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An amazing aspect of studying human development in utero is the differentiation of the sex organs. What is just as amazing is how it works out due to its complexity and thousands of variables that need to work just right to make us female or male. This will not be a discussion of gender issues or its ramifications in today’s political climate.

In an early embryo, there is no sexual differentiation. Only after hormones act upon the neutral duct it becomes either the wolffian duct that later becomes the male sexual organs or the Mullerian duct that becomes the female sex organs. So in that sense we all started the same.
Hormones play a crucial role in this differentiation. The presence or absence of hormone receptor sites is also crucial. Once the receptor sites are stimulated first by maternal hormones and then by the infant in uteri’s hormones the differentiation continues. By 12 weeks of gestation the external genitalia begin to develop and differentiate. By 14-15 weeks the external genitalia are formed and can actually be seen on an ultrasound after this.
Discussing the analogues between the two sex organ systems helps us treat our patients as adults. In the male, the prostate is the analogue for the uterus in the female. That means that it is very receptive to estrogens.  This plays a significant role in the treatment of prostatic hypertrophy. This requires a reduction of estrogens by administering anti-estrogen therapy to men whose estrogen levels become elevated. Testosterone converts to estrogens in males and that is the issue that needs to be addressed.
In the female, the continual exposure to the sex hormones, progesterone, estrogens and testosterone are required to maintain the correct growth and development of the sex organs. The size and shape of the external genitalia is mainly guided by the genetics of the individual. In the rare cases of genital ambiguity, the issue surrounds itself with receptor site reactions to these hormone stimuli that is usually caused by specific genetic issues in the infant. This can also be affected by outside hormone stimulation from synthetic hormones and environmental hormones exposures.

Dr. Edward Eckert
President of Hormonify

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