and causing typical skeletal malformations (Antley-Bixler syndrome), and PAPSS2, coupled to SULT2A1, that promotes sulfation of DHEA to DHEAS, preventing active androgens to accumulate. Its deficiency results in reduced DHEAS and elevated DHEA and androgens with virilization. Future and necessary studies will shed light on remaining issues and questions on adrenal steroidogenesis.

Humans , Male , Adrenal Hyperplasia, Congenital/metabolism , Hyperaldosteronism , Steroids , Cytochrome P-450 CYP11B2 , Androgens
Article in Chinese | WPRIM | ID: wpr-936150


OBJECTIVE@#Androgen deficiency is common in aging males and may have unfavourable health consequences. Large-scale studies suggested low testosterone level might increse mortality and morbidity in ageing males. However, young men with low testosterone level might be neglected. Recent studies reported young men with infertility may have reduced testosterone level. To investigate the incidence of androgen deficiency in males with infertility and possible factors affecting the low testosterone level.@*METHODS@#Between January 2011 and December 2012, 407 men with infertility caused by varicocele (VC), obstructive azoospermia (OA) and nonobstructive azoospermia (NOA) in our center were included. The number of men in each group of OA, NOA and VC was 141, 97 and 169, respectively. All the eligible patients underwent a serum testosterone assessment by a single morning blood draw (between 8:00 to noon) to test for concentration of the total testosterone. All serum samples were determined by radioimmunoassay in our andrology laboratory. Androgen deficiency was defined as having a total testosterone level less than 300 ng/dL.@*RESULTS@#The mean age was (30.4±5.8) years. The mean testosterone level was (4.18±1.64) ng/dL (range 0.30 to 11.32 ng/dL). The overall incidence of androgen deficiency was 26.5% (108/407). The incidences of androgen deficiency in NOA, OA and VC groups were 40.2% (39/97), 19.1% (27/141) and 24.9% (42/169), respectively, which were significantly higher in the NOA than in the VC and OA groups (P < 0.001). The incidences had no difference between the VC and OA groups (P=0.229). Univariate analysis revealed the cause of infertility, FSH and the mean testis volume as possible affecting factors for androgen deficiency. However, on multivariate analysis the only cause of infertility was an independent predictor. The incidence of androgen deficiency was the highest in the NOA group [OR 0.492 (95% confidence interval 0.288-0.840)].@*CONCLUSION@#NOA and varicocele might be risk factors of androgen deficiency. Young men with NOA may have a higher possibility of low testosterone level. Testosterone level should be followed up after NOA and varicocele treatment. Androgen deficiency should be assessed in males with infertility in clinical practice.

Adult , Androgens , Azoospermia/etiology , Female , Humans , Male , Testis , Testosterone , Varicocele/complications , Young Adult
Article in English | WPRIM | ID: wpr-928930


OBJECTIVE@#To evaluate the efficacy and safety of Pai-Neng-Da Capsule (, panaxadiol saponins component, PNDC) in combination with the cyclosporine and androgen for patients with chronic aplastic anemia (CAA).@*METHODS@#A total of 79 CAA patients was randomly divided into 2 groups by a random number table, including PCA group [43 cases, orally PNDC 320 mg/d plus cyclosporine 5 mg/(kg·d) plus andriol 80 mg/d] and CA group [36 cases, orally cyclosporine 5 mg/(kg·d) plus andriol 160 mg/d]. All patients were treated and followed-up for 6 treatment courses over 24 weeks. The complete blood counts, score of Chinese medical (CM) symptoms were assessed and urine routine, electrocardiogram, hepatic and renal function were observed for safety evaluation. Female masculinization rating scale was established according to the actual clinical manifestations to evaluate the accurate degree of masculinization in female CAA patients treated by andriol.@*RESULTS@#The effective rates were 88.1% (37/42) in the PCA group and 77.8% (28/36) in the CA group based on the standard for the therapeutic efficacy evaluation of hematopathy. There was no significant difference in the white blood cell (WBC) counts, platelet counts and hemoglobin concentration of peripheral blood between two groups after 6 months treatment. The masculinization score of female patient in the PCA group was significantly lower than the CA group (P<0.05). The mild abdominal distention was observed in 1 cases in the PCA group. In CA group, the abnormalities in the hepatic function developed in 2 cases and the renal disfunction was found in 1 case.@*CONCLUSION@#The PNDC possesses certain curative effects in the treatment of CAA without obvious side-effects and can partially replace andriol thereby to reduce the degree of masculinization [Registried at Chinese Clinical Trial Registry (ChicTR1900028153)].

