Androgen Deficiency In Aging Male Research Articles

Symptomatic androgen deficiency and sexual dysfunctions in male patients receiving alectinib for ALK-positiveadvanced nonsmall cell lung cancer.

It is reported that treatment with anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) induces hypogonadism both in male patients with ALK-positive cancer and in murine models. In this study, three groups, including an experimental group of male patients with ALK-positive, advanced nonsmall cell lung cancer (ANSCLC) who were receiving alectinib (cohort A), a control group of female patients with ALK-positive ANSCLC who were receiving alectinib (cohort B), and a control group of male patients with ALK-negative ANSCLC (cohort C), prospectively underwent a full hormone assessment for androgen deficiency at 8 weeks after the start of treatment and in case of reported suspected symptoms. Patients with major sexual dysfunctions were referred to an endocrinologist. Ninety-five patients were consecutively enrolled onto the study. Among sixty-eight male patients, both median total testosterone levels (2.93 vs. 4.92 ng/ml; p=.0001) and free testosterone levels (0.11 vs. 0.17 pg/ml; p=.0002) were significantly lower in ALK-positive ANSCLC patients in cohort A compared with ALK-negative patients in cohort C; conversely, median FSH (10.32 vs. 17.52 mUI/ml; p=.0059) and LH levels (4.72 vs. 7.49 mUI/ml; p=.0131) were significantly higher in cohort C compared to cohort A. Median inhibin B levels were higher in ALK-positive male patients (74.3 vs. 44.24 pg/ml; p=.0038), but all patients had inhibin B values within the normal range. The percentage of male patients who had positive scores on the Androgen Deficiency in Aging Males (ADAM) questionnaire was 62% in cohort A and 26.8% in cohort C, including eight patients who reported at least one major symptom and were referred to Andrology Unit. No significant differences in the endocrine assessment were reported between cohorts A and B. Symptoms of androgen deficiency should be tracked in male patients with ALK-positive ANSCLC who are receiving alectinib, and testosterone replacement should be considered, as appropriate.

(111) Penile Constriction Device Satisfaction: Does Sexual Preference Have Any Effect on Preferences and Effectiveness?

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices between heterosexual and homosexual men. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. We then took the data collected and matched 2 homosexual participants to 1 heterosexual participant by age. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. After matching the patients by age, 21 were included in the analysis. Among the 21 participants, 14 (66.7%) were homosexual and 7 (33.3%) heterosexual. There was no statistically significant preference or effectiveness amongst the heterosexual group for either device. However when comparing both devices within the homosexual group, 11 (78.6%)) would recommend the FirmTech to a friend, compared to 5 (35.7%) who would recommend the Eddie by Giddy device (p=0.0412). Within the homosexual group, they preferred the ease of putting on the device while flaccid and erect and its comfort (MDs -1.14, -1.79, and-1.50; respective p-values 0.0019, 0.0010, and 0.0160). Homosexual participants also had a significantly better overall impression of the FirmTech device (MD=-0.79; p=0.0099). Lastly, the homosexual participants were significantly more likely to use the FirmTech device in partnered sex as compared to the Giddy (MD=-01.36, p=0.0038). Conclusions These findings suggest that homosexual men favor the FirmTech device over the Eddie by Giddy, rating it more positively and being more likely to recommend it to a friend. Further research with a larger and more diverse sample is needed to fully comprehend the different preferences and satisfaction with penile constriction devices among men with different sexual orientations. Disclosure Yes, this is sponsored by industry/sponsor: FirmTech Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech.

(367) Penile Constriction Device Satisfaction: Does Sexual Preference Have Any Effect on Preferences and Effectiveness?

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices between heterosexual and homosexual men. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs Eddie by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. We then took the data collected and matched 2 homosexual participants to 1 heterosexual participant by age. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. After matching the patients by age, 21 were included in the analysis. Among the 21 participants, 14 (66.7%) were homosexual and 7 (33.3%) heterosexual. There was no statistically significant preference or effectiveness amongst the heterosexual group for either device. However when comparing both devices within the homosexual group, 11 (78.6%)) would recommend the FirmTech to a friend, compared to 5 (35.7%) who would recommend the Eddie by Giddy device (p=0.0412). Within the homosexual group, they preferred the ease of putting on the device while flaccid and erect and its comfort (MDs -1.14, -1.79, and-1.50; respective p-values 0.0019, 0.0010, and 0.0160). Homosexual participants also had a significantly better overall impression of the FirmTech device (MD=-0.79; p=0.0099). Lastly, the homosexual participants were significantly more likely to use the FirmTech device in partnered sex as compared to the Giddy (MD=-01.36, p=0.0038). Conclusions These findings suggest that homosexual men favor the FirmTech device over the Eddie by Giddy, rating it more positively and being more likely to recommend it to a friend. Further research with a larger and more diverse sample is needed to fully comprehend the different preferences and satisfaction with penile constriction devices among men with different sexual orientations Disclosure Yes, this is sponsored by industry/sponsor: FirmTech and Eddie by Giddy Clarification: Industry funding only - investigator initiated and executed study Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech- On Scientific Review Board.

