Clinical advantages derived from the administration of exogenous androgens, such as testosterone or its derivatives, to address states of hormonal insufficiency or specific clinical indications. This therapeutic approach aims to restore physiological androgen levels, which often decline with age or due to underlying medical conditions. Key outcomes include improvements in body composition, bone mineral density, and aspects of quality of life. The goal is to mitigate the adverse effects associated with hypogonadism in both men and women, carefully weighing the potential benefits against known risks.
Origin
The concept originates from endocrinology and the identification of androgens, like testosterone, as crucial sex hormones responsible for development and maintenance of male characteristics, and also vital in female physiology. The therapeutic application evolved from early 20th-century studies on glandular extracts to modern, evidence-based hormone replacement protocols. Clinical practice now utilizes synthetic and bioidentical formulations for precision dosing and personalized treatment plans.
Mechanism
Androgens exert their effects primarily by binding to the intracellular androgen receptor (AR), a ligand-activated transcription factor found in target tissues throughout the body, including muscle, bone, and the central nervous system. This receptor-ligand complex translocates to the nucleus, modulating gene expression to promote anabolic effects like protein synthesis and erythropoiesis. Additionally, some benefits stem from the local aromatization of testosterone into estradiol, which contributes significantly to bone health and cognitive function.
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