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Partial androgen insensitivity--are all tissues equal?

E J Keely1, D D Belsham, K Wrogemann

  • 1University of Manitoba, Health Sciences Centre, Winnipeg, Canada.

Fertility and Sterility
|August 1, 1993
PubMed
Summary
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High-dose nonaromatizable androgens did not increase phallic size in a patient with partial androgen insensitivity. This suggests varying tissue sensitivity to androgens, making lab tests unreliable for predicting genital response.

Area of Science:

  • Endocrinology
  • Androgen Biology
  • Reproductive Medicine

Background:

  • Partial androgen insensitivity (PAI) is a condition affecting sexual development.
  • Treatment of PAI often involves androgen therapy to promote virilization.
  • Assessing treatment efficacy typically relies on biochemical markers and physical changes.

Observation:

  • A patient with PAI received high-dose nonaromatizable androgens.
  • Despite treatment, no significant change in phallic size was observed.
  • Biochemical markers, including sex hormone-binding globulin (SHBG) and gonadotropin levels, showed expected declines.

Findings:

  • The lack of phallic growth despite hormonal changes indicates differential tissue sensitivity to androgens.
  • Standard laboratory tests may not accurately predict genital response to androgen therapy in PAI.

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  • Androgen action can vary significantly across different target tissues.

    • Implications:

    • Therapeutic trials of androgens are crucial for evaluating treatment effectiveness in PAI.
    • Clinical response, rather than solely laboratory values, should guide treatment decisions.
    • Further research is needed to understand tissue-specific androgen metabolism and receptor function in PAI.