(135) A Randomized Survey Study Comparing the Preference and Effectiveness of Two Different Penile Constriction Devices

Abstract Introduction Penile constriction devices are a noninvasive way to improve sexual performance and erectile function, making them an appealing choice for men. To understand their clinical value and patient satisfaction, it is important to assess patient preferences and the efficacy of different devices. Comparative studies between heterosexual and homosexual men are also necessary to recognize and meet the diverse needs and experiences of these populations, leading to more tailored and effective recommendations. Objective To assess and compare the preference and effectiveness of two medical-grade penile constriction devices. Methods Between May 2023 and July 2023, males were recruited via social media platforms and prospectively enrolled into an IRB-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men (SHIM) and Androgen Deficiency in Aging Males (ADAM). Participants were then randomized to which device (FirmTech vs Eddie by Giddy) they would receive first and were instructed to use the device twice either during masturbation or intercourse within a two-week timeframe. Once utilized, the participants completed a 17-question, five-point Likert scale device satisfaction questionnaire. Once the first device and survey were completed, the other device was sent and the process was repeated. In the device satisfaction questionnaire, lower numbers indicated more positive responses to the questions. Responses from the questionnaire with numerical values are presented as the mean difference (MD) and analyzed using a paired t-test. Questionnaire responses that were “yes” or “no” were analyzed using McNemar’s chi-square analysis. A p-value less than 0.05 was considered significant. Results Fifty men were enrolled and 44 completed the study. Among the participants, 31 (70.4%) identified as homosexual, 10 (22.7%) as heterosexual, and 3 (6.8%) as bisexual with a mean age of 36.5 (IQR = 16.5). Table 1 provides a summary of the demographic characteristics. The baseline mean SHIM and ADAM score was 19.5 and 0.5, respectively. A statistically significant preference for the ease of putting on the FirmTech device while erect was found (MD,-0.84; p = 0.001). There was also a statistically significant preference for the comfort, adjustability, and stretch of the FirmTech device (MDs -0.66, -0.32, and -0.86; respective p values 0.018, 0.033, and <0.001). Finally, 35 (79.5%) participants stated that they would recommend FirmTech to a friend, as opposed to 25 (55.6%) who would recommend Eddie by Giddy (p = 0.020). Conclusions These findings suggest that, when comparing penile constriction devices, men prefer the FirmTech device over the Eddie by Giddy with respect to ease of putting on the device, comfort, stretch, and adjustability. Men are more likely to recommend the FirmTech device over Eddie by Giddy. Further research with a larger sample size, which includes a more equal distribution of men of different sexual orientations, is warranted to further support the generalizability and validity of these initial findings, illustrate consumer preference for FirmTech, and expound upon its preferential qualities. Disclosure Yes, this is sponsored by industry/sponsor: FirmTech and Eddie by Giddy. Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: FirmTech- On Scientific Review Board.

Patient Satisfaction with Oral Testosterone Undecanoate in Men Who Received Prior Testosterone Therapy: An Open-Label, Single-Center Clinical Trial.

To evaluate patient satisfaction and symptom control in hypogonadal men transitioning from other testosterone therapies to oral testosterone undecanoate (TU). In this open-label clinical trial, men aged 18 to 75 years with hypogonadism were switched to oral TU after a sufficient washout of previous testosterone therapies. Treatment satisfaction and symptom control were primarily measured using the 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) and quantitative androgen deficiency in aging males (qADAM) questionnaires, respectively. Secondary outcomes included changes in serum testosterone (T), estradiol (E2), hematocrit (HCT), and prostate-specific antigen (PSA) levels. Forty-one men participated, with significant improvements in all TSQM-9 scores observed over 6 months. Symptom control as measured by qADAM remained consistent. There was a significant increase in serum T and E2 levels, but HCT and PSA levels remained stable. Switching to oral TU from other testosterone therapies is associated with increased patient satisfaction and stable hypogonadal symptom control.

