Aging Male Symptoms Scale Research Articles

Androgen Receptor (AR) Gene (CAG)n and (GGN)n Length Polymorphisms and Symptoms in Young Males With Long-Lasting Adverse Effects After Finasteride Use Against Androgenic Alopecia.

IntroductionLong-term adverse symptoms of men who used oral finasteride against androgenic alopecia have been recently described as post-finasteride syndrome (PFS).AimTo determine whether (CAG)n-rs4045402 and (GGN)n-rs3138869 polymorphisms in the androgen receptor (AR) gene are implicated in PFS.MethodsAR polymorphisms were studied according to PFS symptoms in 66 white participants (31.8% Italian, 28.8% American, and 39.4% other).Main Outcome MeasuresSymptoms were investigated by an ad hoc 100-item questionnaire and the Arizona Sexual Experience Scale and Aging Male Symptom Scale (AMS). (CAG)n and (GGN)n repeats were categorized as short ([CAG]9–19, [GGN]<23), medium ([CAG]20–24, [GGN]23), or long ([CAG]25–37, [GGN]>23).ResultsMedian age was 32 years, duration of finasteride use was 360 days, and time from finasteride discontinuation was 1,053 days. We observed several frequency differences in symptoms according to (CAG)n and (GGN)n repeat numbers. Three AMS items were worse for medium (GGN)23 than for long (GGN)>23 carriers and one item was worse for short (GGN)<23 carriers. The AMS item for decrease in sexual desire or libido was worse for short (CAG)9–19 carriers than for medium (CAG)20–24 carriers. Through the ad hoc questionnaire, significant findings in (CAG)n and/or (GGN)n repeats were obtained for penile discomfort, loss of scrotal sensitivity, scrotal discomfort, less pubic hair, loss of perceived perineal fullness, increased sperm density, involuntary muscle spasms, loss of muscle tone, increased weight (>2 kg), increased skin dryness, and onset of symptoms after finasteride use.ConclusionThis study showed that short and/or long (CAG)n and (GGN)n repeats had different frequencies according to symptoms reported by patients with PFS, likely reflecting the vast array of genes modulated by the AR. This study showed a U-curvilinear profile of (CAG)n repeats for skin dryness symptoms, where the two extremes exhibited a worse condition than medium repeats. Further studies are necessary to investigate the PFS pathophysiology using a precision medicine approach.

120 Serum PSA as a Predictor of Symptomatic Hypogonadism

INTRODUCTION AND OBJECTIVES: We often see low levels of PSA in men with symptomatic hypogonadism. The relationship between serum PSA and testosterone levels is still controversial. According to the saturation hypothesis, a significant relationship is apparent only in the low testosterone range. We hypothesize that PSA might represent a surrogate marker for symptomatic hypogonadism. METHODS: Patients presenting to our academic mens health clinic reported hypogonadal symptoms using the Aging Males Symptoms (AMS) scale which grades each hypogonadal symptom on a 5point Likert scale. Several hormonal and biochemical parameters were measured the same day the survey was completed. In order to prevent possible bias in the analysis, we selected only subjects without a history of prostate disease and with a PSA level <4 ng/mL. RESULTS: 149 men were included for analysis with an average age of 55y 10. At baseline, mean AMS scale 47 12, mean total testosterone (TT) 4.65 1.91 ng/mL, mean free testosterone(FT) 7.45 2.70 pg/mL, mean PSA 1.15 0.78ng/mL. We tested the efficacy of PSA, TT, and FT in detecting severe hypogonadism, defined as AMS scale 50 in symptomatic subjects. Receiver operating characteristic (ROC) curve analysis for PSA showed an accuracy (area under the ROC curve) of 0.667 0.046 (p<0.01), in predicting severe hypogonadism. In particular, when a threshold of 0.8 ng/mL was chosen, sensitivity and specificity for severe hypogonadism were 72.8% and 59.0%. ROC curve analysis for TT and FT showed an accuracy of 0.51 (p1⁄40.811) and 0.480 (p1⁄40.693), respectively. We also tested the efficacy of PSA in detecting severe hypogonadism, defined as FT<8.5 pg/mL. ROC curve showed an accuracy of 0.512 (p1⁄40.816). After adjusting for age, low PSA (<0.8ng/mL) was not associated with hypogonadism related features, such as metabolic syndrome. CONCLUSIONS: Our data demonstrated that PSA levels were more accurate for the prediction of severe hypogonadism compared to testosterone levels and suggest that low PSA levels may represent a new tool in confirming severe hypogonadism.

