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Gynecomastia in older men is estimated to be present in 24–65 percent of men between the ages of 50 and 80. Estimates on asymptomatic gynecomastia is about up to 70% in men aged 50 to 69 years. [26] [50] The prevalence of gynecomastia in men may have increased in recent years, but the epidemiology of the disorder is not fully understood. [40]
5α-Reductase inhibitors have minimal side effects and are well tolerated in both men and women. [219] [220] In men, the most common side effect is sexual dysfunction (0.9–15.8% incidence), which may include decreased libido, erectile dysfunction, and reduced ejaculate.
In general, androgens are considered "male sex hormones", since they have masculinizing effects, while estrogens and progestogens are considered "female sex hormones" although all types are present in each sex at different levels. [6] Sex hormones include: Progestogens. Pregnenolone → Progesterone → Allopregnanedione → Allopregnanolone
Aromatase excess syndrome (AES or AEXS) is a rarely diagnosed genetic and endocrine syndrome which is characterized by an overexpression of aromatase, the enzyme responsible for the biosynthesis of the estrogen sex hormones from the androgens, in turn resulting in excessive levels of circulating estrogens and, accordingly, symptoms of hyperestrogenism.
[19] [20] Aromatization of testosterone into the estrogen estradiol appears to be partially responsible for the effects of testosterone on sexual desire and function in men. [ 21 ] [ 22 ] [ 23 ] 5α-Reduction of testosterone into the more potent androgen dihydrotestosterone (DHT) may have a small contribution to the effects of testosterone on ...
In women, estrogens can additionally cause vaginal bleeding, vaginal discharge, and anovulation, whereas in men, estrogens can additionally cause gynecomastia (male breast development), feminization, demasculinization, sexual dysfunction (reduced libido and erectile dysfunction), hypogonadism, testicular atrophy, and infertility.
The effect of estradiol (and estrogens in general) upon male reproduction is complex. Estradiol is produced by action of aromatase mainly in the Leydig cells of the mammalian testis, but also by some germ cells and the Sertoli cells of immature mammals. [14] It functions to prevent apoptosis of male sperm cells. [15]
In females, breasts are a manifestation of higher levels of estrogen; estrogen also widens the pelvis and increases the amount of body fat in hips, thighs, buttocks, and breasts. [1] [2] Estrogen also induces growth of the uterus, proliferation of the endometrium, and menstruation. [1] Female secondary sex characteristics include: