Effect
of androgens on the brain and other organs during development and
aging.
Swerdloff RS,
Wang C, Hines M, Gorski R.
Harbor-UCLA Medical
Center, Torrance 90502.
Androgens have
important biological effects on accessory sexual organs and have a
broad range of effects on metabolic processes. Male hormones have
been shown to have important organizational and activational effects
on morphological, behavioral, and cognitive activity in experimental
animals. Sexual dimorphic effects on cognitive and behavioral activities
in animals have been linked to androgens during the fetal period.
The effects of testosterone on sexual drive are well established in
humans, although the threshold for such activity appears to be lower
than that required for many of the other and organic effects of testosterone.
There are suggestive
data to link fetal androgen levels to cognitive and behavioral activities
in children and adults, but the behavioral activities may be modified
by social and other learning processes. Androgen levels fall in older
men at a time when impaired sexual function, osteopenia, and decreased
muscle mass can be identified. The relative importance of androgen
deficiency in these disorders requires further study, since they are
likely to be multifactorial in pathogenesis. Replacement therapy of
elderly men who have lowered testosterone levels has been proposed
to decrease bone and muscle loss as well as to improve sexual function
and general well-being.
Careful studies
will be required to assess the risk-to-reward ratio of such treatment,
since theoretical adverse effects on prostate and cardiovascular diseases
may occur. While conservation in management has its virtues, we should
be reminded that several decades ago estrogen replacement of postmenopausal
women was highly criticized until data supporting its favorable therapeutic
ratio were demonstrated.
Articles
75