Psychometric Evaluation of the Hypogonadism Impact of Symptoms Questionnaire

IntroductionThe Hypogonadism Impact of Symptoms Questionnaire (HIS-Q) is a patient-reported outcome measurement designed to comprehensively evaluate the symptoms of hypogonadism and to detect changes in these symptoms in response to treatment. AimTo conduct item analysis and reduction, evaluate the psychometric properties of the HIS-Q, and provide guidance on interpreting the instrument score. MethodsA 12-week observational, longitudinal study of hypogonadal men was conducted. Participants completed the HIS-Q every 2 weeks. Blood samples were collected to evaluate testosterone levels. Participants also completed the Aging Male's Symptoms Scale, the International Index of Erectile Function, the Short Form-12 Health Survey, and the Patient-Reported Outcomes Measurement Information System Sexual Activity, Satisfaction with Sex Life, Sleep Disturbance, and Applied Cognition Scales (at baseline and weeks 6 and 12). Clinicians completed the Clinical Global Impression of Severity and Change measurements and a clinical form. Main Outcome MeasuresIndividual item performance was evaluated using descriptive statistics and Rasch analyses. Reliability (internal consistency and test-retest), validity (concurrent and know groups), and responsiveness were assessed. ResultsIn total, 177 men participated in the study (mean age = 54.1 years, range = 23–83). The original 53-item draft HIS-Q was reduced to 28 items; the final instrument included five domains (sexual, energy, sleep, cognition, and mood) with two sexual subdomains (libido and sexual function). For all domains, test-retest reliability was acceptable (intraclass correlation coefficients > 0.70), construct validity was good (|r > 0.30| for all comparisons). Known-groups validity was demonstrated for all HIS-Q domain scores, subdomain scores, and the total score as measured by the Clinical Global Impression of Severity, and total testosterone level at baseline (P < .05 for all comparisons). All domains and subdomains were responsive to change based on patient-rated anchor questions (P < .05 for all comparisons). ConclusionThe final 28-item HIS-Q is reliable, valid, and responsive. The HIS-Q is suitable for inclusion in future clinical trials to help characterize the effects of testosterone replacement therapy.

MP47-12 SERUM PSA AS A PREDICTOR OF SYMPTOMATIC HYPOGONADISM

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation1 Apr 2016MP47-12 SERUM PSA AS A PREDICTOR OF SYMPTOMATIC HYPOGONADISM Kazuhito Matsushita, Osamu Takahashi, Masaki Shimbo, Fumiyasu Endo, Osamu Muraishi, and Kazunori Hattori Kazuhito MatsushitaKazuhito Matsushita More articles by this author , Osamu TakahashiOsamu Takahashi More articles by this author , Masaki ShimboMasaki Shimbo More articles by this author , Fumiyasu EndoFumiyasu Endo More articles by this author , Osamu MuraishiOsamu Muraishi More articles by this author , and Kazunori HattoriKazunori Hattori More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.331AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We often see low levels of PSA in men with symptomatic hypogonadism. The relationship between serum PSA and testosterone levels is still controversial. According to the saturation hypothesis, a significant relationship is apparent only in the low testosterone range. We hypothesize that PSA might represent a surrogate marker for symptomatic hypogonadism. METHODS Patients presenting to our academic mens health clinic reported hypogonadal symptoms using the Aging Males Symptoms (AMS) scale which grades each hypogonadal symptom on a 5-point Likert scale. Several hormonal and biochemical parameters were measured the same day the survey was completed. In order to prevent possible bias in the analysis, we selected only subjects without a history of prostate disease and with a PSA level <4 ng/mL. RESULTS 149 men were included for analysis with an average age of 55y±10. At baseline, mean AMS scale 47±12, mean total testosterone (TT) 4.65±1.91 ng/mL, mean free testosterone(FT) 7.45±2.70 pg/mL, mean PSA 1.15±0.78ng/mL. We tested the efficacy of PSA, TT, and FT in detecting severe hypogonadism, defined as AMS scale≥50 in symptomatic subjects. Receiver operating characteristic (ROC) curve analysis for PSA showed an accuracy (area under the ROC curve) of 0.667±0.046 (p<0.01), in predicting severe hypogonadism. In particular, when a threshold of 0.8 ng/mL was chosen, sensitivity and specificity for severe hypogonadism were 72.8% and 59.0%. ROC curve analysis for TT and FT showed an accuracy of 0.51 (p=0.811) and 0.480 (p=0.693), respectively. We also tested the efficacy of PSA in detecting severe hypogonadism, defined as FT<8.5 pg/mL. ROC curve showed an accuracy of 0.512 (p=0.816). After adjusting for age, low PSA (<0.8ng/mL) was not associated with hypogonadism related features, such as metabolic syndrome. CONCLUSIONS Our data demonstrated that PSA levels were more accurate for the prediction of severe hypogonadism compared to testosterone levels and suggest that low PSA levels may represent a new tool in confirming severe hypogonadism. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e631 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kazuhito Matsushita More articles by this author Osamu Takahashi More articles by this author Masaki Shimbo More articles by this author Fumiyasu Endo More articles by this author Osamu Muraishi More articles by this author Kazunori Hattori More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia.

