What Are Androgens?
Androgen is a male sex hormone that plays an important role in developing male characteristics.
-
The androgen is produced by the testes in males in large amounts and in small amounts from the ovaries in females. It is also produced from the adrenal glands in both sexes. Androgens are responsible for regulating facial hair growth, muscle mass development, and deepening of the voice in men during puberty.
-
Androgens play a role in the regulation of RBC (red blood cell) production, mood, and bone density. A very important and well-known androgen is testosterone, which is referred to as the male hormone. The production of androgens is a complex process that involves many hormones working together to maintain proper levels of important hormones.
-
Abnormalities in androgen production or low levels of androgens lead to hypogonadism. Hypogonadism is a condition where the body does not produce sex sufficient sex hormones. High levels of androgens can cause conditions such as polycystic ovary syndrome (PCOS) or excessive hair growth (hirsutism).
-
In males, the androgens are primarily produced in the testes; in females, it is produced from the ovaries and adrenal glands.
-
The production of testosterone is balanced by luteinizing hormone (LH) from the anterior pituitary gland in the brain. The ovaries in females produce small amounts of androgens that are responsible for regulating important muscle mass, bone density, and sex drive. The adrenal glands produce androgens in both sexes. These androgens can be converted into estrogen or testosterone depending on the requirements or needs of the body. The adrenal gland is located in each kidney and produces several hormones, including androgens such as dehydroepiandrosterone (DHEA) and testosterone.
-
The androgen production by the adrenal gland is regulated by the hypothalamus-pituitary-adrenal (HPA) axis. The adrenal gland disorders lead to abnormal production of androgens.
What Are the Causes of Androgen Insufficiency?
Androgen insufficiency is a medical condition where the body does not produce enough androgen hormones. It is caused due to many factors like testicular injury or disease, chemotherapy or radiation therapy, genetic disorders, and certain medications. The symptoms of androgen insufficiency are erectile dysfunction, fatigue, low sex drive, and depression.
Androgen insufficiency is also known as hypogonadism. The various factors that are involved in adrenal insufficiency are:
-
Any injury or damage to the pituitary gland, testes, and pituitary gland or hypothalamus damage to the testes, pituitary gland, or hypothalamus can result in androgen insufficiency. Certain conditions like Klinefelter syndrome (a genetic condition causing a range of physical, cognitive, and behavioral symptoms), hemochromatosis (excessive accumulation of iron in the body), and pituitary tumors can also cause this condition.
-
Certain lifestyle factors, such as smoking, excessive alcohol consumption, and obesity, have been linked to decreased testosterone levels.
-
As age increases, the testosterone levels of males decrease. This is a common cause of androgen insufficiency, and it is also called late-onset hypogonadism.
-
The other causes of androgen insufficiency are genetic disorders such as Prader-Willi syndrome and myotonic dystrophy (a genetic disorder that causes obesity and related health problems such as type 2 diabetes, sleep apnea, and cardiovascular disease).
What Is Partial Androgen Insufficiency?
Partial androgen insensitivity is a rare genetic disorder that affects sexual development before puberty and birth. In this condition, the mutated androgen receptor gene impairs the body's ability to respond to androgens. This inability to respond results in many physical and developmental abnormalities.
Ambiguous genitalia is a condition where the external genitalia does not clearly appear male or female. The genitalia may also appear male or female but with some degree of ambiguity. This makes it difficult for parents and doctors to assign the gender of the baby. The affected individuals experience incomplete masculinization of their bodies, leading to a range of physical characteristics such as reduced body hair and breast development. The degree of masculinization varies depending on the severity of the mutation and genetic factors. It also affects the testes and prostate gland.
What Are the Causes of Partial Androgen Insufficiency?
Partial androgen insufficiency is due to mutations in the androgen receptor gene that encodes a protein that binds to the androgens. These types of mutations can decrease the sensitivity of the androgen receptor to androgens. The main reason for partial androgen insensitivity is genetic mutations in the androgen receptor gene. The mutations are inherited from one or both parents. The severity of the condition depends on the specific mutation of the androgen receptor.
Another important reason for Partial androgen insufficiency (PAIS) is exposure to certain drugs that disturb androgen signaling. Some anti-androgen drugs block the effects of androgens on the body. Exposure to environmental toxins can disrupt normal hormone signaling, and the toxins include phthalates and dioxins. Partial androgen insensitivity syndrome is caused by genetic mutations in the androgen receptor gene, exposure to certain medications or chemicals, and environmental toxins.
What Are the Symptoms of Partial Androgen Insufficiency?
The symptoms vary depending on the severity of the condition. Some individuals have mild symptoms, and others have more severe symptoms. The severe symptoms affect the overall health and physical appearance. The most common symptom of PAIS is ambiguous genitalia. Ambiguous genitalia is a condition where the external genitalia is not developed fully as male or female. The person may have a small penis or a partially formed scrotum. Other symptoms include sparse or absent facial and body hair, risk of testicular cancer, reduced muscle mass, breast development, delayed puberty, and infertility.
What Is the Diagnosis and Treatment for Partial Androgen Insufficiency?
-
The levels of testosterone in the blood are measured. A total testosterone level below 300 milligrams/decilitre indicates the presence of partial androgen insufficiency.
-
Other tests include measuring follicle-stimulating hormone (FSH) levels and luteinizing hormone (LH) that stimulate testosterone production. The treatment depends on the cause of the condition.
-
In genetic mutation conditions, hormone replacement therapy (HRT) is recommended to replace the missing androgens. The therapy involves natural or synthetic hormones to replace the missing hormones in the body.
-
Lifestyle changes such as a healthy and regular diet help improve symptoms of partial androgen insufficiency.
-
Psychological counseling is given to help individuals cope with the emotional effects of the condition.
Conclusion
Partial androgen insufficiency, or late-onset hypogonadism, is characterized by decreased testosterone. Some believe this condition is due to the normal part of aging, while others consider it a pathological condition. The symptoms of partial androgen insufficiency are erectile dysfunction, decreased muscle mass, decreased libido and strength, and depression. The symptoms are similar to hypogonadism, a more severe form of testosterone deficiency. The management involves hormone replacement therapy with natural or synthetic androgens.
