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Steroidal antiandrogens (SAAs) are a type of antiandrogen that are structurally related to the steroid hormones. They act by blocking the effects of androgens like testosterone and dihydrotestosterone (DHT) in the body, which they do by preventing androgens from binding to the androgen receptor.

Mechanism of action

SAAs work by competing with androgens for binding to the androgen receptor. By occupying the receptor, they prevent androgens from binding to it and exerting their biological effects. Some SAAs, like cyproterone acetate and spironolactone, also have additional actions. For instance, they can suppress androgen production by the adrenal glands and ovaries.

Uses

SAAs are used in the treatment of various androgen-dependent conditions. These include prostate cancer, hirsutism (excessive hair growth in women), acne, seborrhea (oily skin), androgenic alopecia (male-pattern hair loss), and certain types of transgender hormone therapy.

Examples

Examples of SAAs include cyproterone acetate, spironolactone, medroxyprogesterone acetate, and megestrol acetate. These drugs are all also progestogens, and have other actions in addition to their antiandrogen activity.

Side effects

Side effects of SAAs can include gynecomastia (breast development in males), sexual dysfunction, and depression. Some SAAs, like spironolactone, can also cause hyperkalemia (high potassium levels), which can be dangerous.

See also

• Nonsteroidal antiandrogen
• Androgen deprivation therapy
• Antiandrogen

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