Concern regarding adverse effects of finasteride is increasing. We aimed to determine the type and frequency of symptoms in men having long-term sexual and non-sexual side effects after finasteride treatment (a condition recently called post-finasteride syndrome, PFS) against androgenetic alopecia (AGA). Subjects were recruited at the Urology Unit of the Trieste University-Hospital, and from a dedicated website. Out of 79 participants, 34% were white Italians, mean age was 33.4 ± 7.60 years, mean duration of finasteride use was 27.3 ± 33.21 months; mean time from finasteride discontinuation was 44.1 ± 34.20 months. Symptoms were investigated by an ad hoc 100 questions' questionnaire, and by validated Arizona Sexual Experience Scale (ASEX) and Aging Male Symptom Scale (AMS) questionnaires. By ASEX questionnaire, 40.5% of participants declared getting and keeping erection very difficult, and 3.8% never achieved; reaching orgasm was declared very difficult by 16.5%, and never achieved by 2.5%. By the ad hoc questionnaire, the most frequent sexual symptoms referred were loss of penis sensitivity (87.3%), decreased ejaculatory force (82.3%), and low penile temperature (78.5%). The most frequent non-sexual symptoms were reduced feeling of life pleasure or emotions (anhedonia) (75.9%); lack of mental concentration (72.2%), and loss of muscle tone/mass (51.9%). We contributed to inform about symptoms of PFS patients; unexpectedly loss of penis sensitivity was more frequent than severe erectile dysfunction and loss of muscle tone/mass was affecting half of the subjects. Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post-finasteride syndrome.

Physical activity level and self-reported musculoskeletal pain perception among older males

BACKGROUND AND OBJECTIVES: In light of the social and economic impact caused by pain and the evidences of benefits provided by physical activity to individuals affected by this unpleasant sensation, this study aimed at evaluating the prevalence of selfreported musculoskeletal pain and at determining its association with the level of physical activity of males aged 40 years or above, dwellers of the urban zone of the city of Pelotas-RS. METHODS: This is an observational, cross-sectional and population-based study. The level of physical activity was measured by means of leisure and commuting sections of the International Physical Activities Questionnaire, being classified as insufficiently active those with scores below 150 minutes/week. To evaluate pain self-perception, a question of the Aging Male's Symptoms Scale was used. Those reporting moderate, severe and intense pain were classified as having pain. RESULTS: The prevalence of pain self-perception was 27.0% (CI95% 22.7 - 31.3) and was significantly associated to the level of physical activity (p<0.001). Males performing 150 minutes/ week or more of physical activity had 60% protection against pain report as compared to those not reaching this cutoff point, being that this result was maintained significant even after adjustment for confounding factors (p=0.02). CONCLUSION: This study has shown that reaching physical activity recommendations may be a protection against musculoskeletal pain perception among studied males.

AB027. Testosterone deficiency of testosterone replacement therapy Mongolian men aged over 40 years old

Background and ObjectiveEarly detection of testosterone deficiency in middle aged and aging male improves their quality of life and prevents testosterone relating disorders. There is not enough evidence based study related testosterone deficiency syndrome and erectile dysfunction in Mongolia. Purpose of our study is investigating TDS and erectile dysfunction among men over 40 years old. We conducted questionnaires of AMS (Aging Male Symptom) scale and erectile function levels and forms of sexual function by IIEF-5 score. And we studied the relation of erectile dysfunction. To determine to testosterone deficiency by serum level of total testosterone less sensitive than free testosterone. To detect the testosterone deficiency syndrome in aging males with erectile dysfunction.Materials and MethodsA total of 309 males over 40 years of age enrolled this study. An approval of the Ethical Committee of MOH was obtained. Each participant was assigned to either an erectile dysfunction (ED) group or a control group depending on results of the IIEF-5 questionnaire. The ED group was further divided into three groups (moderate, severe and very severe) based on a level of ED. The total testosterone (TT) levels were determined in blood serum, using a competitive ELISA analytical system and free testosterone (FT) calculated as described by Vermeulen. Test samples were collected between 8:00-11:00 am. The biochemical diagnosis of TDS was based on ISSAM guidelines, particularly, if TT was ≤3.46 ng/mL or free testosterone FT was ≤0.072 ng/mL.ResultsED of moderate, severe and very severe levels were diagnosed in 199 (64.41%) out of 309 participants. There was an inverse association between an erectile function and age (r=−0.380, P<0.01). The average TT was 5.75±2.316 ng/mL and FT was 0.091±0.0084 ng/mL. Compared to the ED group, the control group had a higher TT level: 5.6440±1.177 ng/mL and 5.812±2.316 ng/mL respectively. In the control group the FT level was 0.061±0.0084 ng/mL whereas it was 0.041±0.0076 ng/mL in the ED group. Late onset hypogonadism detection by using calculated free testosterone was three times higher when using total testosterone. Testosterone replacement therapy improved erectile function, aging and reducing waist circumference and maintain testosterone in biological level.ConclusionsOur study showed that most of aging males had a moderate to very severe ED (64.55%). The level of TT (5.644±1.177 ng/mL) and FT (0.041±0.0036 ng/mL) was significantly lower in ED patients (P<0.05). The testosterone deficiency syndrome was detected in 24.27% of the ED group.

