Endocrine Disruptors and Male Sexual Dysfunction
Rajesh K. Naz in Endocrine Disruptors, 2004
The large interindividual variability of androgen levels in healthy men is attributable to genetic, socioeconomic, and environmental factors. Meikle et al. attributes about 30% of the variability to genetic factors [67]. Circadian and ultradian pulsatile variations in androgen levels also play a role in the variability of the measured values. Among the more personal factors, obesity, probably via the induced hyper-pinsulinemia and low SHBG levels, is accompanied by decreased testosterone levels and in morbid obesity, even decreased free testosterone level, whereas several studies suggest that a vegetarian diet is accompanied by lower free testosterone levels [68]. Smokers have a higher free testosterone level than non-smokers. Physical or psychological stress is generally accompanied by decreased testosterone levels. This androgen deficiency in elderly men is generally moderate and some authors suggest using the term: Partial Androgen Deficiency of the Aging Male (PADAM).
Androgens and bone function
Barry G. Wren in Progress in the Management of the Menopause, 2020
The clinical sequelae of androgen deficiency in women and the benefits of testosterone replacement are being increasingly acknowledged. Androgen replacement in postmenopausal women is potentially an effective alternative therapeutic approach to osteopenia and osteoporosis, however prospective data confirming a reduction in fracture rate with such therapy in women are lacking. Further basic scientific and clinical research into the role of androgens in bone function is required, in order to define the appropriate clinical application of androgen replacement in postmenopausal women.
The adrenal cortex
Martin Andrew Crook in Clinical Biochemistry & Metabolic Medicine, 2013
Androgen deficiency is not clinically evident because testosterone production by the testes is unimpaired in males and because androgen deficiency does not produce obvious effects in women. The pigmentation that develops in some cases of Addison’s disease is due to the high circulating levels of ACTH or related peptides resulting from the lack of cortisol suppression of the feedback mechanism. Patients with primary adrenal insufficiency, as in Addison’s disease due to autoimmune disease, may also show vitiligo.
Use of testosterone in men infected with human immunodeficiency virus in the veterans healthcare system
Published in AIDS Care, 2018
Guneet K. Jasuja, Shalender Bhasin, Adam J. Rose, Joel I. Reisman, Avy Skolnik, Dan R. Berlowitz, Allen L. Gifford
Androgen deficiency occurs in many men with human immunodeficiency virus (HIV) infection (Rochira & Guaraldi, 2014), and is associated with muscle, weight and bone loss, fatigue, depression, and reduced quality of life (Grinspoon, Corcoran, & Lee, 1996). Low testosterone levels are more frequent in HIV-infected men than in non-infected men (Arver et al., 1999; Dobs, Dempsey, Landeson, & Bolk, 1988; Rochira, Zirilli, & Orlando, 2011). Although this prevalence has decreased since the advent of highly active antiretroviral therapy (HAART), low testosterone levels remain common even among relatively young men treated with HAART (Rochira et al., 2011; Wunder et al., 2007). Clinical guidelines for androgen deficiency suggest consideration of testosterone in HIV-infected men with low testosterone and weight loss, to promote weight maintenance and muscle strength (Bhasin et al., 2010). But testosterone may increase risk of atherosclerosis (Basaria, Coviello, & Travison, 2010; Budoff, Ellenberg, & Lewis, 2017), which itself is an increasingly recognized clinical complication of HIV (Post, Budoff, & Kingsley, 2014).
The effects of gonadotropin-releasing hormone agonist (buserelin) and orchidectomy on bone turnover markers and histomorphometry in rats
Published in The Aging Male, 2020
Nur-Vaizura Mohamad, Soelaiman Ima-Nirwana, Kok-Yong Chin
Results of circulating bone turnover markers in this study coincided with the histomorphometric observation, whereby orchidectomy increased CTX-1, a product of bone matrix degradation and a marker of bone resorption in the rats. The level of CTX-1 was elevated in buserelin groups but did not reach statistical significance. However, osteocalcin level was not significantly affected by androgen deprivation. Conventionally, androgen deficiency is related to decreased bone formation and oestrogen deficiency is associated with increased bone resorption [33]. Androgen and oestrogen were interconvertible through aromatase and both play a role in determining bone health in men [34]. Considering these facts, it is hypothesised that orchidectomy and buserelin initially suppress bone formation due to androgen deprivation as reported by Chin et al. [31,32], and subsequently increase bone resorption due to the loss of circulating oestrogen as reported in this study. It is acknowledged that bone turnover is a dynamic process and high bone turnover (concurrent increased in bone formation and resorption) has been reported in other castrated male rat models [20,29,35]. This hypothesis needs to be validated in another study assessing sequential changes in bone turnover in castrated male rats.
What is the position of testosterone in the care of women?
Published in Climacteric, 2019
The resultant Position Statement provides guidance for clinicians with respect to the measurement of testosterone in women, the limitations of the available methods, and the interpretation of biochemical results. It reviews the benefits and risks based on past meta-analyses7,8 and when and how a trial of testosterone is appropriate. Noteworthy points included in the Position Statement are that androgen deficiency is not diagnosed by a biochemical test; that the clinical meaning of free testosterone is uncertain; that presently the only indication for initiating a trial of testosterone therapy in a woman is a diagnosis of HSDD; and that compounded testosterone preparations cannot be recommended. Although testosterone therapy was found not to be associated with serious adverse events, the limitations of the safety data were highlighted.
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