• Acne (especially for prepubertal males and females)
• Bladder irritability
• Changes in alkaline phosphatase
• Changes in libido
• Chronic priapism
• Increases in aspartate aminotransferase (AST, SGOT), serum bilirubin, and alanine aminotransferase (ALT, SGPT)
• Inhibition of testicular function
• Retention of serum electrolytes (calcium, phosphate, potassium and sodium chloride)
• Testicular atrophy and oligospermia
Neural injections of Bromodeoxyuridine (BrdU) were applied to males of both groups to test for neurogenesis . Analysis showed that testosterone and dihydrotestosterone regulated adult hippocampal neurogenesis (AHN). Adult hippocampal neurogenesis was regulated through the androgen receptor in the wild-type male rats, but not in the TMF male rats. To further test the role of activated androgen receptors on AHN, flutamide , an antiandrogen drug that competes with testosterone and dihydrotestosterone for androgen receptors , and dihydrotestosterone were administered to normal male rats. Dihydrotestosterone increased the number of BrdU cells, while flutamide inhibited these cells.
In addition to the endogenous steroid metabolites highlighted in Figure 15-1 , there are also a variety of drugs with androgenic activity. These include anabolic steroids, such as nonaromatizable oxandrolone , that bind and activate AR (albeit with lower affinity than testosterone [ 43 ]) and a class of drugs under extensive development referred to as selective AR modulators (SARMs), which demonstrate tissue-specific agonist or antagonist activities with respect to AR transactivation [ 44 ]. These orally active nonsteroidal, nonaromatizable SARMS are being developed to target androgen action in bone, muscle, and fat and to influence libido but to not exacerbate prostate growth, hirsutism, and acne. Several have been identified with beneficial effects on bone mass [ 45–47 ] and provide a new alternative to androgen replacement therapy.