- Hyperandrogenism - if the female body behaves as a male
- Symptoms and causes
- The clinical picture
Hyperandrogenism - is the most common endocrine disorder in women of reproductive age. Male sex hormones, or androgens in women are produced mainly by the adrenal glands and ovaries. However, from the peripheral tissues such as adipose tissue and skin, also depends on the level of androgens in the body, as they play a role in the transformation of weak androgens more potent. Hyperandrogenism, or an excess of androgens can affect various tissues and organs, causing a number of violations, among them - acne, hirsutism
Hirsutism - when femininity leaves
, Virilization, and dysfunction of the reproductive system.
Sources and types of male sex hormones in women
The glands of the endocrine system produce a total of five kinds of androgens: testosterone, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione and androstenediol. Last possesses both androgenic and estrogenic properties. Testosterone and its biologically active form - dihydrotestosterone (DHT), are the only androgen capable of directly providing androgenic effect. DHEAS, DHEA and androstenedione are precursors of testosterone.
- Androgens are produced by the ovaries
The ovaries produce 25% of testosterone circulating in the blood of women. Its secretion of luteinizing hormone dependent, which in turn allocates anterior pituitary. The ovaries also produces 50% of androstenedione and DHEA 20%.
- Androgens are produced by the adrenal glands
Produced in the adrenal glands in the body all the available DHEAS, DHEA and 80%. They produce 50% and 25% of androstenedione testosterone. The secretion of adrenal androgen independent of adrenocorticotropic hormone, which is produced in the anterior pituitary. In the adrenal glands can also be influenced by estrogen and prolactin.
- Peripheral conversion of testosterone
Skin, adipose tissue, liver, and organs of the urogenital system also influence the level of testosterone in the blood. For example, androstenedione and, to some extent, DHEA is converted to testosterone in the skin.
- The metabolism of androgens
Of all androgen circulating in the blood only testosterone and dihydrotestosterone can activate androgen receptors. In women of childbearing age 25% of testosterone is produced in the adrenal glands, and the same - in the ovaries. Rest of testosterone produced during the conversion of androstenedione and other androgens in peripheral tissues. Normally, 80% of testosterone is associated with binding globulin sex hormones (SHBG), 19% - with albumin and a 1% testosterone circulating freely in the bloodstream. The level of androgens in the body depends mainly on whether the number is associated with SHBG.
The level of SHBG may increase:
- Drugs, which include estrogen.
- The level of SHBG is reduced:
- Synthetic progestins (norethindrone, norgestrel, desogestrel, norgestimate);
- Growth hormone;
DHEAS, DHEA and androstenedione almost completely bound to albumin.
The adrenal glands start to produce more male sex hormone that raises the level of adrenocorticotropic hormone (ACTH), but the feedback in this process is not - that is, the level of androgens in the body does not affect the secretion of ACTH. Androgens are produced by the ovaries, is also not affect the level of luteinizing hormone. Thus, even at an elevated level of androgens organism can continue to produce them more and more.
Most circulating testosterone
Five myths about testosterone
in the liver and processed into androsterone etioholanolon which then react with glucuronic acid and other substances, and excreted in urine in the form of 17-ketosteroids. Only 20-30% contained in urine 17-keto steroids obtained during metabolism of testosterone. The remaining part thereof formed as a result of processing of steroid hormones.
The role of androgens in the body
Male sex hormones have a direct impact on the various systems of the body, and are precursors of estrogen
Estrogen - the key to bone health
. Androgen receptors are present in many tissues, such as the skin, skeletal muscle, gastrointestinal tract, genitourinary system, bones, brain, cardiovascular system, placenta and adipose tissue. The effects of androgens have not been studied thoroughly. Then we talk about how male sex hormones and excess observed at hyperandrogenism, affect different organs and body systems.
Androgen receptors in the brain are located in close proximity to the estrogen receptors. In certain areas of the brain contains enzymes 5-alpha reductase and aromatase ability to convert testosterone into dihydrotestosterone or estradiol
Estradiol, the most important hormone
With an increase in testosterone levels as a result of intravenous injection (to treat certain diseases), many women have atypical aggressive behavior.
Numerous data suggest that androgens are responsible for sex drive in women. Patients who are prescribed for the treatment of hyperandrogenism drugs that inhibit the activity of male hormones, there was a significant weakening of the sex drive. On the other hand, increased levels of androgens can become a cause of increase libido.
Male sex hormones play an important role in bone mineralization. Reduced levels of androgens associated with a decrease in bone density - is one of the reasons why anti-androgen drugs for the treatment of hyperandrogenism should be taken with caution.
In epithelial cells, along with estrogen and progesterone receptors and androgen receptors are. Studies have found that androgens, particularly testosterone and DHEA, prevent the proliferation of epithelial cells in female monkeys. The opposite effect was observed when the animals were injected with drugs antiandrogenic action. The action of androgens on the human breast is not well studied, but now experts believe that elevated levels of male sex hormones do not significantly affect the likelihood of developing breast cancer.
Laboratory studies have shown that androgens can inhibit the proliferation of the endometrium and may prevent the development of endometrial cancer. However, human studies that could confirm this hypothesis has not yet been carried out.
Women suffering from hyperandrogenism and polycystic ovary syndrome, the risk of cardiovascular disease is significantly higher than average.