Androgen Insensitivity Syndrome Medication

Updated: Oct 16, 2017
  • Author: Christian A Koch, MD, PhD, FACP, FACE; Chief Editor: Robert P Hoffman, MD  more...
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Medication

Medication Summary

Hormone replacement therapy (HRT) with estrogens has been the standard of practice for postorchidectomy patients with androgen insensitivity syndrome (AIS). Although most physicians prescribe estrogen alone, some physicians have begun adding progesterone to the regimen, based upon a relatively small amount of data that suggests progesterone may lower the risk of breast cancer, have a role in the ductal development of the breast, or have some role in bone mineral accretion. (These potential benefits are hypothetical.)

Administration of androgens in more masculinized patients with partial androgen insensitivity syndrome (PAIS) has been suggested but remains highly controversial. Because some patients now are assigned male gender and are identifying as males in adulthood, this treatment probably will be described more extensively soon. No data currently describe dosage, administration, benefits, or adverse effects of androgen administration to patients with androgen insensitivity syndrome. Dosage and response likely depends on the severity of the receptor defect. Dihydrotestosterone (DHT) or androgen analogues that cannot be aromatized to estrogen appear to be the treatments of choice.

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Estrogens

Class Summary

These agents are used as hormone replacement for women with androgen insensitivity syndrome who are postgonadectomy to support development and maintenance of secondary sexual characteristics and to prevent osteoporosis.

Conjugated estrogens (Premarin)

Conjugated estrogens represent the average composition of estrogens in pregnant mare urine. They are composed of estrone, equilin, 17-alpha estradiol, equilenin, and 17-alpha dihydroequilenin (in small amount). It is rapidly biotransformed after administration.

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