What is Androgen Ablation?

Androgen ablation is a medical treatment to block the production of male hormones. Also known as androgen deprivation or suppression, this treatment is most commonly used in the management of prostate cancer, with the goal of controlling tumor size by limiting hormone production. An endocrinologist is a central person in the process of developing a treatment plan where androgen ablation is involved, and the patient may work with other specialists like oncologists as well.

One simple method for eliminating male hormones is the removal of the gonads. This technique is used when people want to irreversibly block production of androgens, hormones associated with male sexual development. Another option is to take female sex hormones with the goal of blocking the production and activity of androgens. Patients can also take antiandrogens, drugs that specifically target male hormone production to stop these hormones from being made or used by the body.

In cancer treatment, androgen ablation can limit the growth of a prostate cancer and allow a patient to live with the cancer for an extended period, or shrink the tumor to make it easier to manage surgically or with the use of treatments like radiation. This treatment is also used in patients who do not want to produce male hormones, for a variety of reasons. For example, antiandrogens can be used in the treatment of transgender children to block the progress of puberty until the children grow up and can seek medical transition, if it is desired.

Patients undergoing androgen ablation can experience a variety of symptoms. Generally, feminization doesn't happen unless patients are taking medications with that as a specific desired effect. The distribution of weight on the patient's body may change, but physical changes associated with puberty, such as chest hair and a deeper voice, will not go away with androgen ablation therapy. If the therapy is discontinued, the man's body will revert to its previous state.

Some nations allow people to opt for androgen ablation as a form of treatment for sex offenses, particularly child molestation. The prisoner may be offered a choice of “chemical castration,” as it is called, or jail time. These patients may be given permanent or temporary treatments, depending on policy and the nature of the offense. This practice is controversial, as some people believe that it is not an adequate response to the crime or that it will not necessarily be effective in all criminals, raising the risk of recidivism. There are also ethical concerns.