Difference In Serum Testosterone Levels Research Articles

Breed Differences in Serum Testosterone Levels of Male Pigs Are Highly Correlated with Differences in Testicular mRNA Levels of Enzymes and Proteins Involved in Testosterone Biosynthesis Process.

To clarify the causes of breed differences in serum testosterone levels of male pigs, which affect the mRNA expression of drug metabolizing enzymes and drug transporters in the liver and kidney, we focused on testicular enzymes and proteins involved in testosterone biosynthesis process and comparatively examined their mRNA levels by real time RT-PCR among low serum testosterone-type Landrace pigs and high serum testosterone-type Meishan and Landrace/Meishan-crossbreed (LM and ML) pigs. Testicular mRNA levels of the enzymes (3-hydroxy-3-methylglutaryl-CoA synthase 1 and 3-hydroxy-3-methylglutaryl-CoA reductase) and proteins (low density lipoprotein receptor and scavenger receptor class B member 1) affecting intracellular levels of cholesterol, a precursor of testosterone, were 2-5-fold higher in Meishan, LM and ML pigs than in Landrace pigs. Likewise, the mRNA levels of steroidogenic acute regulatory protein, which imports cholesterol to the inner mitochondrial membrane, and of testosterone biosynthesis enzymes (CYP11A1 and CYP17A1) were over 10-fold and approximately 3-fold higher, respectively, in Meishan, LM and ML pigs than in Landrace pigs. Furthermore, positive correlations between those mRNA levels and serum testosterone levels were observed. Despite large breed differences in testicular mRNA levels described above, no significant breed differences in intratesticular testosterone levels were observed. The present findings strongly suggest that breed differences in serum testosterone levels of male pigs are probably, at least in part, caused by differences in testicular mRNA levels of enzymes and proteins involved in testosterone biosynthesis process and by differences in the levels of testosterone released from testes.

Study on the Efficacy of Electric Acupuncture in the Treatment of Premature Ejaculation Based on Testosterone Level.

Objective To investigate the clinical efficacy and possible mechanism of electroacupuncture in the treatment of premature ejaculation. Methods 50 cases of premature ejaculation patients who met the diagnostic criteria were randomly divided into 2 groups with 25 cases in each group. The observation group was treated with electroacupuncture, and the control group was treated with Longdan Xiegan decoction. The treatment period was 4 weeks. Ejaculation latency (IELT), sexual satisfaction score of patients, sexual satisfaction score of partners, testosterone test, and drug safety assessment were performed in all 4 groups before and after treatment. Results IELT was prolonged in all groups after treatment, the difference was statistically significant (P < 0.05). At the same time, the IELT of the observation group was significantly higher than that of the control group after treatment. Life satisfaction scores of patients and spouses in 2 groups were improved after treatment compared with before treatment, the difference was statistically significant (P < 0.05). After treatment, the satisfaction scores of patients and spouses in the observation group were higher than those in the control group, and the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in serum testosterone levels among all groups (P > 0.05). Serum testosterone levels in all groups were decreased after treatment compared with before treatment, with statistical significance (P < 0.05). After treatment, the serum testosterone level of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). During the treatment, the adverse reactions in each group disappeared after treatment, and no obvious abnormality was observed in the safety indicators. Conclusion Electroacupuncture can improve the symptoms of premature ejaculation, which may be related to the regulation of serum testosterone by acupuncture.

