Conclusions

Although pathways of steroid hormone biosynthesis in the adrenals, ovaries, and testes have been known for a number of years, recently only have we begun to understand how genes control the enzymes associated with these pathways. Even less is known about how genes control the enzymatic steps involved in steroid metabolism. This is due to the fact that there are so many metabolites formed, as evident in the discussion on estrogens. Large interindividual differences exist in the metabolism of steroid hormones, which may be reflected in interindividual differences in estrogen action. The formation of so many metabolites raises the question of why it is necessary for the human body to form all of these metabolites. The usual answer to this question is that it is nature's way of detoxifying potent biologically active hormones. However, the metabolites might have important but unrecognized biological effects that are necessary for the action of some hormones. A clearer picture of the molecular mechanisms involved in hormone biosynthesis and metabolism will help us to understand better the role of hormones in health and disease.

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