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 Once a woman discovers she is pregnant, she is slowly withdrawn from the anti-androgen medication.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.
Some serious concerns:
1. Can breastfeeding cause autism?
2. Can cell phones cause autism?
3. Can stem cell therapy cure autism?
This is an area I have been particularly interested in. There is also an association recently found among people with “higher functioning” Autism and Androgyny. Findings are relevant both in structure of the brain and physical characteristics that can be measured, such as 2d/4d digit ratio.
Interestingly, Simon Baron Cohen found a low digit ratio among individuals with Autistic Disorder in his research in the early 2000’s, but did not see as strong an association among individuals with Asperger’s Syndrome.
The recent research on Androgyny actually shows a slightly higher digit ratio among males than one would expect in the general population.
The females had a lower digit ratio than what would be expected among females in the general population; however, the digit ratio was similar to the males in the study with “high functioning” Autism.
It is also worth noting than many individuals who could be diagnosed under Gillberg Criteria, in the past, with Hyperlexic and Pragmatic Language Impairment are currently diagnosed with PDDNOS or Autistic Disorder, in part, because of a language development delay that is considered part of the Gillberg Criteria for Asperger’s Syndrome, but excluded from ICD 10 and DSM IV criteria.
Per research, led by Andrew Whitehouse, in Australia, it appears that low digit ratio may be associated with higher levels of Prenatal Testosterone and language development delay/impairment in general population samples.
Whitehouse, is currently in process of leading a 5 year study aimed at studying these issues specific to Autism. The UC Davis Mind Institute also started a similar 5 year study in the fall of 2011, at about the same time that the 5 year study Whitehouse is leading, started.
There are many other potential environmental toxin variables that may also impact prenatal development per the developing hormonal environment, brain development, and associated language development.
Most interesting, to me, in the research that Whitehouse did with the general population, higher levels of prenatal testosterone measured by umbilical cord was conversely, a protective factor for language in females.
I don’t like to stereotype, but Scientists who are women, overall, in most every field do exhibit androgynous physical characteristics. While it is not uncommon that the males in this field have androgynous characteristics, as well, above what one might see in other fields that require good motor skills abilities associated with Low Digit Ratio in males and females.
There is a correlation between lower IQ among male individuals that have very low testosterone levels and a correlation among males who have very high testosterone levels. So, it appears that Androgyny, in general, may be correlated with higher IQ, but I don’t think any studies have pursued that area, in the US, as it is not a “Politically Correct” issue to study in some circles.
Finally though, the question remains, why is there a disconnect in emotion and language among those individuals on the spectrum who are extremely verbal, but not in a “figurative” way per expressing words associated with emotion?
Eighty-five percent of individuals on the spectrum are currently assessed with Alexithymia, in a criteria that has not historically required the difficulties in social-emotional reciprocity associated with that condition.
With strict adherence to DSM5 criteria for diagnosis, per the last two decades, if one could go back and do that with the new mandatory criterion element of deficit in social-emotional reciprocity, Alexithymia, at this time, might be considered the core issue of Autism per Kanner’s original research on “Disturbances of Affective Contact” and Hans Asperger and his research on “Autistic Psychopathy”.
Gillberg Criteria for Asperger’s, along with his current analysis of Autism, and Lorna Wing, who brought “light” to the term “Asperger Syndrome’, both acknowledge that the core impairment of Autism is in “social instinct” that is also described as a core issue of deficit among other associated conditions, which Gillberg describes as “The Autisms”, including “Psychopathy”.
Most interestingly, it is the “Anti-Social Personality” behavior associated with “psychopathy,” as described as “potentially negated” in Asperger’s Syndrome, by Gillberg, because of Motor Development deficit.
There is also an association of the prenatal environment correlated with Androgens that influence motor development, so perhaps the issue with prenatal testosterone , either high or low, and other hormonal issues in the prenatal environment, impacted by environmental issues ranging from toxins to drugs to familial/cultural stress influence Asperger’s and what has traditionally been described as Autistic Disorder, in significantly different ways.
