Androgen in women is not a major hormone, but it cannot exist without it. Without it, women are not women in the true sense. The growth of individual female external hair, pubic hair, and armpit hair is entirely due to androgens, and the development of external genitalia such as the clitoris, labia, and mons pubis in the vulva is inseparable from the involvement of androgens.
Androgens also have a very important role. After a woman becomes pregnant, during the embryonic period before the reproductive tract develops to a critical stage, it causes the brain and reproductive tract to differentiate toward males.
As we all know, the sex of a fetus is determined by chromosomes. However, if there are no other factors, the basic development of the fetus’s brain and reproductive tract will always develop in the direction of women. This phenomenon is like a computer The same as the default program, when you open the computer, this default window always pops up. Without the presence of androgens, even in male individuals, the reproductive tract will develop into a female form, and mature individuals will exhibit female sexual behavior. This is feminization of male fetuses.
The medical manual lists the normal reference range of female plasma testosterone (T) (radioimmunoassay): 100-200ng/L in late adolescence; 200-800ng/L in adults; 80 after menopause ~350ng/L.
However, due to different testing methods, the reference values of each hospital may be somewhat different from the data in the medical manual.
In fact, several sex hormones (progesterone, androgen and estrogen) are called steroid hormones. Their chemical structures are almost the same. The only difference is the number of carbon atoms. For example, progesterone has 21 carbon atoms, androgens have 19 carbon atoms, and estrogens have 18 carbon atoms. That is to say, androgen only needs to remove one carbon atom to become estrogen. In the female body, a large part of estrogen is indeed converted from androgen, so androgen is actually the precursor of estrogen (bottom) things).
If a woman’s body can no longer produce androgen, then the level of estrogen will certainly not be very high. However, androgens do not naturally convert into estrogens! Just like tofu is made from soy milk, but soy milk does not naturally turn into tofu. Some kind of substance, such as gypsum or salt brine, must be added to transform it. The same is true for the conversion of androgens. It requires an enzyme called aromatase. The existence of these enzymes enables the androgens present in women\’s bodies to be continuously aromatized into estrogen, ensuring that women have an estrogen-based body. The host\’s hormonal environment.
Aromatase is present in the female brain and ovariesThese enzymes are very important, just like the key factors that make soy milk turn into tofu. Because the male testicles do not have this enzyme, the androgens they produce are still androgens; and the female ovaries have this enzyme, so they can aromatize androgens into estrogens. Therefore, the difference between men and women is not so much due to estrogen and androgen. It\’s different, it\’s better to say it\’s because the enzymes are different.
Every woman has aromatase in her body, but the only difference is the quantity and activity. Once the quantity and activity of aromatase are insufficient, there may be excessive androgen content and excessive activity. Strong, low estrogen state. This state is a pathology called hyperandrogenism.
Patients with hyperandrogenism will have problems with follicular development because androgens can cause follicle atresia. When a large amount of androgen contained in the follicular fluid cannot be aromatized into estrogen, causing the amount of estrogen to increase rapidly, the follicle will be atretic during development. If the follicles that are blocked are not one but a group—more than 10 in total on the left and right ovaries—then you have polycystic ovary syndrome.
Among infertile people, the proportion of polycystic ovary syndrome is increasing. Because it originates from chronic hyperandrogenism, it is formed unknowingly. People almost never pay attention to the changes in these two gonadotropins (LH and FSH). You must know that these two gonadotropins directly affect the ratio of androgens and estrogen in the ovaries.
LH acts on theca cells to produce androgens; FSH acts on granulosa cells to produce estrogen. Another important function of FSH is that it induces aromatase activity and enhances aromatase activity. When the activity of aromatase is enhanced, androgens can be aromatized into estrogen more effectively, thereby increasing the estrogen content in the follicular fluid. Therefore, it is necessary to maintain a reasonable ratio of the two hormones LH and FSH, and create an optimal follicular development environment through a series of complex and coordinated interactions between them.
The reasonable ratio of these two hormones should be 1.5:1. If the ratio of LH to FSH is higher than 3:1, doctors will highly suspect that you have polycystic ovary syndrome.
For hyperandrogenism, the antiandrogen preferred by doctors is Diane-35, whose scientific name is cyproterone acetate (CPA), which is a contraceptive. Take one tablet daily for 21 days starting from the 5th day of menstruation. Diane-35 has a unique anti-androgen effect. It competitively seizes androgen receptors in cells, reduces androgen activity, and increases the clearance rate of androgen metabolites through the liver. It has a strong anti-gonadotropic effect. Reduce LH secretion and inhibit ovarian androgen secretion.
If patients with long-term anovulatory hyperandrogenism can insist on taking Diane-35, they can not only adjust the menstrual cycle, prevent intimal hyperplasia and cancer, but also effectively control the level of androgens in the blood; for those without For patients who require fertility, it can effectively prevent pregnancy and significantly improve virilization and other problems. It is a treatment method that serves multiple purposes.
Among patients with hyperandrogenism, 75%Most androgens come from the ovaries, and the remaining 25% come from subcutaneous tissue and adrenal glands. A small amount is produced by adrenal gland and ovarian tumors. Therefore, depending on the source of androgens, other drugs besides Diane-35 can also be used, such as dexamethasone or prednisone, Septelumab acetate, spironolactone, etc. There are many drugs for treatment. Sisters should not take them indiscriminately. They must follow the doctor\’s advice and use the right drugs
This article is provided by Baidu Reading and is excerpted from \”Pregnancy Can Be Simple\” Author: Fei Fei\’s mother