Converting Men From Clomiphene Citrate to Natesto for Hypogonadism Improves Libido, Maintains Semen Parameters, and Reduces Estradiol

ObjectiveTo evaluate outcomes including libido, semen parameters, testosterone, estradiol (E2), follicle stimulating hormone (FSH), and luteinizing hormone when converting men with low libido on Clomiphene Citrate (CC) to Natesto. MethodsA retrospective chart review was performed. Baseline hormones prior to treatment, and again on CC and Natesto, as well as semen parameters on CC and on Natesto were assessed. ResultsIn 41 men, there was no difference in serum testosterone levels on CC vs Natesto, however; there was a significantly higher E2 on CC than on Natesto. Although FSH levels were significantly lower on Natesto than at baseline, the mean FSH level on Natesto remained in the normal reference range. There was no difference in luteinizing hormone levels at baseline vs on Natesto. There was not a significant difference in semen parameter values when men were on CC vs when they were on Natesto for 3 months. At 3 months after changing to Natesto, 38 of 41 (92.7%) men reported significantly improved libido on Natesto when compared to CC. ConclusionMen on CC and Natesto reach eugonadal testosterone levels, however; on CC the E2 level nearly doubled from baseline, and converting men from CC to Natesto returned E2 to nearly baseline levels. There was not a detrimental effect on semen parameters, and there was subjective reporting of improved libido after converting from CC to Natesto in this cohort, but further long-term studies are needed prior to Natesto being established as a definitive treatment for hypogonadism for men desiring to maintain fertility.

Evaluation of bilateral vasocystostomy for canine sterilization

This study was aimed to evaluate canine vasocystotomy as a testosterone-preserving method of sterilization and investigate its potential post-operative complications. Five healthy adult male dogs underwent surgical procedure to transplant vasa deferentia to the urinary bladder. Under general anesthesia, caudal abdomen was opened and both vasa deferentia were ligated and transected. Then, the proximal free ends were sutured to mucosal layer of urinary bladder on its cranio-dorsal aspect. Serum testosterone level was measured on a weekly basis. Six-week postoperative assessments were performed including semen and urine sampling, ultrasound, contrast vasography, and tissue sampling. Statistical analyses revealed no significant differences in serum testosterone levels compared to its baseline value. Along with non-motile and broken spermatozoa, no cast or crystals were observed in urine samples. Semen analyses revealed azoospermia. No vasal obstruction or contrast leakage was observed in vasographs indicating bilateral patency in all dogs. Normal thickness of the bladder was found in ultrasounds. Histopathology showed normal testicular architecture and no inflammatory response was found in bladder or vas deferens following vasal transplantation. No significant change was found in testicular volume at the end of the study. This study suggested that vasocystostomy could be considered as an alternative method for canine sterilization with no significant changes in the testosterone concentrations and no evidence of postoperative complications. The preservation of testosterone could be regarded as an advantage and makes this approach favorable compared to the routine methods of sterilization especially for herding and guard dogs, because it prevents overpopulation while maintains the functionality.

Influence of melatonin and sexual hormones on the expression of proliferating cell nuclear antigen in the adrenal cortex of a seasonal breeder (Lagostomus maximus).

The viscacha (Lagostomus maximus) is a rodent of nocturnal habits, whose physiology and behavior vary according to modifications of environmental signals. The objective of this study is to assess the influence of melatonin and sexual hormones on the viscacha adrenal cortex proliferative activity through the immunohistochemical detection of proliferating cell nuclear antigen (PCNA) along with hormonal determinations. PCNA expression was studied in male viscachas to assess the effect of melatonin administration, castration, and the annual reproductive cycle. In female viscachas, PCNA was studied in nonpregnant and pregnant viscachas. PCNA expression was observed in adrenocortical cells (PCNA-A) and endothelial cells (PCNA-E). Melatonin-administered animals showed a significantly lower number of PCNA-A compared to the control group. No significant difference could be established in the number of PCNA-A and PCNA-E between castrated and control animals. However, the morphometric analysis showed an increase in the size of the cortex of castrated animals, along with other cytological features. Significant differences in serum testosterone levels were observed during the male viscacha reproductive cycle, with the lowest levels encountered during the regression period (winter). Male viscachas exhibited a significantly high number of PCNA-A during late autumn and a high number of PCNA-E during winter. In females, hormonal determinations showed a peak of progesterone and estrogen during mid-pregnancy, along with a notably high number of PCNA-A and an increase in the number of PCNA-E. Our results suggest that proliferation in the adrenal cortex of the viscacha varies in relation to melatonin, sexual hormones, and environmental conditions.