Androgens , Anemia, Aplastic/drug therapy , China , Female , Humans , Nonprescription Drugs , Saponins/therapeutic use
Chinese Medical Journal ; (24): 820-827, 2022.
Article in English | WPRIM | ID: wpr-927550


BACKGROUND@#Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).@*METHODS@#Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.@*RESULTS@#A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR] = 1.07, 95% confidence intervals [95% CI] = 0.60-1.90, P = 0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction = 0.0247, HR = 0.37, 95% CI = 0.14-1.00, P = 0.0497).@*CONCLUSION@#Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.

Androgen Antagonists/therapeutic use , Androgens , Castration , Humans , Male , Neoplasm Recurrence, Local/pathology , Prostatectomy/methods , Prostatic Neoplasms/surgery , Retrospective Studies
Rev. chil. obstet. ginecol. (En línea) ; 86(6): 516-520, dic. 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388692


INTRODUCCIÓN Y OBJETIVO: El rol de la testosterona exógena en la función sexual femenina ha sido estudiado durante muchos años, con resultados contradictorios. En el último tiempo se ha promovido el uso de pellets de testosterona como una solución para mejorar la libido femenina, la cognición, la fuerza muscular y los sistemas cardiovascular y óseo, e incluso evitar el envejecimiento. Por ello, revisamos las publicaciones para tratar de responder si esto es una moda o el tratamiento más innovador del último tiempo. MÉTODO: Se analizaron las bases de datos PubMed/Medline, Trip Database, Cochrane, SciELO, Scopus, UpToDate, Ovid, ProQuest, Science Direct y ResearchGate. RESULTADOS: De acuerdo con la evidencia, la mejor testosterona disponible es la transdérmica y debe ser usada solo en el trastorno del deseo sexual hipoactivo (TDSH). Los trabajos que evalúan los pellets de testosterona tienen sesgos metodológicos importantes. Si bien son útiles para mejorar la función sexual femenina, producen concentraciones plasmáticas suprafisiológicas de testosterona, por lo que no se puede establecer su seguridad a largo plazo. Tampoco hay datos suficientes que avalen su uso para mejorar el rendimiento cognitivo y el bienestar general, en el tratamiento de enfermedades cardiovasculares o en la prevención de enfermedad ósea. CONCLUSIONES: La testosterona solo se recomienda en el tratamiento del TDSH por vía transdérmica. No recomendamos el uso de pellets de testosterona para el tratamiento de la disfunción sexual ni como hormona antienvejecimiento, ya que no hay estudios consistentes sobre su seguridad, eficacia y efectos adversos a largo plazo.

INTRODUCTION AND OBJECTIVE: The role of exogenous testosterone in female sexual function has been studied for many years with contradictory results. In recent times, the use of testosterone pellets has been promoted as a solution to improve female libido, cognition, muscle strength, cardiovascular system, bone and even prevent aging. Therefore, we will review the publications in order to answer whether this is a fad or the most innovative treatment of recent times. METHOD: The databases PubMed/Medline, Trip Database, Cochrane, SciELO, Scopus, UpToDate, Ovid, ProQuest, Science Direct and ResearchGate were analyzed. RESULTS: So far, the evidence best testosterone available is transdermal testosterone and that it should be used only in hypoactive sexual desire disorder (HSDD). Papers evaluating testosterone pellets have significant methodological biases. While they are useful in improving female sexual function, they produce supra-physiological plasma levels of testosterone, so their long-term safety cannot be established. There is also insufficient data to support their use in improving cognitive performance and general well-being, treatment of cardiovascular disease or prevention of bone disease. CONCLUSIONS: Testosterone is only recommended for the tratment of HSDD via the transdermal route. We do not recommended the use of testosterone pellets for the treatment of sexual dysfunction or as an anti aging hormone, as there are no consistent studies on its safety, efficacy, and long-term adverse effects.

Humans , Female , Testosterone/administration & dosage , Sexual Dysfunctions, Psychological/drug therapy , Drug Implants , Androgens/biosynthesis
Braz. j. biol ; 81(3): 526-536, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153404


