Androgen adverse effects

Both are poorly tolerated because of androgenic adverse effects, which include weight gain, hirsutism, acne, mood changes and occasionally deepening of the voice, which may be irreversible. 

Clinical studies also have been carried out with nonbio degradable implants releasing the progestin desogestrel (8). Unlike levonorgestrel, desogestrel possesses lower androgenic activity and thus has less adverse effect on blood Hpids. 

The answer is a. (Hardman, pp 1482—1483. Katzung, pp 673-674.) Metyrapone inhibits 11-hydroxylation of steroid precursors, which prevents formation of cortisone and cortisol. These precursors are then diverted into aldosterone and androgen production pathways, which explains the adverse effects of hirsutism and edema... 

Androgen synthesis inhibitors provide symptomatic, but brief, relief in approximately 50% of patients. Aminoglutethimide causes adverse effects in 50% of patients, such as lethargy, ataxia, dizziness, and self-limiting rash. The adverse effects of ketoconazole are GI intolerance, transient increases in liver and renal function tests, and hypoadrenalism. 

Adverse effects include changes in libido and the occurrence of oedema, weight gain and gynecomastia, may occur. Androgens are potentially hepato-toxic, testosterone less than methyltestosterone and fluoxymesterone. Androgens can potentiate anticoagulant action. 

Adverse effects include flushes, weight gain, mood changes, vaginal dryness, decreased libido, breast enlargement and tenderness and in some patients the prolonged time required for the return of normal ovulatory function. Androgen side-effects like acne and hirsutismus can occur with the 19-nortestosterone derivatives. 

Anabolic-androgenic steroids (AAS), which are analogs of the male hormone testosterone, are used among athletes and bodybuilders. AAS alter the hormonal systems of males and females, and induce many adverse effects. In addition to the sex-related changes, violent behavior and psychological dependence can also occur. The use of AAS in professional sports as well as in high school sports has aroused considerable attention. 

Eplerenone is a spironolactone analog with much greater selectivity for the mineralocorticoid receptor. It is several hundred-fold less active on androgen and progesterone receptors than spironolactone, and therefore eplerenone has considerably fewer adverse effects. 

When androgen therapy is used in postmenopausal women who complain of poor libido, poor energy, or a feeling of malaise (2), it should be given in association with estrogens, because of its adverse effects on serum lipids. 

Adverse effects of pharmacological doses of androgens include, as one would expect from male hormones, hirsutism with acne and other signs of virilization, along with adverse lipoprotein profiles, endometrial hyperplasia in women, and an increased risk of cardiovascular disease. Some compounds are particularly likely to cause liver disorders. 

Basaria S, Dobs AS. Safety and adverse effects of androgens how to counsel patients. Mayo Chn Proc 2004 79 (4 Suppl) S25-S32. 

The effect of adding finasteride 5 mg/day to high-dose bicalutamide 150 mg/ day has been studied in 41 men with advanced prostate cancer treated over a mean of 3.9 years (21). The serum prostate-specific antigen (PSA) concentration was measured every 2 weeks until disease progression. At the first nadir of PSA, the median fall from baseline was 96.5% a second nadir occurred in 30 of 41 patients, with a median fall of 98.5% from baseline. The median times to each nadir were 3.7 and 5.8 weeks respectively. The median time to treatment failure was 21 months. Adverse effects were minor, including gynecomastia. Sex drive was normal in 17 of 29 men at baseline and in 12 of 24 men at the second PSA nadir, but one-third of the men had spontaneous erections at both times. The authors concluded that finasteride provided additional intracellular androgen blockade when added to bicalutamide. The duration of control was comparable to that achieved with castration, with preserved sexual function in some patients. 

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