Serum testosterone level in patients with low sex drive after COVID-19 infection

Chronic obstructive pulmonary disease (COPD) is a complex condition that can be associated with various comorbidities, including anemia and hormonal imbalances. The relationship between COPD, anemia, and serum testosterone levels has not been thoroughly investigated. To examine the relationship between COPD, anemia, and serum testosterone levels in patients with COPD. This cross-sectional study was conducted at Shahid Faghihi and Namazi hospitals in Shiraz, Iran, and included 43 patients with COPD who were admitted to internal medicine and emergency departments between autumn 2018 and autumn 2019. Patients were evaluated for anemia, and serum testosterone levels were measured. Data were analyzed using SPSS version 22. The study included 27 males (62.8%) and 16 females (37.2%). The prevalence of anemia was 48.1% (13/27) in males and 50% (8/16) in females. Total testosterone was significantly higher in males (M=1.74, SD=1.85) compared to females (M=0.47, SD=0.69), P.001. The study found that females with anemia had significantly higher mean testosterone total levels compared to those without anemia (p=0.047). However, no significant differences were found in testosterone levels between males with and without anemia. While females with anemia had a mean total testosterone level of 0.32 (SD=0.27), while those without anemia had a mean level of 0.61 (SD=0.91), with a significant P-value of 0.047. This study suggests a potential relationship between anemia and serum testosterone levels in female patients with COPD. Further research is needed to confirm these findings and explore the underlying mechanisms.

It has been suggested that dysregulation of hormones is associated with schizophrenia (SCZ). This study aimed to measure the serum levels of progesterone and testosterone in 125 SCZ patients at different stages of treatment and 96 healthy control (HC) subjects. Our results showed that first-episode drug-free SCZ patients had significantly increased testosterone levels when compared with HC subjects, and chronic medication, but not short-term medication, further increased the serum testosterone levels in the patients. Further analysis suggested that the sex of the patients did not affect testosterone levels. In contrast, serum progesterone levels did not show significant differences between first-episode, drug-free SCZ patients and controls, and the antipsychotics increased progesterone levels in the male SCZ patients, but not female patients. Interestingly, our analyses demonstrated that the serum progesterone levels were negatively correlated with PANSS total score and PNASS positive score, suggesting a correlation between blood hormone levels and disease severity in SCZ patients. Taken together, our data showed differential changes in serum testosterone and progesterone levels in SCZ patients with or without antipsychotics, and our results suggest that increased sex hormone levels may be a defensive response to protect the human body under stress.

To compare the effects of leuprolide acetate and goserelin acetate for suppressing serum testosterone levels in Japanese patients with prostate cancer, as several recent studies suggested that serum testosterone is not always suppressed below the upper limit of the castration range in patients using luteinizing hormone-releasing hormone (LH-RH) agonists, especially leuprolide acetate. In all, 232 patients with prostate cancer, whose serum testosterone levels were measured before and during treatment using a 1- or 3-monthly formulation of leuprolide or goserelin, were enrolled in a retrospective study. The mean age of the patients was 69.8 years and the mean testosterone level before the LHRH treatment was 4.54 ng/mL. The patients had their testosterone levels assessed a mean (range) of 5.4 (1-35) times during the LHRH treatment. A castrate serum testosterone level was defined as <or= 0.5 ng/mL. The mean maximum testosterone level during 1-monthly leuprolide (40 patients), 3-monthly leuprolide (68), 1-monthly goserelin (50), or 3-monthly goserelin (74) treatment was 0.22, 0.20, 0.19 and 0.20 ng/mL, respectively (not significant). Four patients, including two treated with 1-monthly leuprolide, one with 3-monthly leuprolide and one with 3-monthly goserelin, had serum testosterone above the castrate level, with a maximum of 0.5-0.65 ng/mL. Three of these patients had elevated testosterone only once or twice during the follow-up, and the remaining patient had serum testosterone fluctuating at 0.4-0.6 ng/mL throughout the follow-up. One- and 3-monthly formulations of leuprolide and goserelin have equivalent and sufficient effects to suppress serum testosterone levels in men with prostate cancer. There were testosterone levels just outside the castrate range in a few patients during treatment.