Are andropause symptoms related to depression?

Andropause is a middle-age condition in which men experience changes in their physical, spiritual and emotional health. The association between andropause and psychological symptoms such as depression are not very clear yet. The objective of this study was therefore to determine the association between the 'Aging Males Symptoms Scale' (AMS) and depression. A cross sectional study was conducted among 521 old men. To collect data, the AMS and the Patient Health Questionnaires 2 and 9 were used to screen depression, in addition to questions on background and fertility. Multiple linear regression analysis was used to assess the association between andropause symptoms and depression. Based on our results and the AMS score, 51.5% of the study population had clinical symptoms of androgen disorder, 3.7% of which had severe symptoms. There was a strong correlation between the AMS score and depression. Depression, diabetes, cigarette smoking and spousal age retained their significant associations even after entering the relevant demographic, anthropometric, smoking and disease variables in the multivariable model. As a positive predictive factor, depression had the strongest association with AMS. Based on our results, there is a direct association between andropause symptoms and depression, where the increasing AMS score corresponds with the severity of depression. Our results show the need of screening for depression when evaluating andropause symptoms.

The relationship between physical activity and aging symptoms among community-dwelling men aged 40-70 years in Shanghai, China.

Research on the relationship between physical activity and aging symptoms among men is limited in China. Eight hundred nineteen participants aged 40 to 70 (mean age = 58.25) were administered the International Physical Activity Questionnaire and Aging Males' Symptoms scale (AMS) in face-to-face interviews between 2009 and 2010. Ordinal logistic regression and generalized linear models were used to examine severity of aging symptoms. AMS total score and subscale scores (psychological, somatic, and sexual health) were examined according to physical activity level. Participants who reported higher levels of physical activity were significantly less likely to develop aging symptoms compared with those who reported lower levels of physical activity, both with (odds ratio [OR] = 0.78, 95% confidence interval [CI]: 0.64 to 0.95) and without (OR = 0.70, 95% CI: 0.56 to 0.87) adjustment for age, body mass index (BMI), smoking, alcohol consumption, and chronic disease. In addition, physical activity was negatively correlated with AMS total score (P < .01) and scores for somatic (P < .01) and sexual (P = .04) health. After covariate adjustment, the negative correlation between physical activity and all AMS scores remained significant (P < .01). Physical activity is negatively correlated with aging symptoms among middle-aged men in Shanghai.

PI-01 BEST ABSTRACT: EFFECTS OF LONG-TERM TESTOSTERONE THERAPY ON PROSTATE, URINARY AND SEXUAL PARAMETERS IN 300 HYPOGONADAL MEN TREATED FOR UP TO 6 YEARS

