Analogs and Antagonists of Male Sex Hormones

The steroid testosterone is the major circulating sex hormone in males and is the prototype for the androgens, the anabolic agents, and androgen antagonists. Endogenous androgens are biosynthesized from cholesterol; the majority of the circulating androgens are produced in the testes under the stimulation of luteinizing hormone (LH). The reduction of testosterone to dihydrotestosterone is necessary for androgenic actions of testosterone in many androgen target tissues such as the prostate; the oxidation of testosterone by the enzyme aromatase produces estradiol. The androgenic actions of testosterone and dihydrotestosterone are due to their binding to the androgen receptor, followed by nuclear localization, dimerization of the receptor complex, and binding to specific DNA sequences. This binding of the homodimer to the androgen response element leads to gene expression, stimulation, or repression of new mRNA synthesis, and subsequent protein biosynthesis. The synthetic androgens and anabolics were prepared to impart oral activity to the androgen molecule, to separate the androgenic effects of testosterone from its anabolic effects, and to improve on its biological activities. Novel nonsteroidal androgens, termed selective androgen receptor modulators, were developed to impart agonist activity in selective tissues. Drug preparations are used for the treatment of various androgen-deficient diseases and for the therapy of diseases characterized by muscle wasting and protein catabolism. Androgen antagonists include antiandrogens, which block interactions of androgens with the androgen receptor, and inhibitors of androgen biosynthesis and metabolism. Such compounds have therapeutic potential in the treatment of acne, virilization in women, hyperplasia and neoplasia of the prostate, and baldness. Keywords: androgens; testosterone; dihydrotestosterone; anabolics; antiandrogens; selective androgen receptor modulators; 5α-reductase inhibitors