Since sexual function and testosterone levels after image-guided proton therapy (IGPT) have not yet been examined in detail, we prospectively evaluated changes before and after IGPT. Among patients treated with IGPT with or without combined androgen blockade (CAB) therapy between February 2013 and September 2014, patients who agreed to participate in the study and were followed up for >3 years after IGPT were evaluated. Serum testosterone levels were regularly measured together with prostate-specific antigen (PSA) levels before and after IGPT. The Erection Hardness Score (EHS) and the sexual domain summary, function subscale and bother subscale of the sexual domain in the Expanded Prostate Cancer Index Composite (EPIC) were assessed. There were 38 low-risk, 46 intermediate-risk and 43 high- or very-high-risk patients (NCCN classification). Although serum testosterone levels in low-risk patients did not decrease after IGPT, reductions were observed in the average EHS and the sexual domain summary score of the EPIC. In intermediate-, high- and very-high-risk patients, testosterone and PSA levels both increased following the termination of CAB after IGPT, and the average EHS increased. The sexual domain summary score gradually increased, but not above minimally important differences. In intermediate-risk patients, the function subscale increased from 4.4 to 14.8 (P < 0.05) 12 months after IGPT and reached a plateau after 60 months. The results of the present study would suggest the potential of IGPT, and further prospective studies to directly compare IGPT with other modalities are warranted.

The hypothesis 'the lower the better when achieving castration levels of testosterone' is based on the data from second-line hormonal manipulation and its molecular basis, and on better oncological results reported for lower castration levels in prostate cancer (PCa) patients, including those achieved with maximal androgen blockade. In this regard, the equivalence of surgical and different pharmacological castrations has been controversial. The modified amino acid structure that makes LH-releasing hormone (LHRH) analogs more potent than LHRH, and the method of delivering the analogs impacts on bioavailibility and potentially causes differences in androgen levels and in its final oncological efficacy. In addition to this, there is a myriad of circumstances, such as those related to ethnic variations and co-morbidities, which uniquely impact on the pharmacological approach in a highly heterogeneous population of castration-resistant prostate cancer (CRPC) patients. Ineffective testosterone suppression through hormonal escape is currently poorly recognized and may result in increased PCa mortality. Until now, the optimal serum testosterone level in patients under castration, and the impact of its variations in patients under LHRH therapy, remain open questions and have been merged to a broad spectra of patients who are highly heterogeneous. This heterogeneity relates to a number of mechanisms regarding response to treatment, which influences the biology of the relapsing tumor and the sensitivity to subsequent therapies in the individual patient. The rationale to achieve testosterone levels below 20-50 ng/dl warrant further investigation as these levels have recently rescued CRPC patients. In the last few years and months, important advancements in prostate cancer treatment have been achieved. Nevertheless, these advances are measured in a few months of additional survival and under high costs, not available to most of the world population, compared with the benefits of hormonal manipulation that are measured in years, there is a huge potential for accessible and durable effect expansion and optimization of treatment, particularly with the current tendency of a more individual approach.

The appropriateness of the interactions between Prolactin, gonadotrophins and testicular hormones ensures that normal spermatogenesis takes place in the male. So this study is an attempt to classify male infertility depending on WHO criteria of seminal changes and to evaluate serum Prolactin, Testosterone FSH and LH levels in the participants, also determine the association between serum Prolactin, Testosterone levels and subtypes of male infertility. This study involved three hundred infertile males having infertility more than one year (cases group) and three hundred age-matched fertile males with definite paternity in past two years (control group) were included to the study from Jan 2018 -Dec 2020 at Shahid Ali Qader consultant clinic in the Sulaimanyah city. Serum levels of hormones were measured by electrochemiluminescense immunoassay technique. Approximately half of patient's age ranged between 30- 39 years. Sixty eight percentage of cases complained from primary infertility. About 71.3% of patients had infertility duration between 1 - 5 years. This percentage decreased with increasing the infertility years. Most common infertile group was Asthenospermia (34.3%). A higher significant levels of serum Prolactin, FSH and LH found in cases than controls (p<0.001). However, the serum Testosterone levels was significantly lower in cases than controls (p<0.05). Moreover, serum Prolactin levels were found significantly elevated in all infertile subgroups (except Normospermic subgroup) compared to control group, while serum Testosterone levels were significantly decreased in all infertile subgroups (except Normospermic subgroup) compared to control group (p<0.05). So we conclude that; Poor spermatogenesis is associated with high serum Prolactin, FSH,LH levels and low serum Testosterone levels in patients with male infertility. Moreover, elevated serum Prolactin levels and decreased serum Testosterone levels were significantly associated with A, AT, OAT, Azoo and OA infertile males. Keywords: Male infertility, primary and secondary infertility, Prolactin, Testosterone, spermatogenesis.

