androgendeprivation

Androgendeprivation refers to the deliberate reduction or suppression of androgens, principally testosterone, in the body. It is used in clinical settings to treat conditions driven by androgen signaling, most notably prostate cancer, where lowering circulating testosterone can slow tumor growth. The goal is to achieve castration-level testosterone, commonly defined as less than 50 ng/dL, though targets may vary by condition and guidelines.

Approaches to androgendeprivation include surgical orchiectomy, which removes the testes as the primary source of testosterone; pharmacologic suppression with gonadotropin-releasing hormone (GnRH) agonists or antagonists that reduce testicular testosterone production; and antiandrogens that block androgen receptors to prevent signaling. Some regimens combine methods, such as GnRH agents with antiandrogens in initial therapy. Historically, estrogens have also been used to suppress testosterone, though they are less common today due to side effects.

Indications are most prominent in advanced or metastatic prostate cancer, where androgen deprivation can delay disease progression and alleviate symptoms. It may be used in locally advanced disease and, in some cases, for other androgen-dependent conditions or as part of gender-affirming care for transgender women in conjunction with other therapies.

Effects and risks include reduced tumor activity and symptom relief, but come with side effects such as hot flashes, decreased libido, erectile dysfunction, fatigue, loss of bone mineral density leading to osteoporosis, metabolic changes, anemia, mood or cognitive effects, and potential cardiovascular risk. Long-term therapy requires regular monitoring.

Monitoring typically involves serum testosterone measurements to confirm suppression, PSA testing in prostate cancer, bone density assessments, and routine metabolic panels to track side effects and overall health.