PD11-12 THE EFFECT OF CLOMIPHENE CITRATE ON PATIENT REPORTED OUTCOME MEASURES

You have accessJournal of UrologyCME1 Apr 2023PD11-12 THE EFFECT OF CLOMIPHENE CITRATE ON PATIENT REPORTED OUTCOME MEASURES Jessica Schardein, Kia Fendereski, Zane Randell, Soren Keihani, Joshua Horns, and James Hotaling Jessica SchardeinJessica Schardein More articles by this author , Kia FendereskiKia Fendereski More articles by this author , Zane RandellZane Randell More articles by this author , Soren KeihaniSoren Keihani More articles by this author , Joshua HornsJoshua Horns More articles by this author , and James HotalingJames Hotaling More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Clomiphene Citrate (CC) is a medication that can be used in hypogonadal men in lieu of testosterone to increase testosterone levels while preserving or improving fertility. Patient reported outcome measures for this medication are limited, especially regarding sexual functioning. Our objective is to assess whether self-reported changes in androgen deficiency symptoms and erectile function are observed along with changes in hormone levels and semen parameters in men taking CC. METHODS: We performed a retrospective review of all patients on CC between 2014 and 2018 for hypogonadism and/or infertility. Patient characteristics including age and body mass index (BMI) along with hormone levels, semen parameters, and self-reported questionnaire scores were obtained. Patients who completed blood work for total testosterone and bioavailable testosterone, a semen analysis, and hypogonadism and erectile function questionnaires including Androgen Deficiency in Aging Male (ADAM) and Sexual Health Inventory for Men (SHIM) before and 3 months after the initiation of CC were included in the analysis. Patients with documented exogenous testosterone, human chorionic gonadotrophin, or anastrozole use were excluded. Changes in baseline and follow-up data were analyzed using paired-sample t-tests. RESULTS: A total of 97 men were identified and included in the analysis. The mean age and body mass index (BMI) were 33.7 ± 6 years and 31.2 ± 7.3 kg/m2, respectively. All patients were followed for at least 3 months. The use of CC significantly increased both mean total and bioavailable testosterone levels by 236.5 ng/dL and 115.6 ng/dL, respectively (p<0.05). Concentration, total progressive motility and morphology all significantly improved as well (p<0.05). Clinical manifestations included a significant improvement in ADAM scores (p=0.025) and no change in SHIM scores (p=0.278). CONCLUSIONS: As more men are placed on CC for hypogonadism and/or infertility, characterizing patient reported outcomes regarding androgen deficiency symptoms and erectile function are important. The medication is able to raise testosterone levels while increasing semen parameters in addition to improving self-reported hypogonadal symptoms and maintaining erectile function scores. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e337 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Schardein More articles by this author Kia Fendereski More articles by this author Zane Randell More articles by this author Soren Keihani More articles by this author Joshua Horns More articles by this author James Hotaling More articles by this author Expand All Advertisement PDF downloadLoading ...

PMON258 Patient-Reported Outcomes for men with Hypogonadism and the Impact of Low Testosterone Levels: a review of measures

Abstract Background To better understand the impact of low testosterone treatments on men with hypogonadism, data on treatment efficacy and safety must be combined with patient-reported outcomes measurements (PROMs). Whether these objective tools conceptualise and measure the impacts of hypogonadism in the same way, is not known. Aim To appraise the evidence on the item content of validated patient-reported outcome measures for hypogonadism evaluations and identify core domains of potential importance in this context. Methods We systematically reviewed tools (e.g., questionnaires, surveys, scales) in published quantitative or qualitative data of men with low testosterone and/or those using (or who had considered treatment). PROMs data extraction forms and data tables were generated for each stage of the extraction process to standardise the information recorded and aid analysis. Data was synthesised by classifying the items identified into domains determined by the nomenclature reported in included studies and the International Classification of Functioning, Disability and Health (WHO-ICF). Finally, a narrative synthesis of the instruments and their inter-related domains and subdomains was conducted to identify areas of both convergence and divergence. Results A total of nine tools measuring PROMs of men with low testosterone were included in this review. The included studies were set within the US (n=5), Canada (n=1), UK (n=1), Germany (n=1), Italy (n=1). The tools identified were: Androgen Deficiency in Aging Males (ADAM) Questionnaire, The Aging Males’ Symptoms (AMS) scale, ANDROTEST ©, The Age-Related Hormone Deficiency Dependent Quality of Life Questionnaire (A-RHDQoL)©, Hypogonadism Energy Diary (HED), Hypogonadism Impact of Symptoms Questionnaire (HIS-Q), HIS-Q-Short Form (HIS-Q-SF), Massachusetts Male Ageing Study (MMAS) questionnaire, Sexual Arousal, Interest, and Drive Scale (SAID). Only HED, SAID, and HIS-Q reported including patients while developing the tool. The number of items varied across instruments and ranged from 3 to 53 items (median=7) with a cumulative total of 98 individual items. The ten domains identified were: Cognition, Energy, General well-being, Mood, Pain, Physical-General, Role, Sexual, Sleep, Social. Across tools, the most frequently identified domain was the sexual domain. However, two of the PROMs, HED and MMAS, did not include any items that covered the sexual domain. Six of the nine tools were considered multi-dimensional, and three were considered unidimensional (i.e. only capturing one domain). The A-RHDQoL tool showed to be the most comprehensive tool across the PROMs included since this was the only one to include items that could be coded to all ten domains. Conclusions This study has demonstrated the considerable item concept variability across disease-specific PROMs for men with low testosterone regarding development and domain coverage. The dominant focus of these PROMs to date has centred around sexual function, but possibly to the detriment of other aspects that also matter to patients. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Frequency and Correlation of Hypogonadism in Men with Type 2 Diabetes

