What Are Androgens?

Androgens mainly refer to a class of endocrine hormones synthesized by the gonads (testicles). Testosterone-producing cells are interstitial cells. In addition, the adrenal cortex can also synthesize a certain amount of androgen, and the ovary can synthesize a small amount of androgen.

English name: Male hormones
Visiting department: Center of Urology, Andrology, Reproductive Medicine
Common locations: Testis, adrenal cortex

Common causes: Androgen secretion
Common symptoms: Obesity, abdominal fat accumulation
Contagious: no
way for spreading: no

Androgen I. Overview

Androgens, also known as male hormones, are hormones that maintain normal sexual desire and reproductive function. Lack of androgen can cause many health problems. Androgens can regulate the distribution and composition percentage of adipose tissue in the human body, and inhibit the increase or increase of body fat. Low androgen levels can cause obesity, abdominal fat accumulation, and other metabolic diseases are likely to follow suit ^[1] .

Androgen II, physiological functions and metabolic effects

Androgens can promote the growth of male organs, spermatogenesis and the development of male secondary sexual characteristics ^[2] , and promote the appearance of male parasexual characteristics such as beards and pubic hair, and maintain male sexual desire. In addition, it also plays a role in regulating body metabolism. Androgen has a strong role in promoting protein synthesis and making the body assume a positive nitrogen balance. This is particularly prominent in children, such as promoting skeletal muscle development and promoting calcium deposition in the bones. , Make bones thicker and grow, and have the role of increasing basal metabolism and stimulating red blood cell production. Androgens can promote RNA polymerase and aminoacyltransferase, hexokinase, phosphofructokinase in glycolysis, and mitochondrial cellular respiration enzymes, thus supplying the energy required for cell anabolic metabolism.

Androgen III. Synthesis and breakdown

Normal adult males secrete 8 (4-12) mg of testosterone every day, which varies greatly from individual to individual. 95% of testosterone released by men from the blood comes from the testes. The testosterone released by women in the blood mainly comes from the adrenal cortex. 98% of the testosterone in the blood is bound to a special -globulin, which is corticosteroid-binding globulin (CBG) or testosterone-binding globulin (TBG). For transportation, a small number of testosterone and albumin bind non-specifically or exist in the blood in free form.

The ability of testes to synthesize testosterone is much greater than that of the adrenal cortex, so when the testicles secrete androgen is insufficient, it cannot be replaced or replaced by the adrenal cortex. However, the vasectomy has no effect on testosterone secretion of testicular mesenchymal cells. Synthetic androgen analog nandrolone phenylpropionate (phenylpropyl nortestosterone) also promotes protein synthesis in the body, but its virilization effect It is lower than testosterone; synthetic 17-methyltestosterone has the highest physiological efficiency of androgens, and can be used orally. It is a commonly used drug in clinical practice.

Androgen IV. Clinical Diseases-Polycystic Ovary Syndrome:

Androgen diagnosis:

The clinical diagnosis of PCOS is performed in accordance with the standards set by the Rotterdam Conference in 2003, which can be diagnosed by meeting two of the following three points: 1. thin ovulation or anovulation; 2. with androgenemia or hyperandrogen Clinical and biochemical characteristics (such as hirsutism, acne, etc.); 3. Polycystic changes in the ovary under ultrasound examination. In addition, other diseases that can cause increased androgens (such as hyperprolactinemia, congenital adrenal hyperplasia, Cushing syndrome, androgen-producing tumors, and thyroid diseases) need to be ruled out.

Androgen pathogenesis

The local androgen environment of the ovary hinders the normal growth of follicles, resulting in anovulation or rare ovulation. The circulating androgen state can cause clinical symptoms such as hairiness, obesity, acne and hair loss. Hyperandrogenemia is an important cause of PCOS ovarian pathological damage.

The main mechanisms for the formation of PCOS hyperandrogenemia may include: (1) abnormal hypothalamic-pituitary-ovarian axis function. The frequency and amplitude of LH secretion by the pituitary gland increase, and high LH promotes the synthesis and secretion of androgens by follicular membrane cells; (2) hyperadrenal function. 20% to 65% of PCOS patients are associated with adrenal hyperandrogenemia. PCOS patients have increased 5-reductase activity and 11-hydroxysteroid dehydrogenase 1 disorder. Occur; (3) insulin resistance and hyperinsulinemia.

Androgen treatment principles

Nowadays, the clinical treatment of PCOS mostly focuses on a certain clinical symptom, and the emphasis of treatment on PCOS patients with fertility requirements is different. For PCOS patients without fertility requirements, long-term management and prevention of complications should be strengthened; and for PCOS patients with fertility requirements, comprehensive evaluation should be performed before assisting pregnancy. Treatment methods mainly include lifestyle adjustments, oral contraceptives, and insulin sensitization Agents, ovulation-promoting treatment, surgical treatment, and assisted reproductive technology, etc., individualized programs should be selected according to the characteristics of the patient to achieve better results in assisted pregnancy.