Chemical Castration in Medicine

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Chemical Castration in Medicine

Drugs that have an anti-androgenic effect are used to bring about chemical castration.

Testosterone is the male hormone that is responsible for maintaining sexual drive, aggression and function of the testes in males. Drugs that reduce the levels or antagonize the actions of testosterone result in chemical or medical castration. These drugs are said to have anti-androgenic properties (since testosterone is an androgen).

Chemical castration is normally used in:

Treatment of Prostate Cancer: Prostate cancer cells normally grow faster in the presence of testosterone. Medical castration reduces testosterone levels, thus keeping the cancerous cells in check. However, the hormonal therapy does not cure the cancer but only shrinks the cancer to some extent. It is used for advanced cases where surgery cannot produce a cure.

Drugs used to bring about chemical castration include:

► Medroxyprogesterone acetate (MPA): MPA is a long-acting injectable progesterone (a female hormone) that is used as a contraceptive in women. In men, it acts as an anti-androgen. The Depo Provera preparation has to be administered every 3 months.

► Cyproterone acetate: Cyproterone acetate is an anti-androgen that is used to bring about chemical castration.

► Luteinizing hormone-releasing hormone (LHRH) analogs: These include drugs like leuprolide, goserelin, triptorelin and histrelin. They bring about an initial release in testosterone, followed by a fall in the levels, with final effects similar to castration. The medications have to be repeated on a regular interval. The side effects of the initial rise can be prevented by administering drugs called anti-androgens like flutamide, bicalutamide, and nilutamide.

► Luteinizing hormone-releasing hormone (LHRH) antagonists: These drugs bring about a fall in testosterone levels without causing the initial rise. The LHRH antagonist, degarelix, is used in the treatment of advanced prostate cancer as a monthly injection.

► Other drugs like estrogen and ketoconazole may also be used in cases where the above drugs are ineffective. In addition, newer drugs are also being evaluated in the treatment of advanced prostate cancer.

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I am 80 years old. I have had since 2010 4 TURP operations resulting in a further 3 bladder neck operations. My prostate [BPH] is strangling my urethra again. If I live that long I can look forward to many such operations being needed. Multi visits to the toilet over night, dribble, delays and week flow. Is testosterone the reason for the growth of my Prostate, if so can I seek chemical or even surgical castration. Surely without testosterone the Prostate cannot grow. I think I would like to start a course of chemical castration treatment even if only to ascertain it reducing the Benign Prostate. It may not be permanent? David

In the USA, I doubt if a doctor would agree unless you probably knew the doctor personally. However, I am a healthy male who decided to chemically castrate myself 7 years ago. I am happy with my decision. I would physically castrate but I love my large testicles. However, I personally a male should physically be castrated at the latest at age 40 and preferably between 30 and 35. He should be chemically castrated in the teen years and continue until physical castration.

Very interesting. A part from the criminals there are plenty of married or single men, who contemplate chemical castration to lower theirs libidos and there fore theirs sexual frustrations. I wonder if there are differences for theirs effectiveness and also theirs side effects, between the different drugs used for chemical castration. Which one would be more cost effective? Is it possible that after many years that a man may never produce testosterone again when he stops chemical castration? If so how long can he use it before he reaches the point of no return? Is there a difference in effects and side effects between chemical and physical castration? If everything goes well and the man is comfortable with his chemical castration, how long should a man wait before considering physical castration? Would doctors agree to to remove healthy testicles following an extended time on chemical castration? I'd appreciate some answers. Thank

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