Aim: The present study aimed to determine the frequency and association of hypogonadism in men with type 2 diabetes mellitus. Material and Methods: This cross-sectional study was conducted on 242 type 2 DM male patients in the Department of General Medicine, Bahria International Hospital, Lahore from 16th January 2022 to 15th July 2022. The Androgen deficiency in aging male (ADAM) questionnaire was used for screening hypogonadal symptoms in the study group. The presence of low serum testosterone below 3 ng/mL and positive ADAM score was referred to as hypogonadism. T2DM patients with and without hypogonadism had their clinical and biochemical variables compared. Total testosterone, BMI, free testosterone, waist circumference, and sex hormone–binding globulin were measured. SPSS version 26 was used for data analysis. Results: Of the total 242 T2DM male patients, the prevalence of hypogonadism was 24.8% (n=60). The most prevalent symptoms in T2DM patients were hypogonadal symptoms. The overall mean age was 45.8± 9.63 years with range (25-70 years). Mean BMI value was 24.8 ± 3.64 kg/m2. The incidence of overweight and obese patients were 17.8% and 49.3% respectively. The prevalence of erectile dysfunction, reduced libido, and work performance deterioration in hypogonadism were 94.8%, 68.2%, and 56.3% respectively. T2DM patients without hypogonadism had lower a) incidence of diabetic neuropathy (18.6% vs. 43.8%; p=0.021), b) T2DM duration (5.3± 3.82 vs. 9.2± 4.9 years; P=0.002), c) occurrence of diabetic retinopathy (26.9% vs. 57.8%; P=0.006), and d) HbA1c (8.9± 1.53% vs. 9.9 ± 2.54%: P=0.005), and insulin therapy (21.5% vs. 45.8%: P=0.031) compared to those with hypogonadism. Conclusion: The present study found that prevalence of hypogonadism was 24.8% in type 2 diabetes mellitus. Patients with hypogonadism had higher HbA1c, higher prevalence of neuropathy and retinopathy, longer diabetic duration, and predominantly used insulin therapy than those T2DM patients without hypogonadism. Keywords: Hypogonadism, Type 2 diabetes mellitus, Androgen deficiency in aging male (ADAM).

Predictors of erectile dysfunction and hypogonadism in men with types 2 diabetes mellitus

ABSTRACT Background It is increasingly apparent that erectile dysfunction (ED), male hypogonadism (MHG) and type 2 diabetes mellitus (T2D) are interlinked. ED occurs in up to 75% of men with T2DM and has complex pathogenesis owing to a combination of micro vascular, macro vascular, endocrine and neuropathic disease. But its prevalence is still debated. On the other hand, hypogonadism in male is characterized by low serum testosterone (Low T) levels along with clinical symptoms and is very frequent in diabetes mellitus (DM). The association between T2D and hypogonadism is not clearly known in the Bangladeshi population. Objectives The key objective of the study was to find out the frequency of erectile dysfunction, hypogonadism predictors and serum status of newly detected male patients with T2D. Materials and Method A cross-sectional study encompassing1940 newly detected T2D male patients were carried out in the out-patient department of endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. The sociodemographic and disease related data were obtained by face-to-face interview and were recorded in the pretested case record form from patients who signed the informed written consent form by knowing all the study related information. A blood sample was taken and serum total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicle stimulation hormone (FSH) were measured by chemiluminescent technology. Results Among hypogonadal patients, according to calculated free testosterone (cFT) and androgen deficiency in aging male (ADAM) criteria, frequency of hypogonadotropic hypogonadism was 80% which on the basis of TT and ADAM criteria was 92.5%. There was no significant difference for hypogonadism among either the glycosylated hemoglobin (HbA1c) categories (p=0.23) or age groups (p=0.9). Hypogonadal and eugonadal groups significantly differed both according to TT and ADAM (81.5% vs 43.4%; p=0.01) and cFT and ADAM (93.3% vs 47.7%, p=&amp;lt;0.001) criteria for ED. There was a significant difference between the groups for SHBG (21.7±11.6 vs 30.71±22; p=0.05) by TT and ADAM criteria. Similarly, cFT and ADAM criteria also revealed statistically significant difference for SHBG (38.04±19.90 vs 25.28±19.37 nmol/l; p=0.03) and Total Cholesterol (211.40±44.7 vs 191.3 ± 32.64 mg/dl p=0.04). However, in both groups, LH, FSH, HbA1c, fasting blood sugar, 2hrs after 75gm glucose, Triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) did not differ significantly. cFT significantly correlated with age (r=-0.3503, p=001) and SHBG (r=-0.37, p=&amp;lt;0.01) while TT with SHBG (r=0.58, p=0.01). In multiple regressions analysis, erectile dysfunction and SHBG were found to be significant predictors for hypogonadism (p=0.01, 0.03 respectively). Conclusion This study demonstrated the significant relationship between d T2DM, hypogonadism and ED presence in men. Many of newly detected male with T2D have symptoms of hypogonadism judged on the basis of TT, cFT and ADAM score. Thus, it should be considered while diagnosing T2D in men. Disclosure Work supported by industry: no, by BSMMU.

