human health

Chemical Castration: What is it? Purposes, Functioning, Drugs and Effects of A.Griguolo

Generality

Chemical castration is a form of inhibition of gonadal activity, obtained by anti-androgen drugs and characterized by a decrease in libido.

Born as a treatment of hormone-dependent tumors (eg: prostate cancer), chemical castration is today known to most people mainly because, in different countries of the world (not Italy), it is used as a form of punishment for offenses with a background sexual.

Currently, the drugs most used to obtain chemical castration are: anti-gonadotropinics, non-steroidal anti-androgens and agonists of the gonadotropin-releasing hormone.

In addition to the decrease in libido, chemical castration reduces sexual fantasies, sexual arousal capacity as well as a series of unpleasant side effects, both in men and women.

Review of the concept of Castration and Gonads

The term " castration " describes the inhibition of the male or female reproductive system, achieved through the removal of the gonads or the repression of their activity .

It should be remembered that the gonads are the primary sexual organs of the human reproductive system, which have the important task of producing gametes (ie the cells necessary for reproduction) and secreting sex hormones (ie the fundamental substances for the development of sexual characteristics secondary and control of the reproductive system itself).

In humans, the gonads are the testicles ; in women, however, the gonads are the ovaries .

What is chemical castration?

Chemical castration is a form of inhibition of the activity of the gonads, obtained by means of drugs - commonly called anafrodisiac drugs - and characterized by a repression of the libido (or sexual desire ).

Chemical castration can be reversible or irreversible, depending on its purpose.

Except in special cases (which will be discussed in the chapter dedicated to "Uses"), chemical castration is a type of conservative castration, in the sense that it does not involve the removal / elimination of male or female gonads, as is the case in surgical castration .

As a pharmacological inhibitor of gonad activity, chemical castration is one of the potential causes of iatrogenic acquired hypogonadism .

Chemical castration is the pharmacological inhibition of the male or female reproductive system, which is characterized by a decrease in libido and sexual desire.

Chemical Castration and Surgical Castration: the comparison

  • Chemical castration is the inhibition of the gonads of man or woman, achieved through the use of anafrodisiac drugs, which have the effect of reducing libido and sexual desire; surgical castration, on the other hand, is the inhibition of the male or female reproductive system, obtained through the removal of the gonads (orchiectomy, in men, and ovariectomy, in women);
  • Chemical castration can be reversible or irreversible, depending on the purposes; surgical castration, on the other hand, is always irreversible.

uses

Chemical castration is known to most people to be a form of punishment applicable, in some countries of the world (not Italy), to people (men in particular) involved in sexual offenses (eg, rape, pedophilia, etc.). ).

Few, however, know that drugs for the implementation of chemical castration were born with the aim of fighting prostate cancer and that they are part of the preliminary therapeutic plan, used in the process of changing sex from man to woman, as far as concerns transsexual subjects.

Did you know that ...

The first historical use of chemical castration dates back to 1944 .

Chemical Castration as a Penalty for Sexual Background Offenses

Chemical castration as a form of punishment for sex offenders is a practice with reversible effects, adopted in various countries of the world, including: the United States, Australia, India, the United Kingdom, France, the Poland, Estonia, Sweden, Norway, Denmark, Spain, Germany, Russia, Canada, Argentina, Indonesia, the State of Israel and South Korea.

In many of the countries listed above, the relevant criminal legislation provides that the same offender of sexual crimes may require the implementation of chemical castration, in exchange for a discount of sentence .

As readers will have noticed, Italy is not included in the list of countries that apply chemical castration in the criminal sphere, although some political parties, in the past, had advanced their use.

A myth to debunk

For several years now, science has dispelled the myth that testosterone levels above normal are present in pedophiles and rapists.

Medical Use of Chemical Castration

Some drugs used for chemical castration are used in the medical field as a form of treatment of hormone-dependent tumors, primarily prostate cancer (hormone-dependent tumors are those tumors that are affected by the hormonal levels present in the body).

The medical use of chemical castration has been extremely successful and is highly appreciated, because, in fact, when it is effective, it replaces the practice of surgical castration for therapeutic purposes.

Clearly, chemical castration with medical purposes is a practice with completely reversible effects on the sexual sphere.

Chemical Castration in the Change of Sex from Man to Woman

The chemical castration in the change of sex from man to woman is, for logical reasons, the only case in which this practice has irreversible effects .

As a rule, this kind of chemical castration involves a drug administration lasting 6 months.

Mechanism

Produced in large quantities by male gonads but also by female ones, androgens - whose main representative is testosterone - are sex hormones, which, among the various functions covered, also have the task of promoting libido and sexual desire in both sexes.

Chemical castration is based on the use of drugs that, with different mechanisms, interrupt the action of androgens, thus obtaining what was hoped for: the decline in libido and sexual desire.

The idea behind chemical castration and the desire to reduce libido and sexual desire is to cancel the androgynous activity .

drugs

Currently, the most widely used drugs for obtaining chemical castration are anti-gonadotropin drugs, followed immediately by non-steroidal antiandrogenic drugs and gonadotropin-releasing hormone agonists .

Both anti-gonadotropinics and non-steroidal antiandrogens and agonists of the gonadotropin-releasing hormone belong to the macro-category of so - called antiandrogens .

It is important to point out that among the drugs that can be used for chemical castration purposes there are also antipsychotics and antidepressants known as selective serotonin reuptake inhibitors .

