Androgens are typically male hormones produced in the adrenal glands, but women carry certain androgens in their bodies too. Progesterone, a recognized “female” hormone responsible for the regulation of the menstrual cycle and maintaining a pregnancy, is actually an androgen itself. Because many autism studies have recently focused on the environmental factors that could cause autism, prenatal care is taken into account as well.
In particular, women who have had problems conceiving or carrying a pregnancy to term or irregularities in their menstrual cycles or their uterine linings are the primary groups under this kind of study. The reason behind it is that these women often have high levels of progesterone which causes a higher rate of miscarriages and uterine health problems. They are prescribed anti-androgen medications to decrease the amount of progesterone in their bloodstreams with the hopes that decreasing the progesterone just enough for them to conceive and carry a pregnancy to term will be beneficial.
The problem is, is that some of those anti-androgen medications, once a woman has started taking them, have a longer half life inside the body. Once a woman discovers she is pregnant, she is slowly withdrawn from the anti-androgen medication. The medication sticks around a little longer than it should or at a level higher than is safe for a pregnancy and a few of them can cross the placenta to the developing embryo. Without enough knowledge about the transmission of drugs to unborn children, the mother and her doctor are taking risks in order to keep a pregnancy going.
Another factor in the middle of this situation is that embryos all start out as girls. At the eighth week of conception, which is usually about the time a woman discovers she is definitely pregnant, the transformation from girl embryo to boy embryo begins. Both the mother and the baby are awash in testosterone, which masculinizes the baby and gives mom a sudden energy boost and a renewed interest in sex. For mom, it tapers off during the next two weeks, but the baby is now a boy. How the two bodies make this decision is another science lesson unto itself.
Now, enter in anti-androgens which the mother has been taking to help her conceive. Guess what? Anti-androgen medicines are anti-boy, which means those testosterone levels needed to make the sex change in utero are being wiped out. By the time mom acknowledges the pregnancy and drops off the medication, the embryo’s little brain is a biochemical war zone. At least, that’s the hypothesis, and it’s a scientifically valid one.
Since there is a possibility for brain and hormone damage in utero, there is also the suggestion that this particular issue might be a reasonable cause for the higher number of boys versus girls diagnosed with autism. It could also explain why girls who stay girls in utero end up with autism as well. Unfortunately, there aren’t going to be any studies any time soon where pregnant mothers subject their unborn children to unknown effects of anti-androgens all in the name of autism research.
However, science can follow mothers with unusually high androgen/progesterone levels, conception problems, and uterine cycle issues who are prescribed these medications. Since the drive toward motherhood affixes itself to 86% of all women in the childbearing years, regardless of their ability to conceive and carry a child to term, that means there are at least 7% of women out there who fall into this category who might be willing to let scientists follow them and their male children after birth until age two to see if it really is a cause of autism. Because they are already in a category that feels they have little choice but to take the anti-androgen medications in order to become moms, they are already aware of the risks and they are putting themselves and their unborn children out there.
It’s not the best way to gather information, but if women are already willingly subjecting themselves to these medications for their current female conditions, then researchers should be allowed to take advantage of the findings and results. At the very least, it would reveal to the pharmaceutical companies that anti-androgens and pregnancy don’t mix, and women would have to find another solution for having a child while maintaining their own health. If it is proven to be a cause of autism, whether or not the mother took anti-androgens and had high progesterone levels all her life, it would be a big breakthrough.
On another but related note, men who are prescribed anti-androgens are essentially chemically castrated males. That is a most unpleasant result of anti-androgens for them, one which has been effective in certain criminal cases. Men who go off these anti-androgen medications for more than a month are able to impregnate a woman, but the medication is still floating around in their sperm. It’s already altered their genetic half of the unborn child; imagine what that does as the embryo grows and the fetus turns into the baby it will be. It’s a dizzying thought, but hopefully women aren’t trying to get pregnant with a chemically castrated man anyway. Thankfully there shouldn’t be too much interest in studying that particular aspect of anti-androgens on baby brain mutation.
While there may be some interest in studying a possible link between anti-androgen medications and autism outside the U.S., there aren’t any current studies with this focus in the U.S. OB/GYN doctors are extremely careful about prescribing such medications to women, especially those who are pregnant or those who are trying to conceive. Furthermore, the national board of medical ethics restrains doctors from intentionally causing harm, following the Hippocratic oath of “do no harm”. It will have to be the results of studies in foreign countries that will lead people to answer the question regarding the use of anti-androgens in pre-pregnancy and early pregnancy and the link to autism.