Testosterone - a male sex hormone related to androgens.Present in the blood of men and women.It begins to produce more in the period of embryonic development of the fetus male testes and adrenal cortex, causing the correct formation of the genital organs of male type.
A small amount of the hormone is produced during the period of childhood and puberty, a sharp increase in testosterone secretion.Girls normally develop ovarian hormone and adrenal cortex cells begins only at puberty.
Testosterone in men
Biological effects of testosterone in men is to acquire the body of masculinity - a complex of physiological, psychological and behavioral characteristics that distinguish man from woman.These are the signs that appear in adolescence and continuing through later life:
- proper development of male sex organs
- formation of sperm in the testes - spermatogenesis
- hair growth on the face, chest, abdomen, pubic hair growth of hands and feet
- bone growth in length and width, increase bone density
- muscle growth
- larynx changes and roughness in voice
- activation of the sebaceous and sweat glands
addition, testosterone in the male body is involved in the regulation of potassium metabolism, calcium,phosphorus, salt and water to enhance anabolism (increased formation of) a protein in the body, the formation of libido and potency, as well as causes psychological features of sexual behavior.
In women, testosterone is produced in much smaller numbers than men.The action of a hormone in women:
- regulation in combination with the female hormones oocyte maturation and corpus luteum, the maintenance of pregnancy
- sex appeal
- formation of breast
- regulation of fat and protein metabolism - in women, unlikemen, testosterone is on the contrary, leads to an increased breakdown of proteins in the body
- participate in the growth of skeletal muscle and bone in puberty
normal level of testosterone in the blood
total testosterone in human blood is composed of free, biologically active fraction (2%) and hormone-related protein (98%).Standards hormone content in the table may differ slightly depending on the facility performing the study.
|20 - 50 years||more than 50 years||20 - 50 years|| Postmenopause |
(50 - 55 years)
|General (nmol / l)||11 - 33||not below 11||0.31 - 3.78||0.42 -4.51||may be exceeded standards 3-4raza|
|Free (pg / ml)||8.8 -42.5||6.5 - 30||0 - 4.2||0.1 - 1.7|
Abnormalities - low testosterone in men
According to statistics, about 13% of men and 50 years old have hidden or obvious deficiency of testosterone in the body.Causes of testosterone reduction can be divided into:
Risk factors that reduce the hormone in the blood
- aging - a natural reason for the decline in testosterone levels in the body, after 40 years of hormone content is reduced by 1.5% per year
- somatic diseases - coronary heart disease,atherosclerosis, prostatitis.It is proved that obesity in men testosterone production is reduced 2.4 times, diabetes - by 2.1 times, in arterial hypertension - 1.8 times
- alcoholism, drug use and smoking
- constant stress, lack of physical activity, unhealthy dietincluding fasting and vegetarianism.
diseases manifesting symptoms of hypogonadism
- congenital defect of the enzyme 5-alpha reductase - an inability to convert testosterone into the biologically active form of dihydrotestosterone, resulting in testosterone in the body is normal, but in the cell it can not act as unable to be contacted with the receptorson the cells.Boy with such a defect is born with androgyny or severe hypoplasia of the penis (micropenis)
- genetic diseases with primary hypogonadism (hypoplasia of the testes) - Shereshevskii syndrome -. Turner, Klinefelter, etc.
- trauma and testicular tumors
- early castration
- panhypopituitarism (failure of the pituitary hormones) as a result of brain tumors, pituitary adenomas
- pituitary adenoma with increased secretion of prolactin
- adrenal insufficiency
- chronic administration of glucocorticoids (prednisone, dexamethasone) and cytotoxic drugs (cyclophosphamide) with rheumatologic, hematologic diseases
Symptoms of lowtestosterone in men
If testosterone synthesis breach due to genetic causes in male fetus occurs hypoplasia of the external genitalia or the formation of the female type.Develops false or true hermaphroditism - signs of male and female genitalia simultaneously.