You have accessJournal of UrologyPlenary Session I: Best Abstract and Late Breaking Abstracts1 Apr 2014PI-01 BEST ABSTRACT: EFFECTS OF LONG-TERM TESTOSTERONE THERAPY ON PROSTATE, URINARY AND SEXUAL PARAMETERS IN 300 HYPOGONADAL MEN TREATED FOR UP TO 6 YEARS Ahmad Haider, Gheorghe Doros, and Abdulmaged Traish Ahmad HaiderAhmad Haider More articles by this author , Gheorghe DorosGheorghe Doros More articles by this author , and Abdulmaged TraishAbdulmaged Traish More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.807AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are still concerns regarding safety of testosterone replacement therapy (TRT) for the prostate. We investigated whether long-term TRT with injectable testosterone undecanoate (TU) affected parameters related to prostate, urinary and sexual function. METHODS Prospective, longitudinal, registry study of 300 patients (mean age 57.7 ± 6.76 years), with testosterone levels ≥ 350 ng/dl (12 nmol/L) receiving parenteral TU 1000 mg at baseline, after 6 weeks and thereafter every 12 weeks for up to 72 months (6 years). Prostate volume and residual voiding volume were measured by ultrasound at every or every other visit. IPSS, IIEF-EF and AMS questionnaires were filled in at every visit and blood samples taken to measure PSA. Because prostatic diseases are closely associated with the metabolic syndrome, we also assessed anthropometric and metabolic parameters. RESULTS Testosterone increased from 9.86 ± 1.34 nmol/L to trough levels of 16 to 17 nmol/L for the observation period. Prostate volume increased from 28.34 ± 10.79 to 30.72 ± 14.28 ml (p<0.0001 vs baseline). PSA increased from 1.77 ± 0.97 to 2.0 ± 1.01 ng/ml (p=0.0021 vs baseline). 5/300 patients were diagnosed with prostate cancer (PCa) following elevated PSA (> 4 ng/mL). Tumor stage was pT2a in 4 and pT1b in 1 man, Gleason score 3+3 in 4 and 3+2 in 1 patient, resp. All men underwent radical prostatectomy. The proportion was 1.7% with an incidence of 39.4 per 10.000 patient years. The International Prostate Symptom Score (IPSS) decreased from 6.57 ± 4.21 to 2.58 ± 1.32 (p<0.0001). The residual voiding volume decreased from 46.78 ± 23.58 to 15.85 ± 5.32 ml (p<0.0001). The International Index of Erectile Function Erectile Function Domain (IIEF-EF, maximum score: 30) increased from 20.01 ± 5.06 to 26.11 ± 3.33 (p<0.0001) with a plateau at 36 months. The Aging Males Symptoms scale (AMS) as a measure of quality of life improved from 53.43 ± 10.21 to 17.41 ± 2.36 (p<0.0001). Weight dropped progressively by 16.8 ± 0.41 kg, and waist circumference (WC) by 8.94 ± 0.24. Similarly, improvements in lipid pattern, blood pressure, and glucose homeostasis were observed. CONCLUSIONS The incidence of PCa did not suggest an increased risk of PCa in hypogonadal men on long-term TRT. Long-term treatment with TU did not negatively affect voiding function as measured by IPSS, or residual voiding volume. Erectile function was markedly and sustainably improved. Part of these effects may be a result of parallel reduction in body weight and visceral fat, measured by WC, and other elements of the metabolic syndrome. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e221-e222 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Ahmad Haider More articles by this author Gheorghe Doros More articles by this author Abdulmaged Traish More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Effects of a Proprietary Freeze‐Dried Water Extract of Eurycoma longifolia (Physta) and Polygonum minus on Sexual Performance and Well‐Being in Men: A Randomized, Double‐Blind, Placebo‐Controlled Study

Background. Physta is a proprietary product containing a freeze-dried water extract of Eurycoma longifolia (tongkat ali), which is traditionally used as an energy enhancer and aphrodisiac. We aim to evaluate a 300 mg combination of Physta and Polygonum minus, an antioxidant, with regard to sexual performance and well-being in men. Methods. Men that aged 40–65 years were screened for this 12-week randomized, double-blind, placebo-controlled, parallel-group study. Outcome measures included validated questionnaires that aimed to evaluate erectile function, satisfaction with intervention, sexual intercourse performance, erectile hardness, mood, and overall quality of life. Results. 12 subjects in the active group and 14 in the placebo group completed the study. Significant improvements were noted in scores for the Sexual Intercourse Attempt diary, Erection Hardness Scale, Sexual Health Inventory of Men, and Aging Male Symptom scale (P < 0.05 for all). Three adverse events were reported in the active group and four in the placebo group, none of which were attributed to study product. Laboratory evaluations, including liver and kidney function testing, showed no clinically significant abnormality. Conclusion. Supplementation for twelve weeks with Polygonum minus and the proprietary Eurycoma longifolia extract, Physta, was well tolerated and more effective than placebo in enhancing sexual performance in healthy volunteers.

Effects of testosterone treatment on body composition in males with testosterone deficiency syndrome

Objective: We evaluated the safety of testosterone treatment and its efficacy on body composition in males with testosterone deficiency syndrome (TDS) over 24 months.Methods: 50 males aged 50–65 years with TDS (Aging Males Symptoms Scale [AMS] > 26 and calculated free testosterone [cFT] 250 pmol/l) were administered 50 mg testosterone gel daily for one year. During the second year, patients received 1000 mg of testosterone undecanoate every 2–3 months. Outcome measures were clinical chemistry values and total testosterone; sex hormone-binding globulin and cFT, changes in AMS and International Prostate Symptom Score; and changes in body composition measured by dual-energy-x-ray absorptiometry.Results: There were no clinically significant changes in clinical chemistry safety parameters. There were significant improvements in both total and cFT and in AMS scores after three months (p < 0.001). Lean mass increased 2.35% at 12 months and 4.5% at 24 months, but proportionally more muscle mass was gained in arms and legs than in the trunk. Fat mass decreased 4.2% at 12 months and 9.1% at 24 months.Conclusions: Testosterone treatment in males with TDS leads to body changes affecting lean and fat mass with significant improvement in AMS scores, and has an excellent safety profile.

Sintomas de disfunção sexual em homens com 40 ou mais anos de idade: prevalência e fatores associados

This study aimed to identify factors associated with sexual symptoms of aging male's in a representative sample of men aged 40 or older from Pelotas, southern Brazil. We performed a population-based cross-sectional study including 421 men who lived in urban area. To evaluate the sexual symptoms of aging male's was used the sexual dimension of the AMS scale - The Aging Male's Symptoms Scale. The prevalence of sexual symptoms of male aging was 64.3% (95% CI: 59.3%-69.1%). Multivariable analysis identified direct association with age and inverse association with health self-rated. We conclude that the prevalence of sexual symptoms in older males is high and important. Public health policies coupled with increased healthy lifestyle habits could minimize the prevalence and provide better quality of life for middle-age and older men.