Objective: To evaluate the effects of hyperbaric oxygen therapy (HBOT) on erectile functions and serum testosterone levels in patients with erectile dysfunction (ED).Methods: The patients treated by HBOT for several diseases between July 2017–May 2018 and had erectile dysfunction were included in the study. All patients filled the International Index of Erectile Function (IIEF) questionnaire form; serum total testosterone (TT) and free testosterone (FT) levels were examined before the first day and after the last day of HBOT. The effects of demographic characteristics of patients on erectile functions were evaluated. Patients were categorized according to the risk factors. The IIEF scores, TT and FT levels of patients in first day and after last day of HBOT were compared.Results: Totally 43 patients were included in the study. The mean post-HBOT IIEF-EF score was significantly higher than the mean pre-HBOT IIEF-EF score of patients (25.4 ± 5.3 vs 20.6 ± 5.1; p < .001). There was no statistical difference between the pre-HBOT and post-HBOT serum TT and FT levels of patients (4.0 ± 2.3 ng/ml vs 4.1 ± 2.0 ng/ml, p = .797; 8.6 ± 3.8 pg/ml vs 8.9 ± 3.5 pg/ml, p = .658).Conclusions: HBOT improved the erectile functions in ED patients however we cannot detect any effect on testosterone levels in our study.

TPS5111 Background: Darolutamide is a structurally distinct and highly potent androgen receptor inhibitor with low blood–brain barrier penetration. In the phase 3 ARAMIS study (NCT02200614) of patients with nonmetastatic castration-resistant prostate cancer, treatment with darolutamide significantly improved metastasis-free survival and overall survival versus placebo, with a favorable safety profile. The incidences of central nervous system adverse events (AEs; e.g. falls, memory impairment, and depression) showed a ≤2% difference between the darolutamide and placebo groups. Fatigue was the only AE with an incidence of &gt; 10% for darolutamide (13.2% vs 8.3% for placebo). In a separate neuroimaging study of healthy volunteers, cerebral blood flow was not altered in patients treated with darolutamide but was significantly reduced in brain areas related to cognition in patients treated with enzalutamide. Furthermore, it is postulated that the low blood–brain barrier penetration of darolutamide may result in lower serum testosterone elevations than those seen with enzalutamide, with the potential of leading to fewer associated feminizing AEs. The objective of ARAMON (NCT05526248) is to compare the effect of darolutamide and enzalutamide monotherapy on post-treatment testosterone levels in patients with hormone-naive prostate cancer experiencing biochemical recurrence after definitive treatment for localized disease. Methods: ARAMON is a two-stage, open-label, phase 2 study of patients with histologically or cytologically confirmed adenocarcinoma of the prostate who have biochemical recurrence after radical primary prostatectomy or radiation therapy, with a prostate-specific antigen (PSA) doubling time of ≤20 months, baseline serum testosterone &gt; 150 ng/dL, and Eastern Cooperative Oncology Group performance status 0/1. During a 52-week lead-in phase, 25 patients will receive darolutamide 600 mg twice daily. If criteria based on serum testosterone increase from baseline to Week 12 are met, the study will proceed to a 52-week randomized phase in which the effects of darolutamide (600 mg twice daily, n = 20) will be compared with the effects of enzalutamide (160 mg once daily, n = 20). The primary endpoint of both phases is the change in serum testosterone level from baseline to Week 12. Secondary endpoints of the randomized phase include the change in serum testosterone levels from baseline to Weeks 24 and 52; PSA at Weeks 4, 12, 24, 36, and 52; changes in blood levels of markers for glucose, lipid metabolism, and endocrine function related to sex hormones; safety; and quality of life. Safety will be assessed through AE monitoring. The first of the 25 planned patients in the lead-in phase was enrolled on January 13, 2023. Clinical trial information: NCT05526248 .

Serum testosterone levels were determined by a radioimmunological method in 102 patients with laryngeal carcinoma and in a control group of 10 healthy men. All patients were examined before the initiation of any operative or radiation therapy and after termination of treatment. The testosterone levels in the cancer patients showed a tendency toward higher values when compared with a control group of healthy men. These results indicate that hormone preparations could be considered as part of the therapy of laryngeal carcinomas.