Abstract To investigate the optimal androgen concentration for culturing Hetian sheep wool follicle and to detect effects of androgen concentration on wool follicle cell proliferation and apoptosis using immunofluorescence labeling and real-time quantitative fluorescence determinations of wool keratin-associated protein gene expression levels. Wool follicles were isolated by microdissection and wool follicles and skin pieces were cultured in various concentrations of dihydrotestosterone (DHT) in culture medium. Next, daily lengthwise growth measurements of wool follicles were obtained using a microscopic micrometer. Cultured Hetian wool follicles were stained using the SACPIC method to reveal wool follicle structure, while sheep skin slices were used to observe cell proliferation by immunostaining and cell apoptosis using the TUNEL method. At the molecular biological level, keratin-associated protein (Kap) gene expression was studied using wool follicles cultured for various numbers of days in vitro. Effects of androgen concentrations on Hetian wool follicle growth and development were experimentally studied. EdU proliferation assays revealed that androgen promoted cell proliferation within wool follicle dermal papillae. TUNEL apoptosis detection demonstrated that androgen treatment could delay cell apoptosis. Quantitative reverse transcription polymerase chain reaction (qPCR) results demonstrated that gene expression level patterns of Hetian mountain sheep super-high sulfur protein. Kap1.1, KIF1.2, Kap2.12 and Kap4.2 gene expression level of the mountainous experimental group was significantly higher than plains Hetian sheep. An androgen concentration of 100 nM can promote the growth of Hetian wool follicle cells in vitro, resulting in overexpression of some genes of the Kap family.

Resumo Investigar a concentração ideal de andrógenos em cultura de folículos pilosos de carneiro Hetiano e detectar os efeitos da concentração de andrógenos na proliferação e apoptose de células foliculares, por meio de imunofluorescência e de determinação quantitativa, em tempo real, da fluorescência dos níveis de expressão gênica de proteína associada à queratina. Folículos pilosos foram isolados por microdissecção, e folículos de lã e pedaços de pele foram cultivados em várias concentrações de di-hidrotestosterona (DHT) em meio de cultura. Em seguida, medições diárias de crescimento longitudinal dos folículos capilares foram obtidas usando um micrômetro microscópico. Folículos de lã cultivados de Hetianos foram corados pelo método SACPIC para revelar a estrutura do folículo piloso, enquanto fatias de pele de carneiro foram usadas para observar a proliferação celular por imunocoloração e apoptose celular por meio do método TUNEL. Em âmbito da biologia molecular, a expressão gênica da proteína associada à queratina (Kap) foi estudada usando folículos capilares cultivados por vários dias, in vitro. Os efeitos das concentrações de andrógenos no crescimento e desenvolvimento dos folículos de lã de Hetianos foram estudados experimentalmente. Ensaios de proliferação de EdU revelaram que o andrógeno promoveu a proliferação celular dentro das papilas dérmicas do folículo piloso. A detecção de apoptose por TUNEL demonstrou que o tratamento com andrógeno poderia atrasar a apoptose celular. Os resultados da reação em cadeia da polimerase transcrição reversa quantitativa (qPCR) demonstraram que os padrões de expressão gênica da proteína de enxofre Kap1.1, KIF1.2, Kap2.12 e Kap4.2 foram significativamente maiores no grupo de ovinos Hetianos de montanha. Uma concentração de androgênio de 100 nM pode promover o crescimento de células foliculares de lã de Hetianos in vitro, resultando na superexpressão de alguns genes da família Kap.

Animals , Wool , Keratins/genetics , Sheep , Hair Follicle , Androgens/pharmacology
Arq. bras. oftalmol ; 84(1): 78-82, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1153102


ABSTRACT This report is of three cases of sicca syndrome, initially suspected to be Sjögren's syndrome, which was ruled out by clinical and laboratory investigations. The patients were a 24-year-old woman, a 32-year-old man, and a 77-year-old woman with chronic symptoms of sicca syndrome, including dry eye syndrome. The first case was associated with the use of isotretinoin, a retinoic acid. The second was associated with the use of anabolic androgenic steroids, and the third was related to a prolactin- secreting pituitary adenoma. All cases manifested sicca, including dry eye syndrome, after those events, and the manifestations persisted. Magnetic resonance imaging revealed bilateral atrophy of the lacrimal gland. The medical history, ocular examinations, laboratory exams, and magnetic resonance images confirmed dry eye syndrome; however, the exams were all negative for Sjögren's syndrome. The lacrimal gland was absent on magnetic resonance imaging in all three cases. The clinical history revealed that the signs and symptoms appeared after chronic exposure to retinoic acid, anabolic androgenic steroids, and a prolactin-secreting pituitary adenoma, respectively. Chronic isotretinoin, anabolic androgenic steroids, and prolactin-secreting pituitary adenoma or, in this last case, its inhibitory treatment, can cause lacrimal gland atrophy, sicca syndrome, and dry eye syndrome, and a differential diagnosis of Sjögren's syndrome. Further studies on doses, time, and other susceptibilities to the long-lasting adverse effects of retinoic acid, anabolic androgenic steroids, and the repercussions of prolactin-secreting pituitary adenoma are necessary to confirm and expand upon these associations.

