Im taking spironolactone, and Ive heard that it doesn decrease blood testosterone levels, but only blocks the action of testosterone at tissue receptors. Is this correct?
Spironolactone is an androgen (testosterone) blocker, and it also decreases testosterone levels. Spironolactone inhibits (perhaps partially destroys) the enzyme P- 450(C17), which catalyses early steps in the conversion of cholesterol to androgens, including testosterone. For all you biochemists: specifically, spironolactone inhibits the conversion of pregnenolone == 17- hydroxypregnenolone == DHEA, and also progesterone == 17- hydroxyprogesterone == androstenedione; these latter compounds are precursors of testosterone. The result is that blood levels of testosterone actually decrease. An article which discusses the clinical use of spironolactone is: Spironolactone with physiological female steroids for presurgical therapy of male-to-female transsexualism, available at this site. Of course, spironolactone also does block the action of testosterone — or, if we wish to be more accurate, its metabolite dihydrotestosterone (DHT) — at tissue receptors.
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