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lizhou zhu

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Jul 27, 2010, 2:27:17 AM7/27/10

Effects on sexual development
Testosterone. Note the major difference -- the 4,5 double-bond on the
A (leftmost) ring.

DHT is produced in different amounts in both males and females, and is
responsible for the formation of secondary sex characteristics in men.
DHT has 3 times greater affinity for androgen receptors than
testosterone and has 15-30 times greater affifinty than adrenal
androgens.[1]

An example illustrating the significance of DHT for the development of
secondary sex characteristics is the congenital 5-α-reductase (5-AR)
deficiency which can result in pseudohermaphroditism. This condition
results in underdeveloped male genitalia and prostate. These
individuals are often raised as girls due to their lack of conspicuous
male genitalia. In the onset of puberty, although their DHT levels
remain very low, their testosterone levels elevate normally. Their
musculature develops like that of other adults. After puberty, men
with this condition have a large deficiency of pubic and body hair,
and no incidence of male pattern baldness.[2]

Unlike other androgens such as testosterone, DHT cannot be converted
by the enzyme aromatase to estradiol. Therefore, it is frequently used
in research settings to distinguish between effects of testosterone
caused by binding to the androgen receptor and those caused by
testosterone's conversion to estradiol and subsequent binding to
estrogen receptors.[3]
[edit] Pathology

DHT is the primary contributing factor in male pattern baldness.[4][5]
However, female hair loss is more complex, and DHT is only one of
several possible causes.[6] Women with increased levels of DHT may
develop certain androgynous male secondary sex characteristics,
including a deepened voice and facial hair. DHT plays a role in the
development and exacerbation of benign prostatic hyperplasia, as well
as prostate cancer, by enlarging the prostate gland.[7] Prostate
growth and differentiation are highly dependent on sex steroid
hormones, particularly DHT.[8]
[edit] Treatment

The drugs belonging to the 5α-reductase inhibitors group are commonly
used for the treatment of those conditions. Dutasteride is approved
for the treatment of BPH and is prescribed off-label for the treatment
of MPB, whereas finasteride is approved for both conditions.
Dutasteride is three times more potent than finasteride in inhibiting
the Type II enzyme and 100 times more potent than finasteride in
inhibiting the Type I form of the DHT-producing enzyme.[9] Currently,
DHT hormone replacement therapy does not exist as a treatment for DHT
androgen deficiency.
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