hormonal treatment

As part of a comprehensive study of hormonal treatment, the level of male and female steroid sex hormones (androgens and estrogens), which are the most significant in the diagnosis of androgen metabolites, are determined, and calculated indicators.

Androgens are steroid sex hormones that are produced in the male body by the testes and in the female by the ovaries. In addition, in both sexes, the cells of the reticular layer of the adrenal cortex can act as hormone producers. The function of androgens includes the formation of secondary sexual characteristics in men. With an excess of the hormone in the female body or a violation of the translation of androgens into estrogens in women, the voice coarsens, the figure becomes masculine, an intensive growth of the body hair is observed (i.e., the process of virilization occurs).

DHEA (dehydroepiandrosterone)

is a multifunctional steroid hormone synthesized primarily by the adrenal glands. It is obtained as a result of the hydroxylation reaction of 17-hydroxypregnenolone (an intermediate product formed from pregnenolone with the participation of the enzyme 17-alpha-hydroxylase, which then converts it to DHEA). A small amount of the hormone is produced by the sex glands (about 5-6%). DHEA is a raw material for the production of sex hormones - androgens (testosterone and androstenedione) and estrogens (estrone and estradiol). Its androgenic properties are 15 times weaker than testosterone. An increase in the excretion of DHEA from the body indicates an excessive synthesis of androgens by the adrenal glands. Most of the DHEA produced is converted to DHEA sulfate.

Androstenedione

is the main androgen secreted by the ovaries. A small amount is also secreted by the adrenal cortex (in both sexes) and the male testes. The hormone has a significantly weaker androgenic effect than testosterone.

Testosterone is the main androgenic steroid hormone.

More than half of the testosterone entering the bloodstream is bound by globulin (SHBG), which is responsible for binding sex steroids. The formation of this bond minimizes the androgenic activity of testosterone by preventing it from entering androgen-sensitive cells. About 43% of testosterone (40% due to albumin, 3% free) remains biologically available. When it enters the tissues, testosterone is converted to its active form - 5-alpha-dihydrotosterone.

Epitestosterone is an isomer of testosterone

That is, a substance with absolutely similar molecular weight and atomic composition, but different in the arrangement of atoms and, accordingly, properties. The androgenic activity of the isomer is low. Its amount is an indicator of the metabolism of testosterone produced in the body (endogenous). The indicator is used to calculate the testosterone / epitestosterone ratio.

Epiandrosterone (isoandrosterone)

is a metabolite of DHEA and an isomer of androsterone, exhibiting 5-7 lower androgenic activity than androsterone. According to the level of epiadndroterone, a conclusion is made about the activity of the enzyme 5 alpha reductase.

With the assistance of estrogens, the following processes take place:

  • - development of the embryo and the formation of its sexual characteristics;
  • - development of female sexual characteristics;
  • - establishing the sexual cycle of women;
  • - development of muscles and glandular epithelium of the uterus;
  • - the formation of the mammary glands;
  • - regulation of sexual behavior (behavior associated with the implementation of sexual needs);
  • - development of the female reproductive cell (ovogenesis);
  • - fertilization and egg implantation.

    • Important information

    The multifunctionality of estrogens is explained by the prevalence of their receptors on the membranes of various types of body cells (blood, nerve, bone, secretory, muscle, connective tissue cells). Therefore, a sharp drop in their level in the female body during menopause is the reason for a change in the work of various systems.

    The action of progesterone is aimed at weakening the readiness of the uterine muscles to contract, i.e. the hormone acts as a "guarantor" of the preservation of pregnancy. In small amounts, it is involved in the ovulation process. Progesterone also inhibits the production of aldosterone by the adrenal cortex, stimulates the process of excretion of sodium in the urine.

    An increase in the concentration of progesterone can cause an increase in body temperature by 0.5-0.7 ° C (i.e., it has a thermogenic effect with an increase in the level). When it enters the liver, progesterone partially loses its activity due to the rapid formation of conjugated (bound) compounds, as a result of which biologically inactive products are formed. Pregnanediol - the main one, accumulates in adipose tissue and is a source of progesterone if the body stops synthesizing it. The ability of pregnandiol to accumulate for a long time in adipose tissue explains the stability of its level in urine when intramuscularly large doses of gesterone (female sex hormone) are injected, although progesterone from the blood quickly disappears. To date, the following scheme has been adopted for the conversion of progesterone in the liver: progesterone → pregnandione → pregnenolone → pregnandiol.

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