Androgens - An Overview

Introduction:

Androgens are hormones that influence the growth and development of the male reproductive system. These hormones are responsible for masculine characteristics in reproductive tissues and contribute to the anabolic status of the bodily tissues. Testosterone and its metabolite Dihydrotestosterone (DHT) are the main androgens involved in the circulation of males.

What Are Androgens?

Androgens are sex hormones that are involved in the process of puberty, reproductive health, and growth and development of the body. Both males and females produce androgens, but more is produced by males. Testosterone is considered the most common of all androgens. Androgens are secreted by the testes in the male reproductive system and the ovaries in the female reproductive system. Adrenal glands situated at the top of the kidneys can produce androgens.

Androgens include

• Androstenedione.

• Dihydroepiandrosterone (DHEA).

• DHEA sulfate (DHEA-S).

• Dihydrotestosterone (DHT).

The role of androgens among both genders is called males and females.

• Androgens help in

• Maintaining bone density.

• Development of muscles.

• Maintain puberty.

• Produce red blood cells.

• Maintain sexual desire and function.

Role of androgens among males:

Androgens function in

• Making the male voice deep (lengthening of vocal cords)

• Growth of hair on the face, scalp, chest, underarms, and genitals.

• Development of sperm.

Role of androgens among women:

Androgens get converted into estradiol. Estradiol is a form of estrogen.

This hormone is responsible for

• Regulation of menstrual cycle.

• Play a role in conceiving and pregnancy.

• Decreases bone loss or osteoporosis.

• Stimulate pubic hair and underarm hair growth.

What Are the Health Issues Related to Androgens?

Any variations in the levels of androgen may lead to health problems.

High levels of androgen (hyperandrogenism) may cause problems for women. Hyperandrogenism occurs most commonly among women with polycystic ovarian syndrome (PCOS). Adrenal and ovarian tumors rarely cause hyperandrogenism.

Low levels of androgen (hypoandrogenism) can cause

• Fractures of bone and osteoporosis.

• Weakness.

• Reduce sex drive.

Health issues related to androgens among males include

Prostate Cancer: Androgens can stimulate cancer cell growth in the prostate gland. In such cases, antiandrogen therapy is used to treat prostate cancer. Anti-androgen therapy can be used to treat tumors and help slow the rate of new cancerous growth. Along with anti-androgen therapy, surgery, and other medications may be necessary to decrease the androgen levels.

Male Hypogonadism: In this condition, a low level of testosterone or androgens can be observed. This condition may cause weakness, anxiety, depression, difficulty concentrating, reduced tolerance to exercise, reduced sex drive, and erectile dysfunction.

Gynecomastia: Lowered levels of androgens may result in gynecomastia or breast development in males.

Health issues related to androgens among females include

PCOS: Females usually produce fewer androgens. Females with PCOS produce more androgens.

This may further result in

• Problems related to ovulation and infertility.

• Periods may extend and be more painful.

• Hair growth may be more.

• Experience acne.

• Experience obesity.

Hormonal therapy can be used to lower the androgen levels in PCOS.

Tumors and Other Issues: Problems related to increased levels of androgens include

• Adrenal gland tumors.

• Ovarian tumors.

• Adrenal hyperplasia.

• Cushing disease.

High levels of androgen among women may also lead to high blood pressure and cholesterol, insulin resistance or diabetes, and heart disease.

Breast Cancer: Recent research has found an association between androgen receptors and breast cancer development. A study done in 2021 found that androgen therapy can help suppress particular types of breast cancer, like estrogen receptor (ER)-α-positive breast cancer.

Health issues related to androgens among children include

Androgens are helpful in the development of genitals as the fetus develops in the uterus.

Some babies exhibit disorders of sex differentiation at birth. This may result in problems related to reproductive organs and their appearance. Gene mutation may be transferred to children.

Gene mutations may lead to

Androgen Insufficiency Syndrome (AIS): Children with AIS may not respond to androgens. The baby exhibits a tiny penis, though they have male chromosomes. Genital may look like females or a mix of sexes.

Congenital Adrenal Hyperplasia (CAH): Increased levels of androgens make the baby with female chromosomes have genitals that look like a male.

How to Diagnose Androgen Imbalance?

Diagnosis of imbalance of androgen include

• A medical history and physical examination are done thoroughly.

• A blood test is done to determine the levels of androgens.

• The lipid profile is done to learn about cholesterol levels.

• The blood test is done to determine other hormones, such as luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and fasting blood sugar.

• Endocrine tests may be done to identify abnormal sites for producing androgens like dehydroepiandrosterone (DHEA) or its sulfate form.

• A thyroid test is also done.

• Inflammatory markers are also measured, as inflammation is a component of PCOS.

How to Treat Androgen Disorders?

Androgen disorders cannot be cured but can be treated.

• Treatment is done through medications.

• Losing weight by 5-10 percent may help in fertility cases and decrease hirsutism.

• Oral contraceptives may be used for treatment.

• In the case of androgen deficiency, hormonal supplements can be prescribed to treat it.

• A combination of estrogen and testosterone pills may be given for androgen deficiency.

• DHEA, a hormone secreted by the adrenal gland, can be used to treat androgen deficiency.

• Research has shown that testosterone patches, skin gels, vaginal suppositories, or creams can help increase androgen levels in women.

How to Prevent Androgen Disorders?

Prevention can be done to reduce some of the worst consequences of androgen disorders.

• Some medications can treat risks like diabetes, glucose intolerance, and high cholesterol. Apart from this, lifestyle modifications can help reduce the risks related to androgen disorders.

• Lifestyle modifications include having a proper diet and practicing exercises.

• In cases of reduced androgen levels, using testosterone supplements can help prevent bone loss and improve sexual life and energy.

• Proper communication with life partners and healthcare professionals and a healthy lifestyle can help lead a good life.

Conclusion:

Androgens are hormones responsible for the onset of puberty. Apart from this function, these hormones are connected with many functions of the body. When these hormones are imbalanced, many important functions, like energy levels and sexual drive, are affected. It may affect blood sugar levels, blood pressure, and cholesterol levels. Hence, it is important to know about androgens, related health issues, and their management. Knowing about androgens helps identify the problems related to them early. Early diagnosis helps achieve effective treatment. This helps achieve a good quality of life. Adopting a healthy lifestyle may help prevent the problems related to androgens.