Androgens adverse reaction

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. 

They have a low incidence of adverse reactions and the reactions that occur are generally mild. Rapid intravenous infusion of H2 antagonists may cause bradycardia. Cimetidine is more inclined to cross the blood-brain barrier and CNS effects such as somnolence and confusion have been described, especially in the elderly and in patients with impaired renal function. Cimetidine in high doses, as the only one of its class, has antiandrogenic effects which could be explained by an increase of prolactin secretion, binding to androgen receptors and inhibition the cytochrome P450 mediated hydroxylation of estradiol. 

Orally active agents used in the treatment of ED are more affected by aging and disease processes than are those injected intracavernosally. In addition, alterations in hepatic metabolism and/or renal clearance in the elderly man (see Chapter 6) influence the frequency of appearance of adverse reactions between several coadministered drugs in the treatment of ED. For example, the concomitant use of sildenafil and nitroglycerin is contraindicated by cardiovascular complications. Also, the use of testosterone in the presence of androgen-dependent tumors may promote tumor growth. 

Sexual function An American group has systematically reviewed the use of finasteride for the treatment of androgenic alopecia and found 12 published studies in 3927 patients that they regarded as eligible for inclusion [48 ]. As far as adverse reactions were concerned, moderate-quality evidence suggested an increase in erectile dysfunction (RR = 2.2 95% CI = 1.03, 4.8 NNTh=82 95% Cl = 56, 231) and a possible increase in the risk of any sexual disturbances (RR=1.4 95% Cl = 0.99,2.0). However, the risk of discontinuing treatment because of sexual adverse reactions was similar to that of placebo. The authors found moderate evidence that daily use of oral finasteride... 

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