Effects of Testosterone Treatment on Quality of Life in Patients With Chronic Kidney Disease.

Testosterone deficiency (TD) is common and impairs quality of life (QoL) in patients with chronic kidney disease (CKD). However, there are no studies about whether testosterone replacement therapy (TRT) can improve QoL in patients with CKD. Therefore, we investigated the effect of TRT on the QoL of patients with CKD and confirmed the safety of TRT. Twenty-five male patients with stages III–IV CKD whose serum testosterone levels were <350 ng/dl (TD) were enrolled and treated with testosterone gel for 3 months (group II). Age-matched controls with stages III–IV CKD and TD (group I) were recommended to exercise for the same period. Before and after the treatment, the BMI and handgrip strength were checked, serological tests were performed, and questionnaires were administered in both groups. Compared to baseline, there was no significant difference in serum testosterone levels, scores of the 36-Item Short Form Health Survey (SF-36), Aging Males’ Symptoms Scale (AMS), and International Prostate Symptom Score (IPSS), and grip strength in group I after 3 months. In group II, a significant increase in testosterone, hemoglobin (Hb), and hematocrit (Hct) was observed, and grip strength significantly increased after TRT. Significant improvement in scores of SF-36, AMS, and IPSS was also confirmed after TRT in group II. There was a significant difference in testosterone, Hb, Hct, grip strength, and scores of SF-36, AMS, and IPSS between the two groups after 3 months. The patients in group II showed positive results and continued with TRT. Therefore, we conclude that TRT safely improves the QoL and TD symptoms in patients with moderate-to-severe CKD.

Clinical and Metabolic Responses to Magnesium Supplementation in Women with Polycystic Ovary Syndrome.

We hypothesized that magnesium supplementation might help improve metabolic profiles and clinical symptoms of polycystic ovary syndrome (PCOS) through its role in insulin action. The present study aimed to investigate the effect of magnesium supplementation on metabolic profiles and levels of sex hormones in women with PCOS. In this parallel randomized, double-blind, placebo-controlled clinical trial, 60 women with PCOS aged 20-45years were recruited. After stratification for body mass index (BMI), age, and types of medications, participants were randomly assigned to consume magnesium supplements (containing 250mg magnesium oxide) or placebo for 8weeks. To assess biochemical indicators, a venous blood sample was taken after an overnight fasting. The mean age of study participants was 26.4years. We found that magnesium supplementation for 8weeks among women with PCOS had favorable effects on BMI compared with the placebo group (changes from baseline in intervention group: - 0.31 ± 0.07 vs. 0.07 ± 0.09kg/m2 in control group). In addition, the supplementation lead to preventing the increase in waist circumference in intervention group compared with the control group (0.02 vs. 1.15cm). No significant effects on glycemic variables and lipid profile were seen following the magnesium supplementation. A significant increase in serum LH levels in intervention group and a decrease in placebo group were observed (P = 0.01). Although we found a significant decrease in serum testosterone levels in intervention and placebo groups, comparing the changes between the two groups, a marginally significant difference in serum testosterone levels was found (51.65 vs. 47.80 in intervention, 43.41 vs. 39.46 in placebo, P = 0.08). A significant increase in serum dehydroepiandrogens (DHEA) (136.32 vs. 172.37 intervention, 102.74 vs. 120.15 placebo, P = 0.01) was seen in two groups. Magnesium supplementation had no significant effects on FSH, 17OH-progesteron, sex hormone-binding globulin (SHBG), and free androgen index (FAI) levels. We found evidence indicating that magnesium supplementation did not influence serum lipid profiles and glycemic indicators among women with PCOS. Magnesium supplementation resulted in reduced BMI and testosterone levels as well as increased DHEA concentrations in women with PCOS. Also, magnesium supplementation may increase serum LH levels. ClinicalTrials.gov IRCT registration no. NCT02178150.