Prevalence of androgen deficiency in aging male in an outpatient population and effects of testosterone gel reposition therapy

Background: Androgen deficiency in aging male (ADAM) is characterized by hypogonadism with symptoms such as reduced sexual desire, muscle mass loss, among others. The treatment with testosterone gel and the results around weight and other indicators are the research objects. Objective: Analysis of association between ADAM and obesity in the outpatient population studied and to verify the outcomes of the testosterone gel treatment. Materials &amp; Methods: From a group of 126 outpatients of University Hospital Mário Palmério, 40 were selected with total testosterone lower than 300ng/dL, upon the signature of written informed consent form and the realization of laboratory tests. After new testosterone dosage and urologic evaluation, 6 patients were treated for an average time of 6 months. Initially the dosage was 50 mg/day, with medical consultations and laboratory tests to verify the effects and to adjust the dosage. The variables analyzed were BMI, abdominal circumference, weight, muscle mass, body and visceral fat, in addition to testosterone serum dosages, lipid profile, amongst others, considering the test t among the beginning and end of treatment, defining the significance level by p&lt;0,05. Results: Significant increase of total testosterone levels (p&lt;0,001) and a tendency of improvement in the free testosterone levels (p=0,061) and no significant reduction of BMI (p=0,4308), abdominal circumference (p=0,1695), weight (p=0,999), body fat (p=0,194) and muscle mass (p=0,632), while visceral fat increased (p=0,5265). Vitamin D had no significant increase (p=0,2422). Conclusion: The total testosterone level was increased after the testosterone gel treatment with statistical significance, however there must be new research with more subjects with ADAM to prove the benefits of this treatment.

Relationship Between Waist Circumference and The Event of Andropause in Male Employees in Government Institutions of Badung Regency

Background: Andropause occurs with slow development and is a physiological process in males. Andropause symptoms arise vary in individuals. One of the factors that influence these symptoms is obesity, especially central obesity with a waist circumference of &gt;90 cm. Objective: The purpose of this study is to show the relationship between waist circumference and the event of andropause. Methods: This research is an analytical study with a cross-sectional study approach conducted in one of the government institutions of Badung Regency, Bali Province. The sampling technique used was purposive sampling. The subjects consisted of 40 male employees at aged around 35-60 years. The research data were obtained from filling out the Androgen Deficiency in Aging Male (ADAM) score questionnaire and direct measurement of waist circumference. The statistical analysis used was the Chi-Square test. Results: The results showed that from 40 subjects, 23 (57.5%) subjects had a waist circumference of &gt;90 cm, and a normal waist circumference of &lt;90 cm in 17 (42.5%) subjects. There were 22 subjects (55.0%) who experienced andropause and 18 (45.0%) subjects who did not experience andropause. It was found that there was a significant relationship between waist circumference and the event of andropause among male employees in government institutions of Badung Regency (p = 0.001, OR = 11.7). Conclusion: The study has found that higher in waist circumference may contribute in the event of andropause. For further studies should takes a higher number of subjects to make it more accurate in wider population.

Androgen Deficiency in Aging Males: Translation and Validation Study of the Iranian Version.