In case of reduction of testosterone at puberty in boys observed the lack of development of the scrotum and penis, slowing growth, the formation of the female type figure (wide hips, narrow shoulders, bloating mammary glands), no increase in muscle mass, "breaking up" the voices and secondarysexual characteristics - body hair breasts, pubic area and armpits.The development of a teenager instead of a natural acquisition of masculinity symptoms predominate infantile features.
In adulthood suggest a decrease in testosterone levels to help these symptoms:
- depression, mood instability, general depression and lack of thirst for life, sleep disorders
- acquisition female traits - tearfulness, resentment, irritability
- decreased physicalendurance, total detraining organism
- erectile dysfunction, decreased libido
- violation of sperm production and infertility, reduced volume of semen during ejaculation, eunuchoid
- atrophy of muscle tissue
- decrease in calcium saturation of bone tissue, leading to osteoporosis and frequent fractures
- losshair on arms, legs and chest
- reduced growth oxen Facial
- obesity on the "pear" type or the female type - the deposition of adipose tissue on the thighs and buttocks, the waist
- gynecomastia - an increase in mammary glands
- sweating,"tides", similar to the female menopause symptoms at
increased testosterone in men
not always elevated levels of hormone indicative of pathology.In some men there is excess testosterone standards in blood without any - any disease with early puberty.
Causes of pathological increase of testosterone in men:
- congenital adrenal hyperplasia (congenital adrenal hyperplasia - VDKN)
- 's disease and Cushing's syndrome - Cushing's caused by pituitary adenoma (gonadotropinomoy, kortikotropinomy) and tumors of the adrenal cortex (corticosteroma)
- testicular tumors
- excessive use of anabolic steroids to build muscle
boys and young men disorders that cause high levels of the hormone, manifested early "breaking" the voice, precocious puberty, an increase in the penis with the absence of scrotal growth, accelerated bone growth, irregular rapid growth.bone growth areas quickly closed early, so teenagers are stunted.When adrenogenital syndrome boys from two - three - years of age are the outward signs of adult men - hair growth on the face, chest and pubic involuntary erections, increased muscle development.
high level of testosterone in adult men is accompanied by changes of psycho-emotional areas - increased aggression, frequent changes of mood, impulsivity.Characterized by high physical endurance and strength, increased sexual desire, prolonged erection, looseness in the relationship with the opposite sex, frequent sexual intercourse with different partners.Men with high testosterone has the right look - developed musculature without a trace of excess fat, excessive body hair of limbs, chest and abdomen, while hair loss on the head and the formation of baldness.
Reduced testosterone in
women Despite the fact that testosterone is typically "male" hormone, its role and importance in the female body for the proper operation of the supporting - motor, endocrine and nervous systems.The lack of the hormone gives discomfort and impact on the appearance of women.
Causes In most cases, the lack of education of the hormone in the body due to innocuous causes, the removal of which leads to the normalization and regression analysis of clinical manifestations.These include:
- diet with restriction of animal fats and carbohydrates, lack of vitamins in the diet
- alcoholism and smoking
- obesity, sedentary lifestyle, lack of physical exercise
- long absence of sexual activity
- prolonged use of estrogen -gestagensoderzhaschih contraceptives
But sometimes androgen deficiency is caused by diseases that require the appointment of drugs:
- diseases of the uterus (endometriosis)
- surgery to remove the ovaries (surgical menopause)
- pituitary adenoma, adrenal insufficiency
For thesediseases and conditions of the female organism, and in which there is a decrease in testosterone levels, is characterized by:
- lethargy, apathy, decreased or absent sexual desire, discomfort during intercourse, lack of orgasm, insomnia, distraction, low mood.
- skin becomes dry, thinning and sagging, decreases the amount of hair all over the body.
- characterized by muscle weakness, fatigue and decreased endurance.
- postmenopausal women with osteoporosis, diabetes, obesity with the deposition of fat on the shoulders, hips and buttocks - often reduced levels of this hormone
Increased testosterone in women
Women are much more common in higher than low testosterone levels in the blood.
