Androgens, in women

Pharmacology Testosterone, produced by the Leydig cells of the testis, is the primary natural androgen. In women, small amounts are synthesized by the ovary and adrenal cortex. 

Vermeulen A. Plasma androgens in women. J Reprod Med 1998 43(Suppl 8) 725-33. 

Demers LM. Biochemistry and laboratory measurement of androgens in women. In Redmond GP, ed. Androgenic disorders. New York Raven Press, 1995 21-34. 

Careful analysis of the biosynthetic properties of the membrana granulosa, the theca interna, and luteinized cells of the Graafian follicle and corpus luteum have revealed some of the factors determining the secretory products of these structures, but the role of the ovarian interstitial tissue is not completely established. There is much evidence suggesting that the latter tissue may secrete the major portion of ovarian androgens in women and in virilizing syndromes accompanying ovarian disease (Gil, L4, Mia, M5). 

Davis SR. The therapeutic use of androgens in women. J Steroid Biochem Mol Biol 1999 69 177-184. 

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. 

Spironolactone is an antiandrogen which blocks androgen-receptors, alters steroidogenesis by adrenals and gonads and inhibits 5-a reductase. In doses of 100-200 mg daily it reduces sebum production and improves inflammatory acne in women. During treatment, birth control measures are required due to the risk of male fetus feminization. 

Figure 25-5. Metabolism of high-density lipoprotein (HDL) in reverse cholesteroi transport. (LCAT, lecithinxholesterol acyltransferase C, cholesterol CE, cholesteryl ester PL, phospholipid A-l, apolipoprotein A-l SR-Bl, scavenger receptor B1 ABC-1, ATP binding cassette transporter 1.) Prep-HDL, HDLj, HDL3—see Table 25-1. Surplus surface constituents from the action of lipoprotein lipase on chylomicrons and VLDL are another source of preP-HDL. Hepatic lipase activity is increased by androgens and decreased by estrogens, which may account for higher concentrations of plasma HDLj in women.

Loss of axillary and pubic hair in women owing to decreased androgen production... 

Cushing s disease and adrenal carcinomas cause adrenal androgen hypersecretion in high enough concentrations to result in signs of androgen excess (such as acne, menstrual irregularities, and hirsutism) and cause virilization in women.4... 

Removal of the adrenal gland, and thus adrenal androgens, has been associated with an inhibition of sexual behavior in both humans and primates. In addition, in primates exogenous androgens, but not estrogens, reportedly reversed the effects of adrenalectomy. Exogenous androgen treatments reportedly can facilitate sexual responses in women (Sherwin, 1996). 

Juricskay S, Telegdy E. 2000. Urinary steroids in women with androgenic alopecia. Clin Biochem 33 97. 

Androgenic steroids are used in medicine for replacement therapy in men with insufficient function of the male sex glands, for maturation arrest, impotency, climacteric, and other irregularities, and in women for breast and ovarian cancer and climacteric disorders. Like all steroid drugs, androgens are functionalized derivatives of cyclopentanophenan-threne. 

Androgens are used for therapy of androgen-deficient conditions such as hypofunctioning testicles, eunuchism and eunuchoidism, castration, impotence, climacteric conditions, and also for breast and ovarian cancer in women under 60 years. 

Cyproterone is used to control sexual attraction in men in cases of sexual deviations, as well as for inoperable prostate gland carcinoma. In women, it is used for severe cases of androgenization, and in children with idiopathic premature sexual maturity. Synonyms of this drug are cyprostat, androcur, daian, and others. 

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