Cited by 65Growth Hormone and Insulin-like Growth FactorsPituitary Gland Disorders and TreatmentsHormonal and reproductive studies

Sex steroids and the GH axis: implications for the management of hypopituitarism

Birzniece, Vita, Ho, Ken K.Y.·2017·Best Practice & Research Clinical Endocrinology & Metabolism

Abstract

Growth hormone (GH) regulates somatic growth, substrate metabolism and body composition. Sex hormones exert profound effect on the secretion and action of GH. Estrogens stimulate the secretion of GH, but inhibit the action of GH on the liver, an effect that occurs when administered orally. Estrogens suppress GH receptor signaling by stimulating the expression proteins that inhibit cytokine receptor signaling. This effect of estrogens is avoided when physiological doses of estrogens are administered via a non-oral route. Estrogen-like compounds, such as selective estrogen receptor modulators, possess dual properties of inhibiting the secretion as well as the action of GH. In contrast, androgens stimulate GH secretion, driving IGF-1 production. In the periphery, androgens enhance the action of GH. The differential effects of estrogens and androgens influence the dose of GH replacement in patients with hypopituitarism on concomitant treatment with sex steroids. Where possible, a non-oral route of estrogen replacement is recommended for optimizing cost-benefit of GH replacement in women with GH deficiency. Adequate androgen replacement in conjunction with GH replacement is required to achieve the full anabolic effect in men with hypopituitarism.

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Crossref · 10.1016/j.beem.2017.03.003

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Authors
Birzniece, V., & Ho, K. K. Y.
Affiliations
Garvan Institute of Medical Research (AU)
Corresponding author
Birzniece, Vita
Venue
Best Practice & Research Clinical Endocrinology & Metabolism
Publisher
Elsevier BV
Published
2017-02
Volume
31
Issue
1
Pages
59-69
ISSN
1521-690X (ISSN-L)
OpenAlex
W2595738792
Cited by
65
References
83
Citations by year
2026: 4 · 2025: 2 · 2024: 14 · 2023: 6 · 2022: 11 · 2021: 10 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 1
FWCI
0.72
Type
journal article
Language
en
Open access
closed
Locations
  • Best Practice & Research Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
sex steroids, growth hormone, hypopituitarism, growth hormone deficiency, estrogen, androgens, selective estrogen receptor modulators, insulin-like growth factor I, growth hormone replacement therapy, androgen replacement
MeSH terms
Androgens, Body Composition, Estrogens, Female, Humans, Hypopituitarism, Insulin-Like Growth Factor I, Male, Gonadal Steroid Hormones, Estrogen Replacement Therapy, Human Growth Hormone, Hormone Replacement Therapy, Selective Estrogen Receptor Modulators

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