What is chemical castration?

The so-called chemical castration method is actually to introduce estrogen (female hormone), anti-androgen (male testicular decondensation agent) or sex hormone stimulating growth hormone decondensation agent into the male's body, making him lose sexual desire and no longer get an erection, so that the male-specific physical reaction disappears. Chemical castration, also known as chemical castration, is a drug control method that injects drugs to reduce male hormones and suppress sexual desire. Unlike surgical castration, which removes the testicles or ovaries, chemical castration will not actually castrate the person, nor will it make him sterile.

Anti-androgen therapy

The male hormone antagonists used in anti-androgen applications fuse with androgen protein kinases, competing to inhibit DHT and fully exert their effects. There are two types of steroid hormones and non-steroid hormones. The former includes chlorpromazine acetate (CPA) and megestrol, and the latter includes flutamide (formerly known as slow tumor regression), Casodex, Nilutamide, etc. The most commonly used one is flutamide, with a dosage of 250 mg, 3 times a day. The key side effects are breast masculinization, nausea, vomiting, etc., and rare cases include low libido and abnormal liver function.

During the entire application process, liver function tests should be reviewed regularly. In 1945, some people underwent orchiectomy and bilateral nephrectomy to eliminate the testicles and kidneys androgens at the same time, which is the so-called complete androgen blockade to treat prostate cancer. However, it was not adopted due to the high incidence of symptoms and poor efficacy. In 1983, Labrie et al. simultaneously used LHRHA and anti-androgen drugs to treat prostate cancer, using both drug castration and anti-androgen drugs to block androgens produced by the kidneys, and the efficacy was significantly better than a single endocrine drug. [1]

side effect

The side effects of medical castration are similar to those of surgical castration. Because the use of LHRHA stimulates the pituitary gland to release progesterone (LH) in advance, the testicles produce a large amount of testosterone, which further aggravates prostate symptoms. For patients with existing spinal metastasis, there is a possibility of spinal cord compression and even death. Therefore, for patients with existing metastatic diseases, especially prostate cancer patients with cervical spondylosis and spinal metastasis, the use of LHRHA treatment should be started one week in advance or anti-androgen drugs should be used at the same time to relieve or prevent the aggravation of prostate symptoms. Medical castration has this disadvantage, and the drug price is relatively expensive and requires long-term medication, so its application is limited. In China, this technique is only used when the patient refuses surgical castration and the economy can afford it.

In the international arena, our country has just begun to implement chemical castration on pedophile criminals to reduce their sexual desire.