- pregnancy.In pregnant women, testosterone is increased due to the functioning of the placenta, and its role in the body of the pregnant woman is reduced to the regulation of metabolic processes.Permissible to consider an increase in the concentration of the hormone in the blood of pregnant up to three - to four - fold, especially if a woman bears a boy.But too much can lead to an increase in the threat of interruption in so-called critical time - 4 - 8 and 14 - 20 weeks of pregnancy.
- genetic predisposition
In addition to these natural conditions of the body, increasing androgen concentrations observed at:
- hyperfunction of the adrenal cortex - the most common cause
- virilizuyuschey ovarian cancer, polycystic ovary syndrome (PCOS)
- breast cancer
- congenital adrenal hyperplasia (congenital adrenal hyperplasia)
- pituitary adenoma
symptoms of high testosterone in women
in congenital overproduction of testosterone by the adrenal cortex in the female fetus shows signs of virilization - the formation of the external genitalia of male type with the right structureuterus and appendages.Girl born with an enlarged clitoris, increased high crotch and labia, which may be mistaken for the birth of a male child with a penis and testicles underdevelopment.If the treatment of congenital syndrome started in time on a girl develops normally.
Girls and women testosterone overproduction manifested clinically aged 6 - 8 years of age and is characterized by a low voice, the rapid growth of the jump, excessive growth of hair on the chest and abdomen the middle line on the legs and pubic area, the formation of male pattern shape - narrow hips and broadshoulders.By the age of ten, the child's growth is stopped due to the rapid closing of growth zones in the bones, and is formed by short stature.
Constant exceeding the normal concentration of hormone in the adult female body leads to the acquisition of signs of male appearance.
- Characteristic hirsutism - increased hair growth on the arms and legs, appear coarse black hair on the breast, on the face of possible growth of whiskers and beard, while the hair on the head fall heavily, perhaps even the appearance of baldness foci.
- suffers psycho-emotional sphere - the woman is more "rigid", rough, aggressive, hot-tempered.
- dramatically increases libido.
- There have purulent acne on the face and neck, increasing muscle mass.
- Menstrual disorders - Rare menstruation scarce, anovulatory cycles, uterine bleeding, absence of menstruation and the inability to get pregnant.
- Women with high testosterone content marked miscarriage.
- Perhaps the development of obesity or, conversely, excessive weight loss and anorexia.
Which examination is necessary?
case of suspected irregularities to the patient is assigned to a study of venous blood hormone content in it.If indeed there is a rise or fall in testosterone, the doctor prescribes further examination.This is necessary in order to accurately determine the cause of this condition, and to determine whether the violation of testosterone in the body naturally (menopause, "male" menopause, starvation) or caused by some - the disease that requires active treatment policy.If you suspect a recent show:
- determining blood levels of adrenocorticotropic hormone (ACTH), growth hormone (GH), prolactin, and female sex hormones (estrogens), thyroid hormones to assess the overall hormonal balance in the body.
- ultrasound of the testicles and prostate
- ultrasound of the breast, uterus and ovaries
- ultrasound of internal organs and the adrenal
- MRI of the brain and the pituitary gland, adrenal
- sugar level in the blood and cholesterol
for early diagnosis adrenogenital syndromehospital all newborns are screened - a survey of five birth defects, one of which is this syndrome.To do this, the child's blood is taken from the heels.In case of questionable analysis of the child's parents will be invited to the medical - genetic consultation to further clarify the diagnosis.Often there are false positive results with this screening.
Preparing to study
Testosterone is determined in venous blood.The result will be ready in a day.The cost analysis is in the range 200 - 1000 rubles in different laboratories.
Analysis of hormone levels shall study on an empty stomach.In two - three days before the study is necessary to cancel any hormones that affect the result, in consultation with the attending physician.12 hours should be deleted alcohol intake and smoking, limit physical activities and sports.Women are encouraged to study for 6 - 7 days of the menstrual cycle.
Need Is in the treatment of deviations from the norm?
If the patient is detected in the analysis of variance for testosterone, the doctor must find out what is the cause, the disease, which leads to hormonal imbalance.