La dihidrotesterona (DHT) también llamada androstanolona es un metabolismo activo de la testosterona. Es un andrógeno muy potente encargado de entre otras cosas del desarrollo genital masculino. La testosterona secretada por los testiculos se transforma en una pequeña cantidad en esta hormona. Al aplicar DHT estamos aplicando ya directamente la substancia que produce el crecimiento actuando sobre los receptores celulares específicos. Hay casos descritos en la literatura científica que prueban su eficacia en hombres con microphone debido a insensibilidad a dicha hormona o por hipogonadismo en los que los crecimientos son espectaculares. Sin embargo en hombres con niveles de testosterona normales podría provocar crecimiento del pene también debido que dichos receptores no se encuentran totalmente cerrados (esto depende de la genética de cada uno) y por tanto ser efectiva. Sin embargo no esta libre de efectos secundarios pudiendo agravar la alopecia androgénica e incluso el uso prolongado producir crecimiento prostático benigno que aunque sea benigno no es bueno que se produzca. Si tenemos un proceso canceroso activo ya sea conocido o desconocido podría activarlo como muchas otras hormonas. Os pongo un estudio del Journal of Pediatric Endocrinology and Metabolism publicado en Febrero de 2016 que habla sobre el tema.
Topical dihydrotestosterone to treat micropenis secondary to partial androgen insensitivity syndrome (PAIS) before, during, and after puberty - a case series.
Becker D, Wain LM, Chong YH, Gosai SJ, Henderson NK, Milburn J, Stott V, Wheeler BJ.
Abstract
BACKGROUND:
X-linked partial androgen insensitivity syndrome (PAIS) causes under-virilization at all stages of development. In two thirds of males, this results in micropenis. Dihydrotestosterone (DHT) is a potent androgen that is critical for male genital development, which when applied topically, has been shown to increase penile length with micropenis of varying etiologies. We present the first case series using topical DHT gel to treat micropenis in 46,XY males with PAIS, before, during, and after puberty.
METHODS:
Three related 46,XY males with confirmed p.L712F androgen receptor mutations exhibited varying degrees of micropenis post-surgical correction. They were of pre-pubertal, peri-pubertal and adult ages, respectively. Following baseline clinical and laboratory assessments all completed a 4-month course of daily DHT gel 2.5% (androstanolone) topically to penis (0.3 mg/kg body weight), with monitoring for adverse effects. Primary outcome was change in stretched penile length (SPL) following treatment.
RESULTS:
Mixed results were obtained following topical DHT therapy. In the pre- and peri- pubertal patients, SPL changed from 2.5 cm to 3.5 cm (+40%), and 3.5 cm to 5.7 cm (+63%), respectively. In the adult patient with 1 year of prior high-dose weekly testosterone therapy, no additional change in SPL was seen. No adverse effects of topical DHT were reported or observed throughout the 4 months of treatment.
CONCLUSIONS:
Topical DHT treatment appears to be a safe and well-tolerated method of virilising micropenis both prior to and during puberty in children with PAIS. Questions remain about long-term outcomes into adulthood, and efficacy in adults with prior lengthy exposure to high-dose testosterone.