Castration

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Castration is any action, surgical, chemical, or otherwise, by which a male loses the functions of the testes or a female loses the functions of the ovaries. In common usage the term is usually applied to males, although as a medical term it is applied to both males and females. For more information about female castration, see oophorectomy.

Castration in Medicine

Testicular cancer is generally treated by surgical removal of the cancerous testicle(s) (orchiectomy), often followed by radiation or chemotherapy. Unless both testicles are cancerous, only one is removed.

Either surgical removal of both testicles or chemical castration may be carried out in the case of prostate cancer [1], as hormone testosterone-depletion treatment to slow down the cancer. Similarly, testosterone-depletion treatment (either surgical removal of both testicles or chemical castration) is used to greatly reduce sexual drive or interest in those with sexual drives, obsessions, or behaviors, or any combination of those that may be considered deviant. Castration in humans has been proposed, and sometimes used, as a method of birth control in certain poorer regions.

Orchiectomy may be performed as a part of sex reassignment surgery.

Chemical Castration

Chemical castration is a form of temporary castration caused by hormonal medication. In the case of chemical castration, ongoing regular injections of anti-androgens are administered.

Chemical castration seems to have a greater effect on bone density than physical castration. Since the development of teriparatide, this severe bone loss has been able to be reversed in nearly every case. At this time there is a limitation on the use of this medication to 24 months until the long-term use is better evaluated.

Medical consequences

A subject of castration who is castrated before the onset of puberty will retain a high voice, non-muscular build, and small genitals. They may well be taller than average, as the production of sex hormones in puberty—particularly testosterone—stops long bone growth. The person may not develop pubic hair and will have a small sex drive or none at all. Castrations after the onset of puberty will typically reduce the sex drive considerably or eliminate it altogether. Also castrated people are automatically sterile, because the testes (for males) and ovaries (for females) produce sex cells needed for sexual reproduction. Once removed the subject is infertile. The voice does not change. Some castrates report mood changes, such as depression or a more serene outlook on life. Body strength and muscle mass can decrease somewhat. Body hair sometimes may decrease. Castration prevents male pattern baldness if it is done before hair is lost; however, castration will not restore hair growth after hair has already been lost due to male pattern baldness. [2] Castration eliminates the risk of testicular cancer.

Without Hormone Replacement Therapy (HRT), typical symptoms (similar to those experienced by menopausal women) include hot flashes; gradual bone-density loss, resulting in osteopenia or osteoporosis; potential weight gain or redistribution of body fat to the hips/chest. Replacement of testosterone in the form of gel, patches, or injections can largely reverse these effects, although breast enlargement has also been reported as a possible side effect of testosterone usage [3].

References

Notes

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