Background:Considering the importance of psychometric evaluation of the male sex hormone deficiency questionnaire by Iranian nurses, this study aimed to determine the translation and validation of the Iranian version of the Androgen Deficiency in Aging Males (ADAM) questionnaire.Materials and Methods:This study was cross-sectional. After obtaining permission from the instrument maker, translating it into Farsi, retranslated it into English, and determining validity and reliability. The study population was 200 Iranian men who admitted to hospitals affiliated with Iran University of medical science and were older than 50 years and selected by convenience sampling method. They were evaluated and monitored based on the Iranian version of the ADAM questionnaire. Sensitivity and specificity were assessed and analyzed by Rock Chart analysis. Descriptive and analytical statistical tests were used at a significant level of 0.05.Results:Findings showed that the Iranian version of the ADAM questionnaire had good face validity. Results showed that Cronbach's alpha in this questionnaire was 0.93, which indicates high reliability, and all the valid questionnaires were reported for the Scale-Content Validity Index (SCVI) calculation. Hence, the questionnaire has good content validity. The Iranian version of the ADAM questionnaire has a sensitivity of 93.85% and a specificity of 77.14% at the cut-off point of 2.2, indicating high sensitivity and specificity.Conclusions:The Iranian version of the ADAM questionnaire is valid and reliable and has high sensitivity and specificity. Nurses can also use it as an adjunctive scale to screen andropause men over 50 years of age.

Frequency and Correlates of Hypogonadism in Adult Males with Type 2 Diabetes Mellitus.

Background and Aims:There is increasing awareness about an association between type 2 diabetes mellitus (T2DM) and male hypogonadism. However, data are sparse and less uniform with respect to factors associated with hypogonadism in males with T2DM. This study aimed to assess the frequency and correlates of hypogonadism in these subjects.Materials and Methods:This cross-sectional study included 130 males with T2DM, age 25-60 years. Study subjects were screened for hypogonadal symptoms using androgen deficiency in aging male (ADAM) questionnaire. Serum total testosterone was measured in subjects with positive ADAM score. Hypogonadism was defined as the presence of positive ADAM score and low serum total testosterone (<3 ng/mL). Clinical and biochemical variables were compared between T2DM subjects with and without hypogonadism.Results:Hypogonadism was observed in 26.9% of the study subjects. Hypogonadal symptoms most frequently observed in patients with T2DM and hypogonadism were erectile dysfunction (96.4%), reduced libido (64.3%) and deterioration in work performance (53.6%). Group with T2DM and hypogonadism had higher (i) duration of T2DM (8.9 ± 5.03 vs. 4.8 ± 4.76 years; P = .001), (ii) frequency of diabetic retinopathy (58.3% vs. 27.3%; P = .008), (iii) frequency of diabetic neuropathy (42.9% vs. 19.7%; P = .024), (iv) proportion of subjects on insulin therapy (46.4% vs. 22.4%; P = .027), and (v) HbA1c (10.9 ± 2.63% vs. 9.3 ± 2.42%; P = .006), compared to group without hypogonadism.Conclusion:Hypogonadism was present in nearly one-fourth of the study subjects with T2DM. Compared to the subjects without hypogonadism, group with hypogonadism had longer duration of diabetes, higher HbA1c, greater frequencies of diabetic retinopathy and diabetic neuropathy, and more subjects on insulin therapy.

The Epidemiological Characteristics of Late-Onset Hypogonadism in Chinese Middle-Aged and Elderly Men: Two Cross-Sectional Studies in the Same Community.

The purpose of this study was to investigate the prevalence and epidemiological characteristics of late-onset hypogonadism (LOH) in middle-aged and elderly Chinese men. Two cross-sectional studies were conducted at 5-year intervals in community-dwelling men living in the same area. A total of 1472 (Study 1, S1) and 944 (Study 2, S2) men aged 40–69 years old were recruited as subjects. Subjects were evaluated through combining serum reproductive hormone levels with the Androgen Deficiency in Aging Males (ADAM) questionnaire and the Aging Males’ Symptoms (AMS) scale. A significant difference was found in mean testosterone deficiency (TD) prevalence between S1 and S2, using either serum total testosterone (TT; 14.02% vs. 6.36%) or serum calculated free testosterone (cFT; 43.69% vs. 16.53%) cutoff values. According to the S1 or S2 data, the mean prevalence of LOH was 37.85%/15.47% in the positive ADAM test and 15.42%/9.43% in the positive AMS test (p < .01). According to classifications of TD based on gonadal status, the prevalence of secondary TD (27.34%) was higher than the primary (16.36%) and compensated (15.42%) TD in S1 (p < .01). However, there were significant differences among the prevalence of primary (6.89%), secondary (9.64%), and compensated (27.65%) TD in S2 (p < .05). Different types of testosterone levels, TD cutoff values, and questionnaires influenced the prevalence of TD and LOH. The serum FT cutoff value was an optimal threshold for evaluating and diagnosing TD and LOH, whose prevalence increased gradually with male aging.