Individuals with Autistic Disorder often do not have the type of Cognitive empathy associated with Psychopathy, but they are also often oblivious to people around them as related to as mechanical aids.
Conversely, studies done on individuals with Asperger’s Syndrome experience higher than usual levels of emotional contagion, to the point where some avoid all types of emotional experience or perhaps repress emotions, when they cannot escape an emotional conflicted environment, leading to symptoms of Alexithymia.
Emotion is core to the memory process, and whether an individual can connect the dots of emotional language and emotion, it is still a vital element of the learning process and memory. It stands to reason that those individuals with very high retention of memory, in that subgroup of the spectrum, would also have a higher experience of emotion with or without the connection of language.
I personally suspect it is the repression of emotion from that higher than usual experience of emotional contagion that may be core to some cases of higher functioning Autism. Point being, look at the pictures of many children with Asperger’s syndrome and see the before and after face of emotional “Affect”, per the young child who is gleaming with emotional “Affect” to almost complete loss of “Affect” later in young adulthood.
This is also not uncommon in other conditions associated with Alexithymia such as BPD, Schizophrenia, PTSD, and ADHD. Additionally, there is an associated lack of focus and deficit in executive function when emotion is repressed and short term memory is impacted by that lack of bonding element, for memory and life experience.
Sorry, that was quite long, but this is one of my favorite areas of interest. So is the association of Schizotypal behavior and “higher functioning” Autism, alone with Psychosis, which is in the ICD10 for Asperger’s in some cases correlated with young adults, but not in DSM criteria.
Higher sensitivity to Dopamine and emotional contagion are associated, so it stands to reason that patterns that others do not notice in life, and perception will be enhanced.
I thought I would add that here, instead of “flooding” your other topic as this does seem to be related to that topic as well, per prenatal hormonal levels, experience of emotional contagion, and generally speaking, higher than average sensitivity to dopamine.
This is not necessarily the case for individuals who have the co-morbid, soon to be separately diagnosed condition of ADHD, without the motor skills difficulties.
Testosterone, Good Motor Skills, and ADHD is correlated with ODD and Psychopathy, according to Gillberg.
In studies done on Personality Disorders among individuals with Asperger’s and Autistic Disorder, ASPD is almost non-existent among people with Asperger’s, but Schizotypal Personality Disorder is one of the higher reported Personality Disorders along with Schizoid Personality Disorder, with the loss of “Affect” often associated with that Personality Disorder. Question being though, is it an issue of repression of “extreme” emotional contagion, or is it neurodevelopmental in origin.
I tend to think for DSMIV Asperger’s syndrome, it is more of an environmental than neurodevelopmental issue, while with Autistic Disorder it may be more of an inherent issue, per the potential different impact of the prenatal hormonal environment.
Of course, the hormonal factor is only one of hundreds, maybe thousands of other factors working alone or in synergy with other factors, underlying the behaviorally observed impairments listed in the Diagnostic manuals, labled as Autism Spectrum Disorder(s)
That was about 1300 words. I will try not to flood your site like this again, but it so, so interesting to me. I have most of this information referenced on my Blog, by the way, generated in part by the “special interest” minds working together at “Wrong Planet”. 🙂
I am Arjan Kuipers, a chiropractic neurologist and have been a practicing clinician for over two decades. I am the founder and chief innovator of Brain Building Company and ADHD & Autism Training, which provides easy to use training programs for parents and professionals that are developed to facilitate a positive lasting change in children with ADHD and autism. My clinical “TOBE” program has been used with hundreds of children with a diagnosis of ADHD and or autism. To date, I had helped over 10,000 people improve their situations with his knowledge of the interaction between the postural system and the brain.
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Mia madre mi dava lo stesso identico consiglio. “My mother gave me the exact same advice” 🙂
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Anti-Androgens were needed by the mom’s to fix excess androgen in their own health. Therefore, a predisposition to excess androgens might be present in the children born to that mom. Autism may sometimes be a condition derived from excess androgens, amongst other factors. (For instance, babies born with pyloric stenosis are found to have high androgen levels. Also, there is a large prevalence of autism affected children who have had pyloric stenosis – and need for surgery from that condition.