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[Antiandrogens. Mechanisms and paradoxical effects]
1Laboratoire de Biochimie B, Hôpital Necker, Paris.
Annales D'Endocrinologie
|January 1, 1989
Summary
Antiandrogens are categorized by their castration or target cell action. Cyproterone acetate (CPA) offers comprehensive antiandrogen effects by suppressing production, increasing elimination, and blocking androgen action.
Area of Science:
- Endocrinology
- Pharmacology
Context:
- Antiandrogens are crucial in managing androgen-dependent conditions.
- Understanding their mechanisms of action is key to effective treatment.
Purpose:
- To categorize antiandrogens based on their biochemical and cellular mechanisms.
- To evaluate the comprehensive efficacy of cyproterone acetate (CPA) as an antiandrogen.
Summary:
- Antiandrogens are classified into three groups: biochemical castration agents (LHRH agonists, steroidogenesis inhibitors), target cell inhibitors, and dual-action agents.
- LHRH agonists cause initial flare-up and don't suppress adrenal androgens. Steroidogenesis inhibitors have incomplete block and rebound effects.
- Non-steroidal antiandrogens inhibit androgen receptors but can increase circulating androgens. CPA, a progestational antiandrogen, suppresses androgen production, inhibits receptor action, and provides contraception.
Impact:
- CPA demonstrates a more complete antiandrogen profile by suppressing testosterone production, increasing its elimination, and blocking its action.
- This comprehensive action makes CPA a highly effective option for managing androgen-dependent conditions, particularly in women requiring contraception.