Endocrine Disruptors and Male Sexual Dysfunction
Rajesh K. Naz in Endocrine Disruptors, 2004
There is lot of debate going on related to decline of human male sexual response with age and its relationship with hypogonadism. Korenman et al. observed an increased prevalence of hypogonadism among older men when compared with young controls in a cohort-controlled study of 267 men with ED and 107 controls [63]. However, when corrected for age, there was no association between hypogonadism and ED in the older population. They concluded that both hypogonadism and ED were common conditions in the aging male but that they might not be causally related. Current evidence further suggests that hormonal factors do not play a substantial role in the age-associated increased prevalence of ED observed in man. Other causes of ED increase with age. Although the predominant etiological factor of ED in older men appears to be vasculogenic disease, the diminution of libido associated with age most likely has an endocrinological basis. Table 11.1 lists such clinical manifestations that may be associated with hypogonadism in aging males. Androgen replacement therapy may not be sufficient to restore normal sexual function in aging men due to the presence of other etiological factors.
Evolution of Brain Mechanisms Controlling Sexual Behavior
Akira Matsumoto in Sexual Differentiation of the Brain, 2017
The expression of three sexually dimorphic behavioral and neural traits in the ancestral sexual species has been characterized. Females, but not males, will display receptive behavior in response to exogenous E2. In addition, exogenous E2 treatment will greatly increase PR mRNA in the VMH of females but not of males. Finally, females have smaller POAH volumes and larger VMH volumes than males,35 and this neurophenotypic trait appears sensitive to androgen levels in males but not in females. After castration, males have POAH and VMH volumes similar to conspecific females.41 Androgen-replacement therapy reinstates male-like morphology in males, but does not masculinize neural morphology in females. The phenotype of the descendant parthenogen is very similar to that of females of the ancestral sexual species. Exogenous E2 treatment induces receptive behavior and increases PR mRNA in the VMH of the parthenogen. The volumes of the POAH and VMH are comparable to females of the sexual species and are not affected by either ovariectomy or androgen administration. However, androgen treatment effectively induces male-typical pseudosexual behavior in the parthenogen. Thus, gross morphological changes in hypothalamic and preoptic areas are neither necessary nor sufficient for the expression of hetero-typical sexual behaviors.
Hypogonadism, erectile dysfunction, and infertility in men
Philip E. Harris, Pierre-Marc G. Bouloux in Endocrinology in Clinical Practice, 2014
Many, but not all, impotent men with low testosterone levels experience improvements in their libido and overall sexual activity with androgen replacement therapy.68,197 The response to testosterone supplementation even in this group of men is variable,53,65–67,69 because of the coexistence of other disorders such as diabetes mellitus, hypertension, cardiovascular disease, and psychogenic factors.53 A meta-analysis197 of the usefulness of androgen replacement therapy concluded that testosterone administration is associated with greater improvements in sexual function than those associated with placebo in men with erectile dysfunction and low testosterone levels.197
A randomized, controlled study of treatment with ojayeonjonghwan for patients with late onset hypogonadism
Published in The Aging Male, 2020
Kyu Won Lee, Sang Rak Bae, Hyun Cheol Jeong, Jin Bong Choi, Sae Woong Choi, Woong Jin Bae, Su Jin Kim, Hyuk Jin Cho, U-Syn Ha, Sung-Hoo Hong, Sae Woong Kim
The treatment of LOH is a androgen replacement therapy (ART) and the testosterone intramuscular injection, patches, and gel preparation are mainly used. However, ART have problems such as induction of testosterone concentration higher than physiological blood level, instability in action time, skin reactions. In addition, ART cannot be performed in patients with cardiovascular disease, prostate cancer, or polycythemia. Several studies have been conducted to overcome the limitations of ART, and clinical study in Japan has reported the improvement of LOH symptom without increasing testosterone after the administration of herbal medicine [18,19]. In our previous study, we performed in vivo test in rat about anti-oxidative effect was identified because oxidative stress is one of the causes of LOH [20]. We used herbal formulation Ojayeonjonghwan, known as KH-204, which protects testis as antioxidants.
Visceral adiposity index is associated with benign prostatic enlargement in non-diabetic patients: a cross-sectional study
Published in The Aging Male, 2018
Huseyin Besiroglu, Emin Ozbek, Murat Dursun, Alper Otunctemur
Considering demographic characteristics of the participants included in our study, hypogonadism and related disorders should not be overlooked in the population. Testosterone deficiency syndrome is a biochemical and clinical entity associated with aging and characterized by a deficiency in serum testosterone level that may affect multiple organ systems and lead to significant deterioration in the quality of life. Many studies indicate a close relationship between hypogonadism and metabolic disorders [28,29]. Several inflammatory cytokines such as TNF-α, IL-6 and IL-1β released from particularly visceral adipose tissue disrupt the hypothalamic-pituitary-testicular axis which ultimately result in decreased testosterone production [30]. Men with lower testosterone level are likely to have increased fat mass and deteriorated metabolism indicators such as diabetes mellitus, dyslipidemia, hypertension and ultimately worsened BPH/LUTS parameters. Several studies demonstrated that androgen replacement therapy improves obesity, metabolic syndrome and BPH/LUTS parameters [31–34]. Beside sex hormones, as an integral part of the general health, we should also pay attention to vitamin D status of the aging male patients. Scientific evidence suggest conflicting results on the association between vitamin D and prostate enlargement but hypogonadal men are more likely to have low vitamin D levels [35,36]. From this point of view, although we did not evaluate hormonal profile of the patients, we may postulate that those with higher VAI are at increased risk for hypogonadism symptoms and related metabolic disorders.
Variation of prostatic morphology in Chinese benign prostatic hyperplasia patients of different age decades
Published in The Aging Male, 2020
Subo Qian, Xujun Sheng, Ding Xu, Haibo Shen, Jun Qi, Yu Wu
Sex hormone is another significant etiology of the pathologic BPH [4,26]. Previous studies have shown a positive correlation between BPH and changes in free T, DHT, estriol, and estradiol levels [8,28–30]. While the precise molecular etiology remains ambiguous, sex steroids have been implicated in the development and maintenance of BPH [26,27]. However, the circulating levels of many sex steroids show a marked decrease with age growth. In men, age-related steroid hormonal changes are less dramatic, but any of serum total T, free T and dehydroepiandrosterone sulfate (DHEAS) do show a significant age-related decrease in the circulation [30–34]. That may partially explain the correlation between age and prostatic morphology discovered in our research. But controversies still exist, because some studies showed low testosterone occurred in more than one out of every five BPH patients at the mean (SD) age of 63.4 (6.8) years [34], and androgen replacement therapy for hypogonadal men with mild BPH could contribute to the improvement of LUTS [32]. Whereas, BPH is a multi-etiological disease, the precise etiology is still needed to be explored.
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