Effect of Unilateral Iatrogenic Testicular Torsion on the Contralateral Testis in Rats: Prepubertal and Postpubertal.

The present study was conducted to investigate the influence of hemicastration and age at hemicastration on the contralateral testis weight and function/testosterone production. 64 Wistar-derived male rats were divided randomly into 4 groups. Group 1 was named immature intervention, group 2 immaturecontrol, group 3 mature intervention, and group 4mature control. In group 1, rats were hemicastrated at 30 days of age (prepubertal). In group 2, sham surgery (midscrotal incision) was per-formed atthe same age. In group 3, rats were hemicastrated at 70 days of age (postpubertal) and in group 4,sham surgery was done at the same age. Twenty days after the first surgery, contralateral orchiectomy wasperformed in intervention groups and controls underwent random orchiectomy (left or right). Blood sampling for evaluation of serum testosterone was performed just before second surgery. The mean testis weight (1692 ± 26.7 in group 1 versus 1375 ± 39.7 in group 2; P < .001 and 1760 ± 26.6 in group 3 versus 1425 ± 44.9 in Group 4; P < .001) and the mean testicular weight (mg) per 100 g of body weight (735.8 ± 82.3 in group 1 versus 634.8 ± 84.8 in group 2; P = .005 and 652.4 ± 61.4 in group 3 versus 572.6 ± 97.7 in group 4; P = .03) were significantly greater in hemicastrated rats as to their controls. Also, these parameters was greater in prepubertal group than postpubertalhemicastrated rats. There was no appreciable difference in serum testosterone levels across the 4 groups (P = .77). Our research demonstrated that hemicastration results in compensatory hypertrophy of the remaining testis and it decreases as the animals age. Hemicastration does not lead to reduction in serum testosterone levels and the remaining testis can retrieve a normal serum testosterone level.

Association of plasma total testosterone level and metabolic syndrome in adult males

Introduction: Low testosterone level has strongly been correlated with body fat accumulation and abdominal obesity in men. Objectives: This study aimed to evaluate testosterone level in men with and without metabolic syndrome to determine the relationship between testosterone and metabolic syndrome. Patients and Methods: This case-control study was conducted on 172 cases of metabolic syndrome and 172 participants as a control group in Rasoul Akram hospital, Tehran, Iran. Demographic characteristics, fasting blood sugar (FBS), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglyceride (TG), and testosterone levels were recorded. SPSS version 21.0 and SAS version 9.1 were used for statistical analysis. Level of significance was considered 0.05. Results: The mean age of the two groups were 45.1±9.3 years and 41.5 ±11.2 years, respectively. There was a significant difference in serum testosterone levels between both groups and low testosterone levels were associated with metabolic syndrome (P&lt;0.001). Serum testosterone levels showed a significant negative correlation with age in the metabolic syndrome group (r= -0.16, P=0.02). The relationship between metabolic syndrome and total plasma testosterone level using logistic regression model showed that, by increasing the total plasma testosterone level, the odds ratio for metabolic syndrome was 0.076 (95% CI: 0.027-0.216; P&lt; 0.001). Conclusion: According to the results, low level of testosterone was related to the presence of metabolic syndrome in adult males. Future studies can investigate diagnostic value of testosterone level in this syndrome.

Comparison of serum dehydroepiandrosterone sulfate, testosterone, and dihydrotestosterone levels in males with various degrees of acne vulgaris severity

Objective: This study compared the levels of dehydroepiandrosterone (DHEA) sulfate, testosterone, and dihydrotestosterone (DHT) in the serum of men with various degrees of severity grading of acne vulgaris. Methods: We conducted a cross-sectional analytic observational study and used the Combined Acne Severity Classification. Serum DHEA sulfate (DHEAS), testosterone, and DHT levels were measured by enzyme-linked immunosorbent assay. We recruited 63 males with acne vulgaris. Results: For mild, moderate, or severe acne, the mean serum level of DHEAS was 90.92, 153.54, and 166.67 ng/ml (P = 0.000); testosterone was 6.66, 8.11, and 8.97 ng/ml (P = 0.445); and DHT was 87.33, 111.72, and 124.71 (P = 0.01), respectively. Post hoc analysis showed significant differences for DHEAS and DHT serum levels. There were significant differences for DHEAS and DHT serum levels. Conclusion: There was no significant difference in serum testosterone levels between groups, although there was an increase in concentration by acne vulgaris severity.