Effects of testosterone treatment on bone mineral density in men with testosterone deficiency syndrome

The decline in testosterone levels found in men with testosterone deficiency syndrome (TDS) is associated with a decrease in bone mineral density (BMD). To study the safety profile and efficacy of testosterone treatment on BMD in patients with TDS. In this 2-year prospective open-label study, patients were administered 50 mg of testosterone gel daily (adjustable after 3 months up to 75-100 mg or down to 25 mg) for 12 months, followed by treatment with 1000 mg of testosterone undecanoate every 2-3 months from months 12-24. Outcome measures were as follows: (i) Changes in clinical chemistry safety parameters and total testosterone, sex hormone binding globulin and calculated free testosterone (cFT) levels; (ii) Changes in Aging Males' Symptoms Scale (AMS) and International Prostate Symptom Score scores; and (iii) Changes in lumbar spine and hip BMD. A total of 50 men aged 50-65 years with TDS (AMS >26 and cFT <0.250 nmol/mL) took part in the study. There was no significant impact of testosterone on safety. Prostate-specific antigen and haematopoietic parameters increased significantly, although the changes were not clinically significant. Total and cFT increased significantly after 3 months (p < 0.001) and there were significant improvements after 3 months in AMS scores (p < 0.001). BMD improved significantly in L2-L4 (2.90 and 4.5%), total femur (0.74 and 3%) and trochanter (1.09 and 3.2%) at 12 and 24 months respectively. Testosterone treatment in men with TDS has a good safety profile, leads to significant improvement in lumbar spine and hip BMD, and improves symptoms, as assessed by the AMS questionnaire.

Safety, efficacy, and health-related quality of life (HRQoL) of the investigational single agent orteronel (ortl) in nonmetastatic castration-resistant prostate cancer (nmCRPC).

5076 Background: Ortl is a selective, non-steroidal, oral 17,20-lyase inhibitor. Due to its lower inhibition of 17α-hydroxylase vs 17,20-lyase, ortl may allow steroid-free dosing. Ortl 300 mg BID was studied in nmCRPC patients (pts). Methods: Pts with nmCRPC, PSA ≥2 ng/mL (PSA ≥8 ng/mL if doubling time &gt;8 mo), and testosterone (T) &lt;50 ng/dL received ortl 300 mg BID until PSA progression, development of metastases (mets), or unacceptable toxicity. Primary endpoint: the percentage of pts with PSA ≤0.2 ng/mL at 3 mo. Secondary endpoints included safety, PSA kinetics, time to mets, and PFS (PSA progression, mets, or death), endocrine and bone markers, bone mineral density (BMD), HRQoL, cardiac and lipid assessments. Results: 38 pts enrolled: median PSA 11.7 ng/mL (range 2.6–67.8), T 8.5 ng/dL (1.4–17.3), and ACTH 20 ng/L (n=32; 0–47). Median therapy duration was 12.4 mo (0.7–27.8); 55% of pts were treated &gt;12 mo. 6 had dose reduction, 12 discontinued due to adverse events (AEs), including 2 for possible adrenal insufficiency. Gr 3 hypertension occurred in 7 pts (18%); various ≥Gr 3 AEs occurred in another 14 pts; 10 pts (26%) had serious AEs. At 3 mo, median T declined 89% to 0.78 ng/dL; median ACTH increased 171%; median cortisol declined 21%, but remained within normal range. 97% of pts had PSA declines; median PSA declined 83%. 18% had PSA ≤0.2ng/mL at 3 mo; 32% achieved PSA ≤0.2ng/mL as best response. Median time to PSA progression was 13.8 mo. Median PFS was 13.8 mo. Kaplan-Meier estimates of 1 and 2 y mets-free rates were 94% and 69%, respectively; 8 pts developed mets on study. The patient-reported Aging Male Symptoms Scale showed no decrease in overall scores, psychological, somatic, or sexual domains in 37, 34, 25, and 19 pts assessed at visits 2, 4, 7, and 13, respectively. Serum lipids, cardiac assessments, HbA1C, or bone-specific enzymes (N-telopeptide, or BMD) were not adversely affected. Conclusions: In pts with nmCRPC, long-term steroid-free ortl was feasible, with clinical activity as reflected by sustained marked declines in PSA and T, and had manageable toxicities, with no adverse effects on HRQoL, cardiac, bone or lipid profiles. Clinical trial information: NCT01046916.

