Abiraretone is a potent inhibitor of CYP17A1, required for the synthesis of gonadal and adrenal androgens
. Combined use of abiraterone with glucocorticoids can effectively lower androstenedione and testosterone metabolites in adult women with 21OHD without any potential side effects including hypertension and hypokalemia.
Thijssen, "Adrenal androgen
secretion and metabolism in postmenopausal women," in Adrenal Androgens
Monitoring of Glucocorticoid Replacement and Adrenal Androgen
Aging accounts for much of the reduction in both ovarian and adrenal androgen
production, but natural menopause does not result in an abrupt decline in testosterone production.
At baseline, women with FSD had significantly decreased levels of testosterone and adrenal androgen
precursors (dehydroepiandrosterone-sulfate, or DHEA-S) but not ovarian androgen precursors (androstenedione), compared with women with normal sexual function.
Prolactin has a direct effect on adrenal androgen
Combined oral contraceptives reduce levels of androgen, especially testosterone, by inhibiting ovarian and adrenal androgen
synthesis and by increasing levels of sex hormone-binding globulin (SHBG).
In males, the testes secrete approximately 95% of testosterone and the rest is made from adrenal androgen
precursors by the peripheral conversion (in liver, skin, and adipose tissue) of androstenedione.
Low-dose glucocorticoids work by suppressing adrenal androgen
(6) Additionally, methyltestosterone prevents suppression of adrenal androgen
synthesis by estrogen treatment alone, thus allowing for enhanced peripheral androgen bioconversion to estrogen.
In addition to increased androgen synthesis in the ovary, there is a significant increase in adrenal androgen
levels seen in many women with PCOS.
(13) Little data exist about the effects of use of exogenous adrenal androgen
alone on BMD.