androgens and anabolic steroids Flashcards
leydg cells are
interstitial cells responsible for the production of testosterone
anabolic androgen steroids AAS
are steroid hormones
endogenous and synthetic
based on testosterone structure
testosterone, DHEA, androstenedione
leydg cells lie
between the seminiferous tubules
GnRH triggers
anterior pituitary to produce LH and FSH
LH
acts on leydig cells to produce testosterone
FSH
acts on Sertoli cells in seminiferous tubules to support spermatogenesis
and to secrete ABP - androgen binding protein
secreted testosterone binds to
ABP
testosterone effects
androgenic - masculinising - foetal male organ development, pubertal maturation, maintenance of sex characteristics, spermatogenesis
anabolic - growth stimulating - increased proton synthesis in growing tissues, maintenance of muscle and bone
testosterone function in foetus/neonate
promote wolffian ducts to form epididymis/vas deferens/seminal vessicles
external genitalia
5a-reductase
converts testosterone to dihydrotestosterone DHT
more potent than testosterone
regulated maturation of external genitalia
DHT also drives
prostate gland hypserplasia
DHT mediates testosterone effects everywhere but the
testis - where testosterone concentration is much higher
aromatase
converts testosterone 17b oestradiol
important for healthy motile sperm and bone
men who have an aromatase mutation are osteopaenic
androgen receptor
ligands are testosterone and DHT gene encoding the androgen receptor is on the X chromosome widely expressed nucelar receptor DHT binds it more avidly
androgen binding
homodimerisation of the receptors and nuclear translocation
testosterone levels peak
in the morning
androgen deficiency
male hypogonadism
clinical diagnosis confirmed by hormone assays
primary hypogonadism
testicular problem - high LH, ls testosterone
sometimes chromosomal, cryptorchidism, trauma, chemo, radiotherapy
secondary hypogonadism
low LH and testosterone
pituitary insufficiency - adenoma, surgery, trauma
kallman syndrome, prader-willi
treatment of androgen deficiency
adrogen replacement therapy
for life
give testosterone esters
testosterone esters
given by IM injection
bioconverted into testosterone
lasts 2-3 weeks
subcutaneous impacts, transdermal gels and patches
contraindicated of androgen therapy
prostate cancer
breast cancer
precautions of androgen replacement therapy
older men - urinary obstruction, libido
puberty - early epiphyseal closure, short stature
androgen sensitive epilepsy, migraine, polycythaemia
bleeding disorders
misuse of AAS
prescribing androgens with no acceptable medical indication
eg.
adult male infertility - causes further suppression of spermatogenesis
erectile dysfunction - increase libido with no change in capacity
adrenopause - little to no benefit with CVS harm
when should ART be prescribed
- testicular or hypothalamic-pituitary disorders with severe androgen deficiency
other conditions involving partial androgen defieicny
partial androgen deficiency
boys experiencing delayed onset of puberty
chronic conditions such as HIV/AIDS to reverse catabolic state
older men and post menopausal women for prevent bone and muscle loss
andropause
menopause for men
androgen levels steadily decline in males as they age
symptoms and signs of andropause
decrease muscle mass and strength
decreased bone mass and osteoporosis
increased central body fat
decreased libido
abuse of AAS
use without legal prescription
increases muscle strength, repairs soft tissue micro injury
recover faster from workout
who benefits more from testosterone abuse
women
designer steroids
aim to maximise anabolic effects of AAS
ie. not converted to oestradiol (less feminising effects) or DHT (less androgenic effects)
not absolutely selective and high doses needed
women staking steroids
hirsutism, decreased breast tissue and mensrtuation,
effects female foetuses during preganancy
men taking steroids
acne
testicual atrophy and reduction in spermatogenesis
short stature in premature epiphyseal closure
mood disturbance, agression and cognition
dylipdameia and hypertension
polycythaemia
hapentitie and hepatic tumours
cognitive effects of AAS
aggression, impulse control and roid rage
CVS effects of AAS
difficult to identify users and unethical to conduct studies
adverse cardiovascular effects
SARMS
selective androgen receptor modulators
stimulate anabolic effects without androgenic effects
developed to treat cancer related muscle less and osteoporosis
