One and the same androgen for all? Towards designer androgens

Area of Science:

• Endocrinology and reproductive medicine
• Pharmacology of steroid hormones

Background:

• Designer estrogens have prompted consideration of selective androgenic compounds for male hormone replacement therapy.
• The full spectrum of testosterone's actions may not be necessary or even desirable for all therapeutic indications.
• Understanding androgen (patho)physiology is essential for defining desired and undesired androgenic properties.

Purpose of the Study:

• To explore the potential of selective androgenic compounds for male hormone replacement therapy.
• To investigate the specific roles and indications for androgenic properties in male health.
• To address the limitations of current androgen replacement modalities.

Main Methods:

• Review of existing literature on androgen and estrogen physiology.
• Analysis of evidence regarding aromatization of androgens to estrogens.
• Consideration of dihydro-testosterone (DHT) roles in different life stages.
• Exploration of potential applications in male contraception and androgen replacement.

Main Results:

• Aromatization of androgens to estrogens may benefit bone mass and cardiovascular risk markers.
• The role of dihydro-testosterone (DHT) in mature and aging males requires further investigation, with no proven negative effect on prostate pathophysiology.
• Progestational agents with strong androgenic properties could be useful for male contraception.
• Critical androgen levels for most actions are not well-established.
• Current androgen replacement faces challenges due to the large molecule quantities required.

Conclusions:

• Selective androgenic compounds hold promise for tailored male hormone replacement therapy.
• Further research into androgen physiology is needed to optimize therapeutic strategies.
• Development of more biopotent androgens could overcome limitations in current replacement modalities.