Introduction: It has been widely accepted that prostate cancer (PCa) growth is related to serum testosterone (ST). A direct correlation between pre-treatment ST level and PCa growth and progression has been reported. However, recent studies have shown that pre-treatment ST levels have a negative correlation with PCa. Thus, the literature is, at best, conflicting. In this study, we examined the pre-treatment serum total testosterone (ST) levels in PCa. Methods: In this prospective observational study, suspected cases of PCa underwent digital rectal examination, routine blood investigation, Prostate-Specific Antigen (PSA) measurement, and prostate biopsy. Diagnosed cases of PCa without any risk factors affecting testosterone levels were included. Their pre-treatment total ST levels were measured. All patients underwent staging evaluation with either Magnetic Resonance Imaging (MRI) &amp; Bone scan or Ga-68 Prostate Specific Membrane Antigen Positron Emission Tomography (PSMA PET). ST levels were also measured in patients with Benign Prostatic Hyperplasia (BPH) and compared with those in PCa patients. ST levels were also assessed according to Gleason Score (GS) and clinical stage in PCa. Results: 110 cases and 54 patients with BPH were included in the study. The median ST level in PCa patients was significantly lower as compared to BPH patients [352.28 ng/dL (Interquartile Range (IQR) 224.99-563.17) vs. 448.29 ng/dL (IQR 400.97-596.42) (p =0.004)]. The median ST level in metastatic PCa was significantly lower than the localized PCa group [298.20 ng/dL vs. 452.30 ng/dL (p=0.0001)]. Moreover, the median ST level was also significantly lower in patients with Gleason Score ≥ 8 than those with Gleason Score ≤ 7 [285.92 ng/dL (149.97-560.40) vs. 425.13 ng/dL (320.43-571.46) (p=0.002)]. Conclusion: This study shows lower ST levels in patients with PCa compared to patients with BPH, thus supporting a potential association as described in previous studies. ST levels may have prognostic value since a low pre-treatment ST level is associated with a higher clinical stage and aggressive PCa.

Serum testosterone level is a potential prognostic marker for castration-resistant prostate cancer. However, its role as a prognostic marker in cabazitaxel chemotherapy remains unclear. This study aimed to elucidate the clinical significance of serum testosterone levels before cabazitaxel chemotherapy. This single-institution, retrospective study included 47 patients with metastatic castration-resistant prostate cancer (mCRPC) who received cabazitaxel therapy. Serum testosterone levels were measured before the initiation of cabazitaxel therapy. Progression-free survival and overall survival (OS) were not significantly different between patients with high and low serum testosterone levels. Analysis of patients aged <70 years revealed that those with high serum testosterone levels (total testosterone level > 0.055 ng/mL) had significantly longer OS than those with low serum testosterone levels (total testosterone level < 0.055 ng/mL, p = 0.012). Multivariate analysis revealed that low serum testosterone levels (hazard ratio [HR] = 11.874, 95% confidence interval [CI] 2.076-67.953, p = 0.005) and high prostate-specific antigen levels (HR = 18.051, 95% CI 2.462-132.347, p = 0.004) in the pretreatment phase were independent prognostic factors for OS in patients receiving cabazitaxel therapy. Serum testosterone level may be a prognostic marker for cabazitaxel therapy in patients with mCRPC who are younger than 70 years, and high serum testosterone levels may lead to longer survival.