Organic Diet and Intermittent Fasting are Associated With Improved Erectile Function

ObjectiveTo explore associations between dietary habits and erectile dysfunction (ED) in a cohort of patients presenting to a high-volume men's health clinic. Materials and MethodsAll patients presenting to a high-volume men's health clinic between July 2018 and May 2019 were evaluated for their dietary habits and screened with the International Index of Erectile Function-5 (IIEF-5) and Androgen Deficiency in Aging Males (ADAM). The primary outcome measure was the impact of dietary habits on ED, defined as IIEF-5 <22. Stepwise logistic regressions were used to control for patient characteristics and relevant comorbidities. ResultsTwo hundred seventy-one patients were included. Primary reasons for visit were ED (110, 40.6%), hypogonadism (39, 14.4%), benign prostatic hyperplasia/lower urinary tract symptoms (80, 29.5%), and Peyronie's Disease (30, 11.1%). 176 (64.9%) followed no diet, while 11 (4.1%), 11 (4.1%), 8 (2.9%), and 11 (4.1%) were whole food only, low-carb/keto, vegetarian/pescatarian, and low-fat, respectively. Additionally, 105 (38.7%) reported organic foods consumption, while 51 (18.8%) had no processed food consumption, and 77 (28.4%) performed intermittent fasting. Patients reporting ED were more likely to be over the age of 65, had higher body mass index, more comorbidities, and less likely to report an organic diet or intermittent fasting. There were no correlations between diet and ADAM score. In adjusted analysis, patients reporting organic diet or intermittent fasting were significantly less likely to have ED. ConclusionThis is the first study suggesting organic diet and intermittent fasting to be protective against ED. These results are hypothesis-generating and warrant further exploration.

The Relationship between Selected Bioelements and Depressiveness Associated with Testosterone Deficiency Syndrome in Aging Men.

Background and Objectives: Abnormal concentrations of bioelements (magnesium, manganese, chromium, copper, zinc) have been associated with physical and emotional dysfunctions, including depression. This association, however, has not been analyzed in testosterone deficiency syndrome (TDS) or patients with depressiveness, i.e., when individual symptoms do not form the picture of a full-syndrome depressive disorder. This study aimed to assess the relationship between concentrations of selected bioelements and the incidence of depressive symptoms in men aged 50 years and older with a concurrent testosterone deficiency syndrome. Material and Methods: Blood samples were taken from 314 men; the mean age of the population was 61.36 ± 6.38 years. Spectrophotometric method for biochemical analysis of magnesium (Mg), manganese (Mn), chromium (Cr), copper (Cu), and zinc (Zn) was used. The diagnosis of testosterone deficiency syndrome (TDS) was based on the total testosterone (TT), free testosterone (FT), estradiol (E2), and dehydroepiandrosterone sulfate (DHEAS) levels by ELISA. Each participant completed the Androgen Deficiency in Aging Male (ADAM) questionnaire, as well as the Beck Depression Inventory (BDI-Ia) measuring the severity of depressive symptoms. Results: Emotional disturbances manifested as depressive symptoms were diagnosed in 28.7% of all participants and testosterone deficiency syndrome in 49.3%. In the TDS group, the analysis showed a significant correlation between the level of manganese (R = 0.225, p = 0.005) and chromium (R = 0.185, p = 0.021) with the incidence of depression. Conclusions: The results of our study demonstrated a relationship between manganese and chromium concentrations with the incidence of depression in men aged 50 years and older with a concurrent testosterone deficiency syndrome. This may indicate that there is a correlation between these bioelements, as well as emotional disorders manifested as depressive symptoms in aging men with a diagnosed testosterone deficiency.

Synthesis and biological evaluation of methylpyrimidine-fused tricyclic diterpene analogs as novel oral anti-late-onset hypogonadism agents

Male late-onset hypogonadism (LOH) is reported as one of the most common age-related diseases occurred in middle-aging men. Testosterone replacement therapy (TRT) is currently the main clinical treatment for LOH, however it has obvious side effects. A 2-methylpyrimidine-fused tricyclic diterpene analog 7 was afforded as anti-LOH hit, which was screened out from our small synthetic library. Then a series of derivates were designed and synthesized based on the hit and their effects in promoting testosterone production and cytotoxicities were evaluated in mouse TM3 Leydig cells. The most potent and safe compound 29 (SH379) was obtained, which significantly promoted the expression of the key testosterone synthesis-related enzymes StAR and 3β-HSD. Further studies discovered that 29 could stimulate autophagy through regulating AMPK/mTOR signaling pathway. More importantly, 29 increased the testosterone levels and the sperm viability and motility in PADAM (partial androgen deficiency in aging males) rats obviously and displayed almost no side effects. Furthermore, Preliminary pharmacokinetics evaluation also indicated an excellent oral bioavailability of 29. Therefore, these methylpyrimidine-fused tricyclic diterpene analogs could be used as leads for the development of a new type of potential anti-LOH agent.

