Einfluß von Antiandrogenen auf das Hypophysenzwischenhirnsystem

Summary

“Pure” anti-androgens affect the function of the hypothalamo-pituitary system of male individuals in a manner similar to orchidectomy. Such an anti-androgen is cyproterone (6-chloro-17a-hydroxy-1a, 2a-methylene-4, 6-pregnadiene-3, 20-dione). This anti-androgen probably mimics an androgen deficiency at those centres which regulate the secretion of the releasing factors. In consequence, an increased output of gonadotropin releasing factors takes place. This results in an elevated secretion rate of gonadotropic hormones which in turn causes an increased production of androgens.

This is the reason why “pure” anti-androgens are not therapeutic value in clinical practice in the human male. The only anti-androgens which may be useful for this purpose are those which have a gestagenic as well as an anti-androgenic effect, because the gestagen has a partially antigonadotropic effect. Cyproterone acetate is a compound with dual activities of this kind.

The most useful application of the “pure” anti-androgens is as a function test in the diagnosis of cases of male infertility. Such a test could differentiate between the disorders which derive from the hypothalamo-pituitary system and those which originate at peripheral sites.