RESUMO O relato descreve três casos de síndrome de sicca, inicialmente suspeitos de serem a síndrome de Sjögren, que fo­ram negados pela investigação clínica e laboratorial. O primeiro associado ao uso de isotretinoína, um ácido retinóico, o segundo ao uso de esteroides androgênicos anabolizantes e o terceiro relacionado ao adenoma da hipófise secretora da prolactina, todos manifestaram sicca, incluindo a síndrome do olho seco após esses eventos e as manifestações persistem. A ressonância magnética revelou atrofia bilateral da glândula lacrimal. Eles eram uma mulher de 24 anos, um homem de 32 anos e uma mulher de 77 anos com sintomas crônicos da síndrome de sicca, incluindo a síndrome do olho seco. A história médica, o exame ocular, os exames laboratoriais e a ressonância magnética foram confirmados como síndrome do olho seco, no entanto, todos os exames foram negativos para a síndrome de Sjögren. A glândula lacrimal estava ausente na ressonância magnética nos três casos. A história clínica revelou que sinais e sintomas se manifestaram após exposição crônica ao ácido retinóico, esteróides anabolizantes androgênicos e adenoma secretivo da prolactina hipofisária, respectivamente. Isotretinoína crônica, esteroides anabólicos androgênicos e adenoma hipofisário secretor de prolactina ou, neste último caso, seu tratamento inibitório pode ser a causa da atrofia da glândula lacrimal, síndrome da sicca e síndrome do olho seco e diagnóstico diferencial da síndrome de Sjögren. Estudos adicionais sobre doses, duração e outras suscetibilidades aos efeitos adversos duradouros do ácido retinóico, esteroides androgênicos anabólicos e repercussões do adenoma da hipófise secretora da prolactina são necessários para confirmar e detalhar essas associações.

Humans , Male , Female , Adult , Aged , Dry Eye Syndromes , Sjogren's Syndrome , Lacrimal Apparatus , Prolactin , Atrophy , Dry Eye Syndromes/diagnosis , Dry Eye Syndromes/chemically induced , Dry Eye Syndromes/pathology , Isotretinoin/adverse effects , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/chemically induced , Sjogren's Syndrome/pathology , Diagnosis, Differential , Androgens , Lacrimal Apparatus/pathology , Lacrimal Apparatus/diagnostic imaging
Article in Spanish | LILACS, COLNAL | ID: biblio-1411092


Objetivo Evaluar la asociación entre el cociente de los dedos segundo y cuarto (2D:4D), como un biomarcador de la exposición prenatal a andrógenos, y la presencia de cáncer de próstata (CaP). Métodos Estudio de casos y controles con 260 hombres que consultaron en el Servicio de Urología del Hospital General Universitario Reina Sofía (Murcia, España). Los casos (n = 125) fueron pacientes diagnosticados de CaP por anatomía patológica a los que se les realizó una prostatectomía radical. Los controles (n = 135) fueron pacientes que consultaron en Urología por otro motivo y que no mostraron signos ni síntomas de patología prostática. La longitud del 2D y 4D de la mano derecha fue medida mediante un pie de rey digital y se calculó el cociente entre ambos (2D:4D). Para los análisis estadísticos se utilizaron modelos de regresión logística obteniendo Odds ratios (OR) crudas y ajustadas e intervalos de confianza al 95%. Resultados Los casos presentaron un cociente 2D:4D significativamente menor que los controles. El cociente 2D:4D se relacionó significativamente con la presencia de CaP. Tras el ajuste multivariante, se observó que los varones que se encontraban en el primer tercil de distribución del cociente 2D:4D, presentaban casi el doble de riesgo de padecer CaP (OR 1,9: IC 95% 1,1­4,0; P-valor = 0,040) en comparación con los varones que se encontraban en el segundo y tercer tercil. Conclusiones Una mayor exposición prenatal a andrógenos, reflejada por un cociente 2D:4D menor, podría estar asociado con riesgo aumentado de padecer CaP, pero más estudios son necesarios para corroborar esos hallazgos.