Prevalence of Age-Associated Testosterone Deficiency Syndrome in Indian Population.

Testosterone deficiency syndrome (TDS) is a gradual age-related phenomenon that occurs in a large proportion of the aging male population. This current prospective study was done with the objective to estimate the prevalence of age-associated TDS in India and its clinical profile. A total of 800 male patients aged ≥40 year were approached to participate in the study. A brief history and focused examination was done. Based on our exclusion criteria, 55 patients were excluded. Androgen deficiency in aging male (ADAM) questionnaire was administered to all remaining 745 patients. Out of these 745 patients, ADAM-positive (symptomatic TDS) patients were found to be 359 and enrolled in the study. In all ADAM-positive patients, serum testosterone levels were measured. Prevalence of symptomatic TDS in study population was found to be 48.18%. Mean total and free testosterone level of symptomatic TDS population were 3.287 ± 1.494 ng/ml (1.12–9.61) and 7.476 ± 2.902 pg/ml (2.18–21.76), respectively. Prevalence of biochemically confirmed TDS among symptomatic TDS population was 60.17%. Prevalence of TDS increases progressively with each decade of life (p=0.034). Prevalence was higher in patients with diabetes, hypertension, coronary artery disease, obesity, and metabolic syndrome. TDS is a real phenomenon with a prevalence of 28.99% in our study population.

A study on hypogonadism in male HIV patients in northeastern part of India.

Context:After the introduction of highly active antiretroviral therapy (ART), the prevalence of hypogonadism among human immunodeficiency virus (HIV)-infected males is decreasing.Aims:The aim of this study was (i) to estimate the prevalence of hypogonadism among HIV-infected males and (ii) to determine the risk factors for hypogonadism.Settings and Design:This was a cross-sectional study undertaken at ART center of a medical Institute.Subjects and Methods:The study recruited HIV-infected males aged 18–65 years receiving ART. Patients with any debilitating chronic illness, diabetes mellitus, chronic smokers or alcoholic, currently on opioids, or methadone were excluded from the study. Androgen Deficiency in Aging Male (ADAM) questionnaire was used to screen patients for the possible presence of hypogonadism. For those screened positive on ADAM questionnaire underwent biochemical evaluation for serum total testosterone, luteinizing hormone (LH), and CD4 count.Statistical Analysis Used:The Chi-square test was used to compare different parameters. Pearson's correlation coefficient was used to assess any relationship between CD4 count, LH, and testosterone. P < 0.05 was considered statistically significant.Results:In the study, 426 were initially screened and 120 patients who had probable hypogonadism were further evaluated. The mean age of the patients was 41.61 years. The mean body mass index (BMI) of the patients was 22.47 kg/m2. The mean duration of ART was 6.13 years and the mean CD4 count was 442.63 cells/mm3. Hypogonadism was seen in 20 (23.3%) and majority (85.7%) had secondary hypogonadism. There was significant association between hypogonadism and CD4 count, but no association was found with BMI and duration of ART.Conclusions:Hypogonadism is seen in 23.3% of HIV-infected males. Majority (85.7%) had secondary hypogonadism. There was significant association of hypogonadism with lower CD4 count.

Evaluation of the effectiveness and safety of a daily dose of 5 mg of tadalafil, over an 8-week period, for improving quality of life among Korean men with andropause symptoms, including erectile dysfunction: A pilot study.

Background:The primary aim of this study was to evaluate the effects of a once-a-day 5 mg dose of tadalafil, prescribed for 8 weeks, on the quality of life (QoL) of South Korean men with andropause symptoms, including erectile dysfunction (ED), using a single group, open-labeled, before-and-after preliminary trial. The secondary objective was to evaluate the effectiveness and safety of tadalafil for ED.Methods:Forty South Korean men (>35 years of age) with andropause symptoms including ED were enrolled into our trial. Andropause syndrome was defined using the androgen deficiency in aging males (ADAM) questionnaire and other screening tests, including testosterone levels. The following outcome measures were obtained at baseline and at 4 and 8 weeks of tadalafil treatment: physical examination, adverse effects, Short Form 12 Health Survey (SF-12) score, International Index of Erectile Function (IIEF-5) score, bioelectrical impedance analysis (BIA), and free radical testing.Results:Treatment increased the SF-12 Mental component score, used as a proxy measure of quality of life, from baseline to at 4 and 8 weeks (P < .05). In addition, the mean IIEF-5 score, which assesses sexual function, increased from baseline at 4 and 8 weeks (P < .05), with this increase being significant at both time points. No adverse effects were noted.Conclusion:Tadalafil (5 mg dose, once daily) is a safe and effective treatment to improve ED, and overall QoL, among Korean men with andropause symptoms, including ED.