The Extragenital Effects of Hormones in Women and in Men – a Comparison

It is a great misconception to believe that the gynecologist – in competition with the urologist – plans to take over the male patients by studying the male endocrine system. There are other reasons why the intensive study of the male endocrine system is supported by gynecology. The opinion that ovarian steroids serve not only for reproduction but also have numerous extragenital functions, which are very important for the diagnosis and therapy of disorders that do not have anything to do with gynecology, has long prevailed in gynecology. Just as certain disorders in women can only be identified and in­ terpreted properly, if the extragenital dimensions of the sexual steroids are taken into account, various complaints and even clear clinical symptoms can be found in men that are not initially associated with testicular function, but which nonetheless are physiologically connected. For gynecologists who have been studying the hormonal situation of men more intensively in recent years, it is not so much a case compet­ ing with the urologists and to treat every man with DHEA or testosterone replacement therapy, but rather an issue of widening the understanding for a development which has clearly im­ proved the pathological understanding of the female body in gynecology. In the English-speaking world, gender specificity is a concept that is taken into account in the presentation of many disorders. In the German-speak­ ing literature, it is still not really taken into consideration. Three examples will serve to explain the differences and the parallels in the physiological and pathophysiological processes that are gender specific and which play a role in the lipid metabo­ lism, bone metabolism and hormone­ related tumors. These three examples should illustrate pars pro toto the funda­ mental gender-specific processes in our body, and how they are partly control­ led by the sexual steroids.