The Brain Is a Target Site for Androgen Action

Many sites in the brain contain androgen receptors, with the highest density in the hypothalamus, preoptic area, septum, and amygdala. Most of those areas also contain aromatase and many of the androgenic actions in the brain result from the aromatization of androgens to estrogens. The pituitary also has abundant androgen receptors, but no aromatase. The enzyme 5a-reductase is widely distributed in the brain, but its activity is generally higher during the prenatal period than in adults. Sexual dimorphism in the size, number, and arborization of neurons in the preoptic area, amygdala, and superior cervical ganglia has been recently recognized in humans.

Unlike most species, which mate only to produce offspring, in humans, sexual activity and procreation are not tightly linked. Superimposed on the basic reproductive mechanisms dictated by hormones are numerous psycho logical and societal factors. In normal men, no correlation is found between circulating testosterone levels and sexual drive, frequency of intercourse, or sexual fantasies. Similarly, there is no correlation between testosterone levels and impotence or homosexuality. Castration of adult men results in a slow decline in, but not a complete elimination of, sexual interest and activity. See Clinical Focus Box 37.2 for a discussion of the effects of testosterone administration.

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