'Toxic Masculinity': impact on COVID19 survival
Finasteride. It opposes androgens. It seems to help.
Trump takes it. For his hair (counters androgenic alopecia aka male pattern baldness). Many others take it for prostatic hypertrophy. And those who were on it when infected with SARS-CoV-2, seemed to have milder symptoms when compared to other men off the drug.
So what really are the impacts of gonadal steroids on COVID manifestation? Finasteride blocks the androgen receptor, but endogenous androgen steroids are still floating through the male body free to interact at other areas - such as in skin, bone, brain, and gonads - and be enzymatically aromatized into estrogens. Yes, testosterone is turned into estradiol. Which is why body builders surreptiously take aromatase inhibitors to boost their T levels. Unbeknownst to them though, estradiol is needed to sustain testes as well as bones. Probably the brain, too. Without estradiol, they can atrophy.
But still, males ARE disproportionately affected by severe symptoms when infected with SARS-CoV2. Is it the Y chromosome? Perhaps. But males also have more of other co factors found to be detrimental, such as, smoking and larger biomass.
More recently, a small study showed better outcomes in men treated with twice daily progesterone injections (big dose). Men do have this steroid endogenously, too, especially as a neurosteroid (anesthetic). But their natural levels never compare to those seen in pregnant women. And what is the immune function like in women who must ‘tolerate’ an immunologic foreign creature embedded and growing within them for months on end? Obviously very suppressed.
The other ‘female’ steroid group, estrogens, are actually implicated in the opposite of immune tolerance - autoimmunity. Diseases such as lupus SLE, are concentrated in the fairer sex. Hmmm… severe covid is hypothesized to be due to cytokine storm, i.e. an exaggerated inflammatory response to viral infection. So maybe, males with severe disease have high estradiol levels relative to their progesterone levels, and instead are suffering from ‘toxic feminity’ ?
Guess it’s all in the perspective.
REFERENCES
Progesterone as a neuroactive neurosteroid, with special reference to the effect of progesterone on myelination
http://www.hormonebalance.org/images/documents/Baulieu%2000%20Prog%20neuroprotective%20Steroids.pdf
Kragie L, Turner SD, Patten CJ, Crespi CL, Stresser DM. 2002 Assessing pregnancy risks of azole antifungals using a high throughput aromatase inhibition assay. Endocrine Research 28 (3): 129-140. https://www.researchgate.net/profile/Laura-Kragie/research
Kragie L. 2002 Aromatase in primate pregnancy: a review. Endocrine Research 28 (3): 121-128. https://www.researchgate.net/profile/Laura-Kragie/research
Many future stories will remain exclusive to the paid subscribers to BioMedWorks Newsletter PREMIUM. So I would be grateful if you do go on to upgrade for just $5 a month or $50 a year.
Y chromosome loss may be linked to men's increased risk of severe COVID-19
December 14, 2022
https://medicalxpress.com/news/2022-12-chromosome-loss-linked-men-severe.html
Bożena Bruhn-Olszewska et al, Loss of Y in leukocytes as a risk factor for critical COVID-19 in men, Genome Medicine (2022). DOI: 10.1186/s13073-022-01144-5