GONADAL HORMONES –

INHIBITORS (UROLOGIC)
BY DR. LEONARDO A. TORRES, FPSECP, FPSP, FPSA, RBA-ABI
FORMER CHAIR , REVIEWER AND FACULTY
UPH-DJGTMU, PLM, AUP, CEU
GONADAL HORMONES - INHIBITORS
 ANDROGENS
 DIHYDROTESTOSTERONE - POTENT
 DIHYDROEPIANDROSTERONE (DHEA) – ADRENAL
 ANDROGENIC / ANABOLIC
 TESTOSTERONE IM/TOP. P, E, U, C 1 : 1
 METHYLTESTOSTERONE PO/SL 1 : 1
 FLUOXYMESTERONE PO 1:2
 OXYMETHOLONE 1:3
 OXANDROLONE 1 : 3 - 1:13
 NANDROLONE 1 : 2.5 -1: 4
REVIEW OF PHYSIO. - ANDROGENS
• SERTOLI CELLS: Mullerian duct inhibitory factors:
• ( INHIBIN AND ACTIVIN ) – FSH-r
• TESTOSTERONE: ADULT MEN = 8 MG. OD
• PLASMA LEVELS IN MALE = 0.6 mcg./dL.
• Plasma level in women = 0.03 mcg./dL.
• DHEA / S : ( - ) ATHEROSCLEROSIS / SLE
• GROWTH-PROMOTING EFFECTS: SEXUAL, LEAN
• BODY MASS, HAIR GROWTH, SEBUM, EPO,
• ( - ) HDL ( + ) LDL
• MOA: INTRACELLULAR PROTEIN S. DNA-RNA
CLINICAL USES OF ANDROGEN
• HRT – HYPOGONADISM CAUTION: HPN, Polycythemia
• GYNE.: Breast engorgement, Endometriosis, Post-
• menopausal, Breast tumors
• Protein-Anabolic agents: Trauma, Surgery, Debilitating d.
• Anemia: Refractory replaced by EPO-recombinant
• Osteoporosis: replaced by Bisphosphonates
• Growth Stimulators: delayed puberty X acc. Epi. Closure
• Anabolic steroid in Sports: X (Strength, Performance,Aggre)
• Aging: ( + ) lean body mass, Ht, ( - ) bone resorption
• ADR/S: Hirsutism, Acne, Na Retention, Hepatic d., BPH,
• Gynecomastia, Azoospermia, Erythrocytosis, HepatoCA.!
GONADAL HORMONES-INHIBITORS
 ANTI-ANDROGENS
 KETOCONAZOLE - STEROID-INHIBITOR (ANTI-GLUCOCORTICOID)
 FINASTERIDE - 5-A-REDUCTASE-INHIBITOR- Hypospadias in male fetus- Terato.
 DUTASTERIDE - “ LONG t ½ + TAMSULOSIN ( COMBINED)- BPH
 CYPROTERONE Ac. - RECEPTOR-INHIBITOR (OCP) – NOT RELIABLE
 ABIRATERONE – NEW ANTI-17-HYDROXYLASE - RPrCA
 FLUTAMIDE - COMPE.ANDROGEN ANTAGONIST
 BICALUTAMIDE + GnRH ( - ) TUMOR FLARE
 NILUTAMIDE - SURGICAL CASTRATION
 SPIRONOLACTONE - ANTI-ALDOSTERONE / (-) 17-A-HYDROXYLASE
 MALE CONTRACEPTION
 GOSSYPOL - Hypokalemia ( MAJOR ADR )
 GnRH-ANTAGONIST + TESTOSTERONE
 IM TESTOS. ENANTHATE + L-NORGESTREL PO OD = AZOOSPERMIA