The Etiocholanolone/Androsterone (E/A) Ratio assesses androgen metabolism by comparing the enzymatic activity of 5b-reductase/5a-reductase. Etiocholanolone is produced via the 5b-reductase pathway and androsterone is produced via the 5a-reductase pathway.
An elevated E/A ratio indicates less 5a-reductase activity, which is not thought to be a clinically relevant finding - though physiologically induced 5a-reductase blockade states via pharmaceuticals may be associated with side effects such as impotence, decrease libido, depression and anxiety in men. Robust inhibition of 5a-reductase activity decreases the production of DHT, resulting in increase levels of testosteronee - and subsequently estradiol (via aromatization pathways). As a result of increased substrate flow through the aromatization pathways, gynecomastia has also been described in men.
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