Medical Consequences
See also: Neutering#Health and behavioral effectsA subject of castration who is altered before the onset of puberty will retain a high voice, non-muscular build, and small genitals. He may well be taller than average, as the production of sex hormones in puberty—more specifically, estrogen via aromatization of testosterone—stops long bone growth. The person may not develop pubic hair and will have a small sex drive or none at all.
Castrations after the onset of puberty will typically reduce the sex drive considerably or eliminate it altogether. Castrated people are automatically sterile, because the testes (for males) and ovaries (for females) produce sex cells needed for sexual reproduction. Once removed the subject is infertile. The voice does not change. Some castrates report mood changes, such as depression or a more serene outlook on life, although this might not be to chemical changes but instead emotional changes due to the implications of the procedure. Body strength and muscle mass can decrease somewhat. Body hair sometimes may decrease. Castration prevents male pattern baldness if it is done before hair is lost. However, castration will not restore hair growth after hair has already been lost due to male pattern baldness.
Historically, eunuchs who additionally underwent a penectomy reportedly suffered from urinary incontinence associated with the removal of the penis.
Without hormone replacement therapy (HRT), typical symptoms (similar to those experienced by menopausal women) include hot flashes, gradual bone-density loss resulting in osteopenia or osteoporosis, and potential weight gain or redistribution of body fat to the hips/chest. Replacement of testosterone in the form of gel, patches, or injections can largely reverse these effects, although breast enlargement has also been reported as a possible side effect of testosterone usage.
A study conducted at a mental institution in Kansas, where a large number of male inmates had been castrated, found that the eunuchs lived an average of 14 years longer than the uncastrated men. A similar study of historical eunuchs in Korea's royal court found a 14 to 19 year increase in lifespan compared to intact men of similar socioeconomic background; these eunuchs had a centenarian rate of over 3%.
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