The Comparison of the Aging Male Symptoms (AMS) Scale and Androgen Deficiency in the Aging Male (ADAM) Questionnaire to Detect Androgen Deficiency in Middle‐Aged Men

The prevalence of androgen deficiency in men increases with aging. Two common instruments, the Aging Male Symptoms (AMS) scale and the Androgen Deficiency in the Aging Male (ADAM) questionnaire, are often used to screen for androgen deficiency in clinical practice. The aim of this study is to compare the capability of the AMS scale and the ADAM questionnaire to detect androgen deficiency in middle-aged Taiwanese men. In April 2008, a free health screening was conducted by Kaohsiung Medical University Hospital. All participants completed a health questionnaire and had blood samples drawn between 8:00 am and noon. Serum total testosterone (TT), albumin, and sex hormone-binding globulin levels were measured. The level of free testosterone (FT) was calculated. Clinical symptoms associated with androgen deficiency were screened by using the AMS scale and ADAM questionnaire. Androgen deficiency was defined as TT < 300 ng/dL or both TT < 300 ng/dL and FT< 5 ng/dL. In total, 339 men were included in the final analysis, with the mean age of 54.6 ± 4.9 years (range, 47-65 years). Androgen deficiency was found in 75 men (22.1%) based on the criteria of TT < 300 ng/dL, and in 54 men (15.9%) based on the criteria of TT < 300 ng/dL and FT < 5 ng/dL. When detecting participants with both TT < 300 ng/dL and FT < 5 ng/dL, the sensitivity and specificity of the AMS scale were 57.4% and 48.1%, compared with 66.7% and 25.6% for the ADAM questionnaire. In a sample of middle-aged Taiwanese men, neither the AMS scale nor the ADAM questionnaire had sufficient sensitivity and specificity to detect androgen deficiency. In addition to using those 2 screening instruments, a thorough physical and biochemical workup should still be conducted in patients at risk or suspected of androgen deficiency.

773 PROSPECTIVE EVALUATION OF THE EARLY IMPACT OF THE LHRH ANALOGUES, IN THE TREATMENT OF PROSTATE CANCER, IN SEXUAL, PSYCHO-COGNITIVE, EMOTIONAL AND QUALITY OF LIFE PARAMETERS

You have accessJournal of UrologyProstate Cancer: Advanced II1 Apr 2012773 PROSPECTIVE EVALUATION OF THE EARLY IMPACT OF THE LHRH ANALOGUES, IN THE TREATMENT OF PROSTATE CANCER, IN SEXUAL, PSYCHO-COGNITIVE, EMOTIONAL AND QUALITY OF LIFE PARAMETERS Alfredo Rodríguez, Javier Romero, Borja Garcia, Felix Guerrero, Angeles Cabeza, Maria Clavel, Beatriz Mugica, Eduardo Lanzos, and Rafael Diaz Alfredo RodríguezAlfredo Rodríguez Madrid, Spain More articles by this author , Javier RomeroJavier Romero Madrid, Spain More articles by this author , Borja GarciaBorja Garcia Madrid, Spain More articles by this author , Felix GuerreroFelix Guerrero Madrid, Spain More articles by this author , Angeles CabezaAngeles Cabeza Madrid, Spain More articles by this author , Maria ClavelMaria Clavel Madrid, Spain More articles by this author , Beatriz MugicaBeatriz Mugica Madrid, Spain More articles by this author , Eduardo LanzosEduardo Lanzos Madrid, Spain More articles by this author , and Rafael DiazRafael Diaz Madrid, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.860AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The castration with LHRH agonists (LHRHa) in the control of the prostate cancer (PC) is associated with a wide spectrum of body, metabolic, sexual and psycho-cognitive alterations. Nowadays it is still not well documented the time to develop and the severity of these changes. We are developing a study to evaluate which, the moment and the severity of appearance of these modifications. METHODS Unique institution prospective and descriptive study. IRB approval. Study population: High risk PC patients submitted to radiotherapy and long period adjuvant hormonotherapy with LHRHa. Included consecutively from September 2009 to January 2011. To evaluate the symptoms 5 validated questionnaires were administered: baseline and 3, 6, 12, 24 and 36 months after therapy start: 1. International Index Erectile Function (IIEF): sexual modifications; 2. Aging Males' Symptoms Scale (AMSS): androgenic deficit, 3. Minimental test (MM): Cognitive area, 4. Short Form Health Survey SF-12 : Quality of life; 5. Beck Depression Inventory (BDI) Mental status and depression. Data were analyzed with the Wilcoxon test with a statistical significance p value < 0,05. RESULTS 61 patients were available at 6 months at least evaluation. The IIEF shows: a dramatic decrease since the first evaluation (p<0,05). AMSS test shows a progressive worsening (28, 32, 33 points at 6 months) (p <0,05). The MM test (cognitive area) does not demonstrate any significant alteration. SF-12 test (mental health area) shows a deterioration after 6 months (p=0,03). The rest of evaluated parameters do not present modifications. A deterioration in the BDI test (depresion area) is observed from the baseline (3,5 points) to the 3 months evaluation (4,9 points) (p=0,08), that consolidates at the 6 months (5,8 points) (p=0,030). CONCLUSIONS Treatment with LHRHa shows from initial stages (3 months) deleterious effects, fundamentally in the sexual sphere. At 6 months a slight deterioration of the mental status appears, which is confirmed in the paragraph of mental health when we evaluate the quality of life. Neither the cognitive capacity, nor the rest of quality parameters of global life seem to be diminished at this early period of time. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e315-e316 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alfredo Rodríguez Madrid, Spain More articles by this author Javier Romero Madrid, Spain More articles by this author Borja Garcia Madrid, Spain More articles by this author Felix Guerrero Madrid, Spain More articles by this author Angeles Cabeza Madrid, Spain More articles by this author Maria Clavel Madrid, Spain More articles by this author Beatriz Mugica Madrid, Spain More articles by this author Eduardo Lanzos Madrid, Spain More articles by this author Rafael Diaz Madrid, Spain More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Survey for late-onset hypogonadism among old and middle-aged males in Shanghai communities

