Hormonal treatment of sexual offenders

The most important modality for the treatment of such offenders is psychotherapy. However, this can be supported or enhanced by therapeutic intervention on the physiological effect of androgens in adult males to achieve a permanently or temporarily reduced sexual drive. The reduction of the sexual drive can be a useful adjunct to treatment but needs to be voluntary and extremely carefully considered. A thorough explanation and willing participation are essential prerequisites to such treatment, i.e. fully informed and voluntary consent is required. Indeed, there are specific informed consent legalities to deal with the prescribing of such medication.

Cyproterone acetate has both antiandrogenic and antigonadotrophic properties, which activate blockade of androgen receptors and lower the androgen levels, and therefore act to reduce male sexual drive. Androgen-dependent areas of the brain connected with stimulation and maintenance of male sexuality are protected from hormonal influences by this dual mechanism of action. The main advantages of cyproterone acetate over other pharmacological methods are its efficacy, low side-effects, and reversibility of action.

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