Endocrine Drugs and Medications Q 28
Androgens are medically indicated in the management of all of the following except:
A. Hirsutism
B. Hypogonadism
C. Metabolic stimulation in prepubertal boys
D. Bodybuilding
Correct Answer: D. Bodybuilding
Androgens can be dangerous drugs and are medically indicated only in severe conditions, such as female hirsutism or male hypogonadism, and as metabolic stimulators. Anabolic androgenic steroids are used by some bodybuilders to enhance performance. While the cardiovascular implications of supraphysiological androgen levels require further clarification, use is associated with sudden death, left ventricular hypertrophy, thrombo-embolism and cerebro-vascular events.
Option A: Hirsutism is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern — face, chest and back. With hirsutism, extra hair growth often arises from excess male hormones (androgens), primarily testosterone.
Option B: Hypogonadism occurs in 19% of men in their 60s, 28% of men in their 70s, and 49% of men in their 80s. Testosterone is FDA-approved as replacement therapy in men who have low testosterone levels and those with symptoms of hypogonadism. It is essential to distinguish between primary (testicular) and secondary (pituitary-hypothalamic) hypogonadism. Symptoms highly suggestive of hypogonadism include decreased spontaneous erections, decreased nocturnal penile tumescence, decreased libido, decreased beard growth, and shrinking testicles.
Option C: Prepubertal patients are able to increase their plasma concentration of testosterone after an acute stimulation with HCG provided they have some testicular tissue. This test is useful in detecting the presence of intra abdominal testes before puberty.