Anti-gonadotropin drugs: how do they work?

To understand: the hypothalamic-pituitary-gonadal axis

The secretion of sex hormones by the gonads depends on other hormones, secreted and released into the circulation by two important anatomical structures located inside the skull: the hypothalamus and the pituitary gland .

Specifically, here's what happens:

  • Endocrine gland belonging to the central nervous system, the hypothalamus releases a series of proteic hormones, known as release hormones or RH hormones (RH stands for Relasing Hormones ).

    Among the various release hormones, there is one known as GnRH or gonadotropin-releasing hormone, which is very important for gonad activity;

  • The function of GnRh, in fact, is to stimulate the pituitary gland, another endocrine gland of the central nervous system, to secrete and release into circulation two hormones, called follicle-stimulating hormone (or FSH ) and luteinizing hormone (or LH ), the which have the task of interacting with the gonads and stimulating them to produce sex hormones (NB: the hormones FSH and LH are also known as gonadotropins, which explains the name "gonadotropin-releasing hormone").

Anti-gonadotropin drugs allow chemical castration to be carried out, because they block the pituitary gonadotropins' release, ie the hormones necessary to stimulate the hormonal activity of the gonads.

The anti-gonadotropin drugs, therefore, act on the central nervous system, interrupting upstream a cascade of events that end with the production of androgens, particularly testosterone.

The most commonly used anti-gonadotropin drugs for chemical castration include: medroxyprogesterone and cyproterone acetate .

Non-Steroidal Anti-androgen Drugs: How Do They Work?

Non-steroidal anti-androgen drugs enable chemical castration to be achieved, because they are capable of blocking receptors exploited by androgens, once secreted, in order to fulfill their functions.

In other words, non-steroidal antiandrogenic drugs deprive the androgens of the medium they need, once secreted by the gonads, to act on the organism.

Among the most widely used non-steroidal antiandrogenic drugs in optical chemical castration, flutamide is worth mentioning, as it is also used as an antiandrogen for prostate cancer treatment.

Gonadotropin Release Hormone Agonist Drugs: how do they work?

To understand: regulation of the hypothalamic-pituitary-gonadal axis

The control of sex hormone secretion by the gonads is an example of negative feedback hormone regulation.

In negative feedback hormone adjustments, the initial stimulus receives a stop signal from the final response, which the initial stimulus itself has caused.

The negative feedback hormonal adjustments represent a winning strategy to limit the response following the initial stimulus, without encountering the problem of exaggerated final reactions.

  • Within the hypothalamic-pituitary-gonadal axis, the initial stimulus is the release of GnRh from the hypothalamus, while the final answer is the release of sex hormones from the gonads;
  • Once the sex hormones have been secreted and are circulating, a part of these goes to interact with the hypothalamus, blocking the release of GnRh;
  • With the GnRh block, the element that, through the gonadotropins FSH and LH, stimulates the gonads is missing.

The agonists of the gonadotropin-releasing hormone allow chemical castration to be obtained, because they exploit hormonal regulation with negative feedback to interrupt the production of sex hormones; in fact, thanks to a marked affinity for the GnRh hormone receptor (the one that releases gonadotropins), they induce a high secretion of FSH and LH, which has the final effect of depressing the hormonal release by the gonads.

In other words, these medicines deceive the body, making it believe, through the massive secretion of FSH and LH, that the production of sex hormones must be stopped upstream.

Among the agonist drugs of the most commonly used gonadotropin-releasing hormone for chemical castration, the leuprorelin stands out, since - like flutamide - it is also among the antiandrogenic medicines for prostate cancer treatment.

Administration

Drugs for chemical castration can be administered orally and by subcutaneous injections .

Reversibility: how do you get it?

To cancel the effects of chemical castration, it is sufficient to stop the pharmacological administration .

Clearly, this discourse is not valid for when chemical castration is aimed at changing sex from man to woman.

Effects

Effects of Chemical Castration on Man

In humans, chemical castration has the effect of:

  • Reduce sexual desire (or libido);
  • Reduce sexual fantasies ;
  • Reduce the capacity for sexual arousal .

Effects of Chemical Castration on Women

In women, chemical castration has similar effects to those found in humans, therefore: a decrease in sexual desire, a reduction in sexual fantasies and a reduction in the capacity for sexual excitement.

Side effects

Chemical castration is not without side effects.

Side Effects of Chemical Castration on Man

In humans, the side effects of chemical castration consist of:

  • Increased body fat, especially in the hips and thighs;
  • Breast enlargement ( gynecomastia ), due not only to an increase in body fat in these sites, but also to a development of glandular tissue;
  • Reduction of bone density, followed by a greater risk of osteoporosis, fractures and cardiovascular diseases ;
  • Inability to procreate .

Side effects of chemical castration on women

In women, the side effects of chemical castration consist of:

  • Blockage of the menstrual flow . In this respect, the situation follows what is observed with the advent of menopause;
  • Breast volume reduction ;
  • Reduction of muscle mass ;
  • Decrease in bone density;
  • Reduction of hair on the whole body.

Criticisms

Chemical castration as a form of punishment for crimes with a sexual background has, for years now, been the subject of numerous debates between those who support it and those who criticize it.

In particular, the idea of ​​critics is that chemical castration represents a cruel punishment, because it exercises control over the minds and instincts of the prisoners, and subjects them to unwanted physical changes (remember that, by reducing bone density, chemical castration increases the risk of osteoporosis and cardiovascular diseases).