Objective To evaluate the association between second to fourth digit (2D:4D) ratio, as a biomarker of prenatal androgen exposure, and the presence of prostate cancer (PCa). Methods This was a case-control study of 260 men attending a Department of Urology in a Murcia Region hospital (Spain). Cases (n = 125) were patients who underwent radical prostatectomy due to PCa and were diagnosed by specimen's histopathology. Controls (n = 135) were patients who showed no signs or symptoms of prostate disease. The length of 2D and 4D of the right hand was measured two times using a digital caliper, and the ratio calculated (2D:4D). Unconditional multiple logistic regressions [crude and adjusted Odds ratios (OR) and 95% confidence intervals (CI)] were performed to evaluate associations between the 2D:4D ratio and presence of PCa. Results Cases showed significantly lower 2D:4D ratios than controls. 2D:4D ratios were significantly associated with the presence of PCa. After controlling for important covariates, men in the first tertile of the 2D:4D ratio distribution, compared with the second and third tertile, were almost two-times [OR 1.9 (95% CI 1.1­4.0; P-value = 0.040] more likely to have PCa. Conclusions A higher prenatal androgen exposure, indicated by lower 2D:4D ratios, might be associated with higher PCa risk, but further research is needed to confirm these findings in other male populations.

Humans , Male , Prostate , Prostatic Neoplasms , Androgens , Pathology , Prostatectomy , Passive Cutaneous Anaphylaxis , Biomarkers , Fingers
Med. lab ; 25(1): 393-408, 2021. tab, graf, ilus, fotografia
Article in Spanish | LILACS | ID: biblio-1292643


La ginecomastia es el crecimiento mamario benigno en el varón. Etiológicamente se clasifica en fisiológica y patológica. La ginecomastia fisiológica se presenta frecuentemente en ciertos periodos de la vida, como la época neonatal, puberal y senil. La patológica se asocia a múltiples factores, incluyendo los hormonales, los de origen tumoral, y al uso de ciertos medicamentos, entre otros; sin embargo, en muchos pacientes no se consigue identificar nunca la causa. La historia clínica y el examen físico son los pilares fundamentales que permiten orientar hacia la etiología, con el apoyo de pruebas de laboratorio e imagenología que permitan descartar una enfermedad clínica subyacente. En los casos moderados o severos, la cirugía es el tratamiento de elección. El objetivo del presente manuscrito es discutir algunos puntos de interés acerca de los aspectos más importantes relacionados con la ginecomastia, incluyendo la fisiopatología, la clínica y el diagnóstico, además de presentar las principales causas asociadas a esta condición. Por último, se describen los tipos de tratamiento disponibles para estos pacientes

Gynecomastia is the benign breast enlargement in males. Etiologically it is classified as physiological and pathological. Physiological gynecomastia is more frequently observed in newborns, adolescents, and in older men. Pathological gynecomastia is associated with multiple factors, including hormonal and of tumor origin, and to the use of certain medications, among other factors; however, in many patients the underlying cause may never be identified. Anamnesis and physical examination are the fundamental pillars that will guide towards the etiology, with the support of laboratory and imaging tests to rule out an underlying disease. In moderate or severe cases, surgery is the treatment of choice. The aim of this article is to discuss some key points about the most important aspects related to gynecomastia, including pathophysiology, symptoms and diagnosis, in addition to presenting the main causes associated with this condition. Finally, the types of treatment available for these patients are described

Gynecomastia , Testosterone , Estrogens , Hypogonadism , Androgens
Evid. actual. práct. ambul ; 24(3): e002106, 2021. tab
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1348697


A partir del caso de una paciente con trastorno por deseo sexual hipoactivo durante su climaterio y a través del resumen de los resultados de dos revisiones sistemáticas, los autores de este artículo revisan la evidencia sobre la suplementación con andrógenos para el tratamiento de esta condición clínica. Concluyen que su uso sería relativamente seguro a corto plazo, aunque su eficacia no alcanzaría la relevancia clínica y no contamos aún con mayor información sobre la seguridad en el largo plazo. Los autores destacan además que el abordaje de las pacientes con este problema de salud debería ser realizado en forma integral, incluyendo opciones terapéuticas no farmacológicas e informando sobre las incertidumbres todavía presentes. (AU)

Based on the case of a patient with hypoactive sexual desire disorder during her climacteric period and through the summary of the results of two systematic reviews, the authors of this article review the evidence supporting androgen supplementation for the treatment of this clinical condition. They conclude that its use would be relatively safe in the short term, although its efficacy would not reach clinical relevance and no further information on long-term safety is available. The authors also highlight that patients with this health problem should be approached comprehensively, including non-pharmacological therapeutic options and providing information on the uncertainties still present. (AU)

Humans , Female , Middle Aged , Testosterone/therapeutic use , Climacteric , Sexual Dysfunctions, Psychological/drug therapy , Androgens/therapeutic use , Menopause , Off-Label Use , Systematic Reviews as Topic
National Journal of Andrology ; (12): 833-839, 2021.
Article in Chinese | WPRIM | ID: wpr-922166


