Gynecomastia & DHT

Michael Scally MD

Doctor of Medicine
10+ Year Member
Cailleux-Bounacer A, Rohmer V, Lahlou N, Lefebvre H, Roger M, Kuhn JM. Impact level of dihydrotestosterone on the hypothalamic-pituitary-leydig cell axis in men. International Journal of Andrology 2009;32(1):57-65.

Summary Dihydrotestosterone (DHT) the physiologically most potent androgen cannot be aromatised into oestrogen. DHT is used as a treatment for idiopathic gynaecomastia. In order to investigate the different sites of action of DHT on the hypothalamic-pituitary-testicular axis, two groups of adult men were studied.

Group I included 10 gonadotropin-releasing hormone (GnRH)-deficient men who were evaluated before and during a pulsatile infusion of GnRH alone for 2 weeks and then in association with DHT given transdermally at doses used in the treatment of gynaecomastia for further two weeks. Luteinizing hormone (LH) pulsatility was assessed at the end of each step of the study. Plasma LH levels were measured every 15 min. Plasma testosterone (T), DHT, oestradiol (E2), free alpha-subunit (FAS) of glycoproteic hormones and LH bioactivity were measured on pooled plasma samples. Group II included 12 healthy men in whom plasma T, DHT and E2 were measured before and then 24, 48 and 72 h after the injection of 5000 IU hCG alone or in combination with either DHT or the pure anti-androgen nilutamide. Two weeks separated each of the 3 hCG testing.

In group I, except for bioactive/immunoreactive (B/I) LH ratio which was unchanged, GnRH treatment induced significant rises (p < 0.01) in all plasma hormone levels, LH pulse amplitude and frequency. During treatment with GnRH+DHT, plasma DHT levels increased up to 16.8 ± 2.5 nm, while plasma hormone levels, B/I LH ratio, LH pulse amplitude and frequency were similar to those obtained with GnRH alone. In group II, the peak of hCG-induced T rise was not modified by either DHT or nilutamide. In contrast, DHT reduced by 50% (p < 0.01) the E2 peak in response to hCG.

These data show that DHT exerts no direct action on the pituitary to retroregulate LH secretion and to modify either B/I LH ratio or FAS secretion. Its reducing effect on LH secretion is likely mediated at the hypothalamic level. DHT does not appear to have a physiological influence on Leydig cells steroidogenesis. Administered at therapeutic doses, DHT directly reduces testicular aromatase activity that combined with its antigonadotropic effect leads to the gain in the symptomatic treatment of gynaecomastia.
 

Attachments

  • Like
Reactions: Old
DR,
Could you explain why people with higher shbg then normal have tendency to have a higher risk of BPH?
Would the explaination that shbg has a higher affiniity for DHT which would be binding it up resulting in one loosing the protective property of DHT to the prostate? DHT and e2 get a bad rap but if they are both bounded by higher SHBG that would mean that they those their bioavailablity which is necessary for postive benefits with in the body. Could you elaborate on this.
 
I am not aswering for the Doc, Of course:D. But adding my thoughts if they are worthy to be included in answer. I kinda see SHBG as the "Themostat" or regulating response for the derivative hormones. Low SHBG = someone who is usually low scenario, HIgher SHBG usually someone not so challenged with TT serum readings. So the BINDING hormone is lowered to free more TT for conversion, right?? Hence the guys with higher SHBG have that higher number because the already have pleanty of homonal derivatives (e2, dht, etc..) Running around doing their work.... Just some thought. Still want the Docs feedback too...:)


DR,
Could you explain why people with higher shbg then normal have tendency to have a higher risk of BPH?
Would the explaination that shbg has a higher affiniity for DHT which would be binding it up resulting in one loosing the protective property of DHT to the prostate? DHT and e2 get a bad rap but if they are both bounded by higher SHBG that would mean that they those their bioavailablity which is necessary for postive benefits with in the body. Could you elaborate on this.
 

Sponsors

Latest posts

Back
Top