This study sought to investigate late-onset hypogonadism (LOH) in old and middle-aged males in Shanghai communities, using symptom score evaluation systems and measurements of sex hormone levels. One thousand cases of males aged 40-70 years were investigated. The aging male symptoms (AMS) scale and androgen deficiency in aging males (ADAM) questionnaire were used at the beginning of the investigation, followed by measurement of the sex hormone-related factors (total testosterone (TT), free testosterone (fT), sex hormone-binding globulin (SHBG) and bioavailability of testosterone (Bio-T)). There were 977 valid questionnaires. The LOH-positive rates shown by AMS and ADAM were 59.88% and 84.65%, respectively; values increased with the age of the patients. There were 946 results related to sex hormone measurements, which showed the following results: TT was not related to aging (P>0.05); levels of SHBG increased with age; and fT and Bio-T decreased with age. There was a significant difference in fT between LOH-positive and LOH-negative patients, as shown by the ADAM. In summary, TT levels were not related to aging, even though SHBG did increase while fT and Bio-T decreased with aging. Clinically, the diagnosis of LOH cannot be based on serum TT level.

A randomized, double‐blind, placebo‐controlled trial on the effect of long‐acting testosterone treatment as assessed by the Aging Male Symptoms scale

Study Type - Therapy (RCT). Level of Evidence 1b. What's known on the subject? and What does the study add? Testosterone deficiency syndrome can be treated with testosterone replacement in the form of injectable, transdermal, buccal and oral preparations. Long-acting i.m. testosterone undecanoate 1000 mg, which is given at 10-14 week intervals, has been shown to be adequate for sustaining normal testosterone levels in hypogonadal men. This study confirms that long-acting i.m. testosterone undecanoate is effective in improving the health-related quality of life in men with testosterone deficiency syndrome as assessed by the improvement in the Aging Male Symptoms scale. Testosterone treatment can be indicated in men who have poor health-related quality of life resulting from testosterone deficiency syndrome. • To evaluate the effect of i.m. injection of testosterone undecanoate 1000 mg over 12 months on the Aging Male Symptom (AMS) scale scores in men with testosterone deficiency syndrome (TDS). • A total of 120 men >40 years old with TDS (total testosterone < 12 nmol/L and total AMS scores ≥ 27) were randomized into i.m. injection of either placebo or testosterone undecanoate 1000 mg. • In all, 56 and 58 participants from the active treatment and placebo groups, respectively completed the study. • An i.m. injection of either placebo or testosterone undecanoate 1000 mg was given at weeks 0, 6, 18, 30 and 48. • Self-administered AMS questionnaires were completed at weeks 0, week 18 and week 48. • Improvement in the total AMS score was significantly greater in the treatment group than in the placebo group (F: 4.576, P= 0.017) over the 48-week period. • The mean (sd) total AMS score was 38.46 (11.85) at baseline and 33.59 (1.69) at 48 weeks for the placebo group, and 41.73 (12.73) at baseline and 32.61 (9.67) at 48 weeks for the treatment group. • The mean change in the total AMS score was -12.6% in the placebo group and -21.9% in the treatment group. • The mean psychological and somatovegetative domain scores decreased significantly more in the treatment group than in the placebo group (-2.8 vs -1.2, P= 0.03; and -3.2 vs -1.8, P= 0.016). • The difference in change between the randomized groups for the sexual domain scores followed the same trend, though the difference was not significant. • Long-acting testosterone is effective in improving health-related quality of life as assessed by the AMS scale in men with TDS.

Assessment of quality of life via the Aging Male Symptoms (AMS) scale after treatment with intramuscular long-acting testosterone

Assessment of quality of life via the Aging Male Symptoms (AMS) scale after treatment with intramuscular long-acting testosterone