Sexual arousal is an important factor for the success of sexual behavior, and regulated by the central nervous system, its underlying mechanism is very complicated. Androgen is the most important endocrine hormone in men, which is deeply involved in the whole process of male sexual response, but how it regulates male sexual arousal has not been fully clarified and remains one of the hotspots in current andrological research. Therefore, this paper presents an overview of the advances in the studies of the related role and mechanism of androgen in male sexual arousal. In the central nervous system, androgen regulates the release of dopamine neurotransmitters by binding androgen receptors or metabolizing neurosteroids, thus activating the brain reward system. Besides, androgen regulates the neuronal plasticity and spinous process formation in the neural circuit of sexual arousal to ensure successful activation and conduction of the neural circuit. However, the specific regulating mechanism of sexual arousal remains to be further explored.

Androgens , Humans , Male , Sexual Arousal
Braz. j. biol ; 81(2): 285-290, 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1153367


Synthetic androgens (male hormones) administered to fish nursery are being used in aquaculture to avoid sexual differentiation and unwanted spawning at the eggs or the first feeding fry stage of fish. Present trial was conducted with the aim to produce male common carp (Cyprinus carpio) by egg immersion technique. Through this little insight, the effect of different hormone concentrations (17α-methyltestosterone @ HC:150, 300, 450 and 600 µgl-1) with immersion times (IT: 24, 48 and 72 hrs) and their interaction effect (HC x IT) on the hatching percentage of Cyprinus carpio eggs, percent survival and percent of male's production was evaluated specifically. Results showed that egg hatching percentage decreased with increased IT likewise, survival of treated fry was affected by increasing the IT (P<0.001). The main interaction effect of HC x IT showed that the highest percent of male individuals (95%) was obtained at 450-600 µgl-1 HC for 72 hrs IT, followed by 88-92.50% at 150-300 µgl-1 HC for 72-hrsof IT, 87.50% at 48-hrs of IT for rest of the hormone treatments, and lowest 47.50% was recorded in control (P<0.05). Increased percent male of Cyprinus carpio was obtained with increasing HC across all ITs. It was observed that the immersion treatment at 600µgl-1 for 72 hours was more effective to change the sex ratio of pre hatch Cyprinus carpio. A comparative outlook made from this experimental trial that sex induction of Cyprinus carpio by eggs immersion using synthetic male steroid hormone is an alternative safe technique of fish sex reversal in contrast to oral administration of hormone in fish feed.

Andrógenos sintéticos (hormônios masculinos) administrados ao viveiro de peixes estão sendo usados ​​na aquicultura para evitar a diferenciação sexual e a desova indesejada nos ovos ou no primeiro estágio de alimentação dos peixes. O presente estudo foi conduzido com o objetivo de produzir carpa comum masculina (Cyprinuscarpio) pela técnica de imersão em ovos. Com essa pequena percepção, o efeito de diferentes concentrações hormonais (17α-metiltestosterona @ HC: 150, 300, 450 e 600 µgl-1) com tempos de imersão (IT: 24, 48 e 72 horas) e seu efeito de interação (HC x IT) na porcentagem de eclosão dos ovos de Cyprinuscarpio, a porcentagem de sobrevivência e a porcentagem da produção masculina foram avaliadas especificamente. Os resultados mostraram que a porcentagem de incubação de ovos diminuiu com o aumento da TI da mesma forma, a sobrevivência dos alevinos tratados foi afetada pelo aumento da TI (P <0,001). O principal efeito de interação do HC x IT mostrou que o maior percentual de indivíduos do sexo masculino (95%) foi obtido com 450-600 µgl-1 HC por 72 horas de TI, seguido por 88-92,50% com 150-300 µgl-1 HC para 72 horas de TI, 87,50% às 48 horas de TI para o restante dos tratamentos hormonais, e 47,50% mais baixos foram registrados no controle (P <0,05). A porcentagem aumentada de macho de Cyprinuscarpio foi obtida com o aumento do HC em todas as TIs. Observou-se que o tratamento de imersão a 600µgl-1 por 72 horas foi mais efetivo na alteração da razão sexual do Cyprinuscarpio antes da eclosão. Uma perspectiva comparativa feita a partir deste ensaio experimental de que a indução sexual de Cyprinuscarpio por imersão de ovos usando hormônio esteróide masculino sintético é uma técnica alternativa segura de reversão do sexo em peixes, em contraste com a administração oral de hormônio na alimentação de peixes.