Disclosure: M.K. Shakir: None. H. Babu: None. N.O. Vietor: None. A.J. Spiro: None. T.D. Hoang: None.Background: Clomiphene Citrate (CC), a selective estrogen receptor modulator, is widely used for treating male hypogonadism. Although serum testosterone (T) levels show a diurnal variation, it is not clear whether patients receiving CC demonstrate such diurnal variation. The diurnal variation of serum T was analyzed in 3 CC-treated patients with secondary hypogonadism. Methods: The serum T was drawn at 7AM while fasting, 11AM before lunch, and 4PM before dinner. T levels were assayed by LC/MS LabCorp TM. Case 1. A 48-year-old man presented with symptoms of hypogonadism. Lab Results: Serum T 148 ng/dL, FSH 4.8 mlU/mL, LH 9.2 mIUL, prolactin 9.6 ng/mL and IGF-1 168 ng/mL. Pituitary MRI revealed a 4 mm pituitary tumor (non-functioning). After counseling, patient was placed on CC 25 mg every other day. Patient noted improvement in hypogonadism symptoms and pituitary MRI remained stable. T levels performed 12 months later showed the following values: T: 7 AM 438 ng/dL; 11AM 399 ng/dL; and 4 PM 378 ng/dL. Case 2. A 38-year-old man presented with symptoms of hypogonadism. Laboratory values: Serum T 154 ng/dL, FSH 4.9 mIU/mL. LH 5.8 mIU/mL, prolactin 9.8 ng/mL, IGF-1 198 ng/mL. Pituitary MRI was normal. He was treated with CC 25 mg every other day. Six months later, T level showed the following values: T 7 AM 326 ng/dL; 11 AM 411 ng/dL; and 4 PM 458 ng/dL. He also had significant improvement in symptoms. Case 3. A 52-year-old man was seen for evaluation of erectile dysfunction and secondary hypogonadism. Laboratory values: Serum T 138 ng/dL, FSH 3.0 mIU/mL, LH 7.1 mIU/mL, prolactin 11.8 ng/mL, IGF-1 138 ng/mL. Pituitary MRI was normal. Patient was treated with CC 50 mg every other day and 9 months later T values were: T 7 AM 478 ng/dL; 11AM 412 ng/dL and 4 pm 398 ng/dL. He noted significant improvement in hypogonadal symptoms. Conclusion: In this case series the serum T levels did not show any diurnal variation. The exact significance of a steady state serum T levels during daytime is not clear. Further studies involving a large number of patients are needed.Presentation: Saturday, July 12, 2025

237 Background: Evaluate long term changes in serum testosterone levels in patients with low and intermediate risk prostate cancer treated with proton therapy (PT) on two prospective clinical trials. Methods: Between August, 2006 and October, 2007, 171 patients with low and intermediate risk prostate cancer were enrolled and treated on the University of Florida Proton Therapy Institute institutional review board (IRB) approved PR01 and PR02 protocols. Of the 171 patients, 20 were excluded for having received hormonal therapy prior to PT. The pretreatment serum testosterone level was available for 149 of the remaining 151 patients. These 149 patients were included in the present study. Proton doses ranged from 78 Cobalt Gray Equivalent (CGE) to 82 CGE to the prostate using passively scattered protons. No patient underwent pelvic nodal irradiation. Results: The median baseline serum testosterone level was 358ng/dL (range 112 to 791ng/dL). Immediately after completion of PT, median serum testosterone was 365ng/dL which was not significantly different from the pre-PT level (p=0.2039). Subsequent median testosterone levels with associate P-Values are shown in the Table. At no point in the 60 month follow up period was the median serum testosterone value significantly different from the baseline value. Conclusions: Conformal proton therapy to the prostate, as delivered using the University of Florida Proton Therapy Institute PR01 and PR02 protocols, did not appear to significantly affect serum testosterone levels within 60 months after PT. [Table: see text]

Normalization of serum testosterone levels in patients treated with neoadjuvant hormonal therapy and three-dimensional conformal radiotherapy for prostate cancer

To investigate the effect of laparoscopic high ligation of spermatic cord vein in patients with chronic prostatitis and varicocele prostatitis. A total of 90 varicocele patients were selected from January 2016 to December 2020, including 33 patients with chronic prostatitis. Changes of white blood cell count, National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score and serum testosterone level in the expressed prostate secretion (EPS) were observed before and after the operation of laparoscopic high ligation of spermatic vein. All patients were followed up three months after the surgery. There was no significant difference in the white blood cell counts in EPS, NIH-CPSI score, and serum testosterone level in patients with varicocele-only who underwent high ligation surgery after the operation. However, the white blood cell count in the EPS of patients with chronic prostatitis was lower than that before 3 months of operation ( ［12.39±4.23］×109/L vs ［21.36±5.05］×109/L). The NIH-CPSI score was significantly lower than that before operation ( ［12.71±6.21］ vs ［26.76±8.43］). And the serum testosterone level was higher than that before operation (［4.34±1.77］ng/ml vs ［2.36±1.05］ng/ml). Laparoscopic high ligation of the spermatic vein in patients with chronic prostatitis and varicocele could effectively reduce the number of white blood cells in the EPS, boost the level of serum testosterone and improves symptoms of chronic prostatitis.