Андрология и генитальная хирургия. 2015; 16: 23-30
Роль эстрогенов в мужском организме. Часть 2. Частная клиническая эндокринология и патофизиология эстрогенов у мужчин
https://doi.org/10.17650/2070-9781-2015-1-23-30Аннотация
Эстрогены традиционно рассматриваются в основном как ключевые половые гормоны, выполняющие важнейшие функции в женском организме, однако их роль в мужском организме оказывается не менее значимой, хотя и остается недостаточно изученной. Тем не менее глубокое понимание мужской физиологии и эндокринологии, необходимое для решения практических задач патогенетической терапии гендерных заболеваний у мужчин, сегодня невозможно как без учета ключевой роли тестостерона, так и без переосмысления роли эстрогенов, до 80 % которых в организме мужчины образуются в результате ароматизации из тестостерона. Таким образом, нарушения синтеза и метаболизма тестостерона у мужчин закономерно приводят к нарушениям синтеза и метаболизма эстрогенов. Это приводит к мысли о том, что без эстрогенов тестостерон не может оказывать весь спектр необходимых мужскому организму физиологических эффектов. Во второй части литературного обзора освещаются именно вопросы частной эндокринологии и патофизиологии эстрогенов у мужчин, которые доказывают данное утверждение. Наиболее важные системы, в регуляции которых роль эстрогенов является первостепенной, представлены у обоих полов центральной нервной и костной системами, и в обзоре подробно освещены возможные патофизиологические механизмы этих эффектов эстрогенов у мужчин. Кроме того, рассмотрены вопросы влияния эстрогенов на состояние грудных желез у мужчин (гинекомастия), а также показано тесное взаимодействие эстрогенов и андрогенов в обеспечении мужской репродуктивной функции и деятельности сердечно-сосудистой системы. Сегодня известно, что патогенез такого распространенного заболевания у мужчин, как доброкачественная гиперплазия предстательной железы (ДГПЖ), тесно связан с патофизиологией как андрогенов, так и эстрогенов, поэтому в обзоре детально рассмотрены механизмы участия эстрогенов в процессах простатической пролиферации, лежащей в основе ДГПЖ. Актуальной проблемой мужского здоровья остается рак предстательной железы, который имеет гормональную природу, поэтому в обзоре представлены современные доступные данные о гормональных механизмах этого заболевания с участием эстрогенов. На основании проведенного анализа литературных данных сделан вывод о том, что эстрогены крайне необходимы для мужского организма, поскольку только в «метаболической связке» с ними тестостерон может эффективно выполнять свои физиологические функции.
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Andrology and Genital Surgery. 2015; 16: 23-30
The role of estrogens at men. Part 2. Private clinical endocrinology and pathophysiology of estrogens at men
https://doi.org/10.17650/2070-9781-2015-1-23-30Abstract
Until now, estrogens are traditionally considered primarily as key hormones that perform critical functions in females, however, their role in males is not less important, although it remains understudied. However, a deep understanding of male physiology and endocrinology, it is imperative to solve practical problems of gender pathogenetic therapy of men,s diseases, is impossible today without taking into account the key role of testosterone in males, and without rethinking the role of estrogens, 80 % of which in males formed as a result of testosterone aromatisation. Thus, the violation of the synthesis and metabolism of testosterone in men naturally lead to disorder of the synthesis and metabolism of estrogen, which allows to express the idea that without estrogens, testosterone alone can not provide the entire range of the male body physiological effects. The second part of the literature review highlights exactly the Private Endocrinology and Pathophysiology of estrogens in men, which prove this assertion. The most important systems in which the regulation of the primary role of estrogens is presented in both sexes are central nervous system and bones, and possible mechanisms of these pathophysiological effects of estrogen in males are reviewed in detail. In addition, issues of influence of estrogens at the state of the male breast (gynecomastia), and shows close interaction of estrogens and androgens in providing function of male reproductive and cardiovascular systems. Today we know that the pathogenesis of such common disease in men as benign prostatic hyperplasia (BPH), is closely associated with the pathophysiology of both androgens and estrogens, so mechanisms of estrogens participation in the processes of prostatic proliferation (BPH) are examined in detail in this review. Urgent problem of men,s health is prostate cancer, which has a hormonal nature, so current data available on the hormonal mechanisms of this disease with estrogens are presents in the review. Based on the analysis of literature data concluded that estrogens are essential for males, because only in the «metabolic conjunction» with them testosterone can effectively carry out their physiological functions in the male body.
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