Animals , Male , Carps/physiology , Androgens/pharmacology , Methyltestosterone/administration & dosage , Sex Ratio , Aquaculture , Immersion
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 34-38, mar. 2020. tab
Article in Spanish | LILACS | ID: biblio-1102292


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)

Humans , Female , Aged , Testosterone/therapeutic use , Postmenopause/drug effects , Appetite Depressants/adverse effects , Phenytoin/adverse effects , Placebos/administration & dosage , Psychotropic Drugs/adverse effects , Tamoxifen/adverse effects , Testosterone/administration & dosage , Testosterone/analysis , Testosterone/adverse effects , Testosterone/pharmacology , Cardiovascular Agents/adverse effects , Indomethacin/adverse effects , Gonadotropin-Releasing Hormone/adverse effects , Postmenopause/physiology , Controlled Clinical Trials as Topic , Cholinergic Antagonists/adverse effects , Contraceptives, Oral/adverse effects , Sexual Dysfunctions, Psychological/etiology , Sexual Dysfunctions, Psychological/therapy , Danazol/adverse effects , Consensus , Aromatase Inhibitors/adverse effects , Off-Label Use , Factor Xa Inhibitors/adverse effects , Amphetamines/adverse effects , Histamine Antagonists/adverse effects , Androgen Antagonists/adverse effects , Androgens/physiology , Ketoconazole/adverse effects , Narcotics/adverse effects
Arch. endocrinol. metab. (Online) ; 64(1): 4-10, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1088773


ABSTRACT Objective The aim of this study was to investigate polycystic ovary syndrome (PCOS) and to explore the relationship between body fat percentage and metabolic markers. Subjects and methods Sedentary women were assigned to PCOS (N = 60) and CONTROL (N = 60) groups. Each group was subdivided into three subgroups according to body fat percentage (22-27%, 27-32% and 32-37%). The protocol consisted of assessments of glucose, insulin, androgens, follicle stimulating hormone (FSH), luteinizing hormone (LH), 17-hydroxyprogesterone (17-OHP), leptin, adiponectin, tumor necrosis factor (TNF-α) and interleukin-6 (IL-6). Results The PCOS subgroups showed higher concentrations of androgens, LH and 17-OHP. Leptin showed direct relationship with increased body fat percentage, whereas adiponectin showed the inverse effect. However, both were unaffected by PCOS. TNF-α and IL-6 were higher in PCOS women and showed a direct relationship with increased body fat percentage. Glucose showed direct relationship with body fat percentage, whereas insulin presented higher values in PCOS women and direct relationship with increased body fat percentage. Conclusions Our findings indicate that PCOS and body fat percentage directly influence concentrations of insulin, TNF-α and IL-6, whereas leptin and adiponectin are influenced only by the increase in body fat percentage in these women. Arch Endocrinol Metab. 2020;64(1):4-10

Humans , Female , Adolescent , Adult , Young Adult , Biomarkers/blood , Adipose Tissue/anatomy & histology , Metabolic Diseases/blood , Insulin Resistance , Luteinizing Hormone/blood , Body Mass Index , Case-Control Studies , Interleukin-6/blood , Tumor Necrosis Factor-alpha/blood , 17-alpha-Hydroxyprogesterone/blood , Leptin/blood , Adiponectin/blood , Follicle Stimulating Hormone/blood , Glucose/analysis , Androgens/blood , Insulin/blood
Metro cienc ; 28(1): 40-47, 2020 enero -marzo. ilus, tab
Article in Spanish | LILACS | ID: biblio-1128413


RESUMEN El síndrome de insensibilidad androgénica (SIA) es una de las anormalidades de la diferenciación sexual (desarrollo sexual diferente). Es un trastorno genético dependiente del cromosoma X, produce una alteración en el receptor de andrógenos, se asocia con testículos en las mujeres cuyo cariotipo es XY y con agenesia vaginal y uterina. Acuden a la consulta médica los padres con su hija recién nacida de 12 días de edad. Motivo de consulta: masa en la región inguinal derecha. Examen físico: signos vitales normales, activa al manejo, reactiva. Se observa una masa en la región inguinal derecha de aproximadamente 2 cm de diámetro, reductible, no dolorosa. Genitales externos femeninos: normales. La paciente es referida al Servicio de Cirugía para proceder a la corrección del defecto herniario. Se indica realizar un estudio citogenético y medir los niveles hormonales en sangre. Resultado del estudio anatomopatológico posquirúrgico, luego de 7 días de haber sido intervenida quirúrgicamente: "Tejido gonadal de tipo testicular con zonas de congestión vascular y hemorragia focal". Los niveles hormonales sanguíneos son normales; el cariotipo es normal masculino XY. Diagnóstico: debido a que el resultado del cariotipo es concluyente, se diagnostica síndrome de insensibilidad androgénica (SIA)" completo.Palabras claves: síndrome de insensibilidad androgénica, hernia inguinal, cariotipo

