**7. Conclusion**

Pregnancy is a stage of life very important. It is important to recognize and to treat adrenal disease during pregnancy to avoid complications in the mother and fetus.

#### **8. References**


be lowered to 0.75 to 1 mg/day in the second half of pregnancy to decrease maternal side

Pregnancy is a stage of life very important. It is important to recognize and to treat adrenal

Schindler AE. Endocrinology of pregnancy: consequences foe the diagnosis and treatment of

Lindsay JR, Nieman LK. The hypothalamic-pituitary-adrenal axis in pregnancy: Challenges

Guilhaume B, Sanson ML, Billaund L, Bertagna X, Laudat MH, Luton JP. Cushing´s

Vilar L, Freitas MDC, Lima LHC, et al. Cushing's syndrome in pregnancy. An overview.

Carr BR, Parker CR Jr, Madden JE, et al: Maternal plasma adrenocorticotropin and cortisol relationships throughout human pregnancy. Am J Obstet Gynecol. 1981; 139: 416. Lindsay JR, Jonklaas J, Oldfield EH, Nieman LK: Cushing's syndrome during pregnancy:

Barasch E, Sztern M, Spinrad S, Chayen R, Servadio C, Kaufman H, Ben Bassat M, Blum I.

Blanco C, Maqueda E, Rubio JA, Rodriguez A. Cushing's syndrome during pregnancy

Berwaerts J, Verhelst J, Mahler C, Abs R. Cushing's syndrome in pregnancy treated by

Casson IF, Davis JC, Jeffreys RV, Silas JH, Williams J, Belchetz PE. Successful management

Ambrosi B, Barbetta L, Morricone L. Diagnosis and management of Addison´s disease

Stechova K, Bartaskova D, Mrstinova M, Cerny M, Snajderova M, Cinek O, et al. Pregnancy

Gradden C, Lawrence D, Doyle PM, et al: Uses of error: Addison's disease in pregnancy.

Sarathi V, Lila AR, Bandgar TR, et al. Pheochromocytoma and pregnancy: a rare but

Hashimoto Thyroiditis. Exp Clin Endocrinol Diab. 2004; 112:333-7.

Syndrome and pregnancy: etiologies and prognosis in twenty-two patients. Eur J

personal experience and review of the literature. J Clin Endocrinol Metab 90: 3077,

Pregnancy and Cushing's syndrome: example of endocrine interaction. Isr J Med

secondary to adrenal adenoma: metyrapone treatment and laparoscopic

ketoconazole: case report and review of the literature. Gynecol Endocrinol. 1999; 13:

of Cushing's disease during pregnancy by transsphenoidal adenectomy. Clin

in a woman suffering from type 1 diabetes associated with Addison disease and

pregnancy disorders. J Steroid Biochem Mol Bio. 2005; 97:386-8..

in disease detection and treatment. Endocr Rev. 2005; 26: 775-99.

Aron DC, Schnall AM, Sheeler LR. Am J Obstet Gynecol. 1990 ; 162(1):244-52.

Buescher, MA. Cushing's syndrome in pregnancy. Endocrinologist 1996; 6:357.

adrenalectomy. J Endocrinol Invest. 2006;29(2):164-7.

during pregnancy. J Endocrinol Invest. 2003; 26698-702.

dangerous combination. Endocr Pract. 2010; 16: 300.

Endocrinol (Oxf). 1987; 27(4):423-8.

Lancet. 2001; 357: 1197.

Arq Bras Endocrinol Metab. 2007; 51:1293.

disease during pregnancy to avoid complications in the mother and fetus.

effects while avoiding fetal virilisation (Pang et al, 1990).

**7. Conclusion** 

**8. References** 

Med. 1992; 1:83-9.

Sci. 1988; 24(2):101-4.

2005.

175.


**Part 3** 

**Effects of Androgens** 


**Part 3** 

**Effects of Androgens** 

60 Basic and Clinical Endocrinology Up-to-Date

Krone N, Wachter I, Stafanidou M, Roscher AA, Schwarz HP. Mothers with congenital

Coleman MA, Honour JW. Reduced maternal dexamethasone dosage for the prenatal

Pang A, Pollack MS, Marshall RN, Immken LD. Prenatal treatment of congenital adrenal hyperplasia due to 21-hydroxylase deficiency. N Engl J Med. 1990; 322: 111.

treatment of congenital adrenal hyperplasia. BJOG. 2004; 111: 176.

Clin Endocrinol. 2001; 55: 523.

adrenal hyperplasia and their children: outcome of pregnancy, birth and childhood.

**4** 

*Chile* 

**Cardiovascular Effects of Androgens** 

*Universidad de Chile, Facultad de Medicina, Instituto de Ciencias Biomédicas* 

Androgens are the male sex hormones responsible for development of the male reproductive system. Testosterone is the main androgen, however, other circulating androgens also exist; these are dehydroepiandrosterone, androstenedione and androstenediol. In some tissues, testosterone can be converted to dihydrotestosterone by action of 5α-reductase. Testosterone is also found in females, but at much lower levels than males; it can be converted into estradiol by the enzyme aromatase. Testosterone has 19 carbon atoms, and is produced from cholesterol, mainly by Leydig cells in the testes. Androgens are responsible for primary and secondary sexual characters in men, and also for the development of skeletal muscle mass and strength, erythropoiesis and bone density,

The divergent effects that androgens have between sexes can be explained by differences in concentration, metabolism and receptor expressions. Male sex hormones are also known to fluctuate along the day and throughout life. Prior to puberty, testosterone level is usually low in males. However, after puberty, testosterone level increases and reaches its peak

Testosterone and its derivatives are well known for their androgenic properties and anabolic effects. These hormones direct the differentiation of organs and tissues towards the adoption of male phenotypes. Thus far, the effects of androgens on the cardiovascular system remain incompletely understood. Some studies point to increased cardiovascular risk associated with a high circulating androgen level, related to responses that lead to changes in blood pressure, ion channel activity and cardiomyocyte hypertrophy. However, other studies support a long-term cardio-protective role for these steroid hormones. Despite these differences, increasing clinical evidence supports consideration for transient use of

Androgens exert most their effects through the direct binding to specific intracellular receptors acting as transcriptional activators (Beato, 1989). Intracellular androgen receptors have been described in neonatal and adult cardiomyocytes (Hickson et al., 1984; Marsh et al., 1998). Genomic responses to testosterone are mediated through the intracellular androgen receptor, which is a 110-kDa protein with domains for androgen binding, nuclear localization, DNA binding, and transactivation (TD). The conserved domain structure has three major functional regions: an NH-terminal transactivation domain, a centrally located

around the age of 20-25 in men. As aging occurs, testosterone levels decline.

testosterone derivatives to improve cardiovascular function.

**2. Mechanism of androgen action** 

**1. Introduction** 

amongst other functions.

Carlos Wilson, Rodrigo Maass and Manuel Estrada
