Bone mass in androgen-insensitivity syndrome: Response to hormonal replacement therapy

  title={Bone mass in androgen-insensitivity syndrome: Response to hormonal replacement therapy},
  author={Manuel Mu{\~n}oz-Torres and Esteban J{\'o}dar and Miguel {\'A}ngel Yanes Quesada and Fern{\'a}ndo Escobar-Jim{\'e}nez},
  journal={Calcified Tissue International},
The response of bone mass to long-term treatment with estrogen and progesterone in patients with complete androgen-insensitivity syndrome (AIS) is unknown. We report a 17-year-old female patient (karyotype 46 X, Y) with AIS studied during a 4-year period. Bone mineral density (BMD) measured by dual X-ray absorptiometry in lumbar spine and proximal femur was sharply reduced at the initial visit, and remained unchanged during long-term follow-up on hormone replacement therapy with estrogens and… 

Adequacy of androgen replacement influences bone density response to testosterone in androgen-deficient men.

A positive relationship between adequacy of testosterone replacement and BMD in men with overt organic AD is demonstrated, and the BMD of well-treated AD men approximates that of age-matched non-AD controls.

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The maintenance of testes may represent a strategy to improve bone health in women with CAIS, but a strict follow-up to monitor the cancer risk is mandatory mainly from their 20s onwards.

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Data suggest an important role for androgens in normal male growth and bone density not replaced by estrogens in patients with AIS with mutations in the androgen receptor (AR) gene.

Reversing sex steroid deficiency and optimizing skeletal development in the adolescent with gonadal failure.

Replacing sex steroids according to a biphasic pattern (starting at low doses and ending at high-normal doses) seems the safest approach to reach targeted height and to optimize bone development.

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On the whole, bone health represents a main clinical issue for the management of persons with disorders of sex differentiation, and well designed longitudinal studies should be developed to improve their bone health and well-being.

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These limited data indicate that adolescents with CAIS have bone mass deficit, and further studies are needed to understand the extent of BMD abnormalities and the effect of gonadectomy, especially early in childhood, and to establish the optimal HRT regimen for bone accrual.

Androgens and osteoporosis

  • P. Ebeling
  • Medicine, Biology
    Current opinion in endocrinology, diabetes, and obesity
  • 2010
Randomized, placebo-controlled trials of testosterone therapy in men with age-related declines in testosterone and osteoporosis are needed, and should carefully evaluate potential risks, as well as its efficacy in reducing fractures and other health benefits.

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The declining sex steroid levels in the elderly may adversely affect the preservation of skeletal integrity and indicates that aromatisation of testosterone to estradiol is an important mediator of bone metabolism inThe elderly.



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Assessment of the effect of gonadal steroid on bone mineral density in adolescent males with osteopenia due to hypogonadism compared with those in patients without this replacement therapy.

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It is suggested that the timing of puberty is an important determinant of peak bone density in men, and men in whom puberty was delayed may be at increased risk for osteoporotic fractures when they are older.

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Of the hormonal variables explaining bone mineral density in antrogenized women, only dehydroepiandrosterone sulfate had a significant negative correlation and women with hyperantrogenic amenorrhea seem to be spared from osteopenia.

Osteoporosis in Men with Idiopathic Hypogonadotropic Hypogonadism

Bone density was determined in 23 hypogonadal men with isolated gonadotropin-releasing hormone deficiency and osteopenia was equally severe in men with immature and mature bone ages, suggesting that abnormal bone development plays an important role in the osteopenia of men with idiopathic hypog onadotropic hypogOnadism.

The effect of cross-gender hormonal treatment on bone metabolism in male-to-female transsexuals.

The effect of cross‐gender hormonal treatment on bone metabolism in male‐to‐female transsexuals

The results indicate that antiandrogen and estrogen treatment in male‐to‐female transsexuals may suppress bone turnover and is not associated with bone loss.

Androgen insensitivity as a cause of infertility in otherwise normal men.

The low amount of androgens receptor and the combination of high serum gonadotropins and plasma testosterone production rates suggest that the defective spermatogenesis in these infertile men was the consequence of androgen insensitivity.

Identification of androgen receptors in normal human osteoblast-like cells.

It is concluded that both androgens and estrogens act directly on human bone cells through their respective receptor-mediated mechanisms.

Androgen resistance and deficiency have different effects on the growing skeleton of the rat

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