ABSTRACT Androgen insensitivity síndrome (AIS) is one of the causes of abnormalities in sexual differentiation (different sexual development). SIA is an X-linked genetic condition caused by an androgen receptor disorder, associated with vaginal and uterine agenesis, and the presence of testicles in women with an XY karyotype. Parents with 12-day-old neonates go to medical consultation. The reason for consultation is a mass in the right inguinal region. On physical examination: normal vital signs, active on management, reactive. A mass is observed at the level of the right inguinal region of approximately 2 cm in diameter, reducible and not painful. Female external genital with normal characteristics. The patient is referred for surgery to correct hernia defect. A cytogenetic study and blood hormone leves are indicated. Seven days after the intervention, parents came with the results of the postoperative pathological study: testicular gonadal tissue with áreas of vascular congestion and focal hemorrhage. Blood hormonal lever are normal and anormal XY male karyotype is seen. Diagnosis: the result of the karyotype is conclusive and a complete AIS is diagnosed.Keywords:androgen insensitivity syndrome, inguinal hernia, karyotype.

Humans , Female , Infant, Newborn , Androgen-Insensitivity Syndrome , Karyotype , Androgens , Sex Differentiation , Receptors, Androgen , Hernia, Inguinal
Rev. Assoc. Med. Bras. (1992) ; 66(1): 36-41, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091909


SUMMARY OBJECTIVE Acne vulgaris in female adolescents, when severe or accompanied by other signs of androgenization, may represent a sign of hyperandrogenemia often underdiagnosed, which will have harmful consequences for adult life. The objective of this cross-sectional and retrospective study was to demonstrate the incidence of hormonal changes in the cases of female adolescents with severe or extensive acne, with or without other signs of hyperandrogenism, and propose a hormonal research pattern which should be indicated in order to detect early hyperandrogenemia. METHODS The medical records of 38 female patients aged between 9 and 15 years old with grade II and/or III acne were analyzed. The dehydroepiandrosterone sulfate, dehydroepiandrostenedione, and androstenedione, total testosterone, and dihydrotestosterone sulfate hormones were required prior to initiation of treatment. The hormonal dosages were performed in the serum after at least 3 hours of fasting by means of radioimmunoassay tests. RESULTS Of the 38 patients included, 44.7% presented changes in androgen levels (hyperandrogenemia), and the two most frequently altered hormones were DHEA and androstenedione, with the same incidence (23.6%). CONCLUSIONS The correct and early diagnosis provides an effective and agile approach, including antiandrogen therapy, with the purpose of avoiding the reproductive and metabolic repercussions, besides controlling the inflammatory picture and avoid aesthetic complications.

RESUMO OBJETIVO A acne vulgar em adolescentes do sexo feminino, quando grave ou acompanhada de outros sinais de androgenização, pode representar um sinal de hiperandrogenemia muitas vezes subdiagnosticado, que acarretará consequências danosas para a vida adulta. O objetivo deste estudo transversal e retrospectivo foi demonstrar a incidência das alterações hormonais nos casos de adolescentes do sexo feminino com acne grave ou extensa, acompanhada ou não de outros sinais de hiperandrogenismo e propor um padrão de pesquisa hormonal que deve ser indicado com o intuito de detectar precocemente o quadro de hiperandrogenemia. MÉTODOS Foram analisados os prontuários de 38 pacientes do sexo feminino com idades entre 9 e 15 anos, portadoras de quadro de acne grau II e/ou III. Os hormônios sulfato de dehidroepiandrostenediona, dehidroepiandrostenediona, androstenediona, testosterona total e dehidrotestosterona foram solicitados antes do início do tratamento. As dosagens hormonais foram realizadas no soro após pelo menos 3 horas de jejum por meio de exames de radioimunoensaio. RESULTADOS Das 38 pacientes incluídas, 44,7% apresentaram alterações dos níveis de andrógenos (hiperandrogenemia), sendo que os dois hormônios mais frequentemente alterados foram o DHEA e androstenediona, com a mesma incidência (23,6%). CONCLUSÕES O diagnóstico correto e precoce propicia uma abordagem efetiva e ágil, incluindo a terapia antiandrogênica, com a finalidade de evitar as repercussões reprodutivas e metabólicas, além de controlar o quadro inflamatório e evitar complicações estéticas.

Humans , Female , Child , Adolescent , Acne Vulgaris/blood , Hyperandrogenism/diagnosis , Androgens/blood , Severity of Illness Index , Hyperandrogenism/blood