Endocrine consequences of antifungal therapy: A missed entity

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Jan 16, 2026; 14(2): 117140
Published online Jan 16, 2026. doi: 10.12998/wjcc.v14.i2.117140

Table 2 Proposed mechanisms of azole-induced male hypogonadism

Drugs	Mechanism	Clinical manifestation
Ketoconazole[46,54]	Inhibition of 17-alpha hydroxylase and 17,20 lyase	Decreased libido
	Increased estrogen: Testosterone ratio	Gynecomastia
	Binding to androgen receptor	Oligospermia; azoospermia
Posaconazole[52]	Inhibition of 11-β hydroxylase	Gynecomastia
	Compensatory increase in steroidogenesis
	Peripheral aromatization of testosterone to estrogen
	Inhibition of CYP3A4 and CYP3A7 slows down the hepatic metabolism of estrogen
Itraconazole[49]	Unknown	Gynecomastia
Itraconazole[49]		Loss of libido

Citation: Thakkar S, Kantroo V, Nagendra L, Dutta D, Kamrul-Hasan ABM, Kalra S, Bhattacharya S. Endocrine consequences of antifungal therapy: A missed entity. World J Clin Cases 2026; 14(2): 117140
URL: https://www.wjgnet.com/2307-8960/full/v14/i2/117140.htm
DOI: https://dx.doi.org/10.12998/wjcc.v14.i2.117140

Thakkar S, Kantroo V, Nagendra L, Dutta D, Kamrul-Hasan ABM, Kalra S, Bhattacharya S. Endocrine consequences of antifungal therapy: A missed entity. World J Clin Cases 2026; 14(2): 117140 [PMID: 41608146 DOI: 10.12998/wjcc.v14.i2.117140]

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