Testosterone Supplementation Increases Lean Mass in Men Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Objectives:Surgical reconstruction of the anterior cruciate ligament (ACL) is essential for those who wish to resume athletic activity following ACL rupture. However, the trauma of surgical repair and post-operative immobility can exacerbate muscle loss and strength. This study investigated the effect of perioperative testosterone administration on lean mass recovery following ACL reconstruction in men. The effects of testosterone on leg strength and clinical outcome scores were also investigated. We hypothesized that testosterone would increase lean mass and leg strength, and improve clinical outcome scores 6 and 12 weeks after surgery to a greater degree than placebo.Methods:This was a randomized, controlled, double blinded clinical trial comparing testosterone and placebo for recovery from ACL repair. Thirteen male subjects scheduled for ACL reconstruction were randomized into two groups, testosterone (n=6) and placebo (n=7). Participants in the testosterone group received 200 mg of testosterone administration weekly for 8 weeks starting 2 weeks prior to surgery. Participants in the control group received a saline placebo intramuscularly following the same schedule. Both intervention groups underwent standard physical rehabilitation. The primary outcome was change in total lean body mass at 6 and 12 weeks, measured by whole-body dual-energy x-ray absorptiometry. Secondary outcomes were extensor muscle strength measured using a Cybex Dynamometer, and the Tegner Activity Score (TAS) and Knee Injury and Osteoarthritis Outcome Score (KOOS).Results:Total testosterone levels in the blood increased from baseline to an average of 860 ± 254 ng/dL by 1 day prior to surgery and 746 ± 173 ng/dL at 6 weeks post-surgery for the testosterone group. The differences in serum testosterone levels between the placebo and testosterone groups at 1 day prior to surgery and 6 weeks post-surgery were both statistically significant (p<0.001). We found that testosterone increased lean mass by 2.8 ± 1.7 kg from baseline at 6 weeks following surgery, while the placebo group had a decrease in lean muscle mass of 0.1 ± 1.5 kg (p=0.01) (Figure 1). Extensor strength of the non-injured leg had a greater increase from baseline in the testosterone group (20.8 ± 25.6 Nm) than the placebo group (-21.4 ± 36.7 Nm) at 12 weeks (p=0.02). There were no significant differences in injured leg strength or clinical outcome scores throughout the study period.Conclusion:Despite a catabolic environment, acute testosterone supplementation increased lean mass 6 weeks after ACL reconstruction, and strength of the non-injured leg 12 weeks after surgery, to a greater degree than placebo. These results suggest that testosterone may be a novel, useful adjunct to physical therapy for knee surgery rehabilitation by offsetting perioperative muscle loss from surgery and immobility. Larger studies are now necessary to elucidate the effects of perioperative testosterone administration on injured leg strength and clinical outcomes following surgery.

Use of statins is associated with lower serum total and non-sex hormone-binding globulin-bound testosterone levels in male participants of the Rotterdam Study

Statins, or HMG-CoA reductase inhibitors, decrease cholesterol production. Because cholesterol is a precursor of the testosterone biosynthesis pathway, there is some concern that statins might lower serum testosterone levels. The objective of the present study was to investigate the association between the use of statins and serum testosterone levels in men. Cross-sectional study within the prospective population-based Rotterdam Study. We included 4166 men with available data on total testosterone, non-sex hormone-binding globulin (SHBG)-bound testosterone, and medication use. Multivariable linear regression analysis was used to compare the differences in serum testosterone levels (nmol/l) between current, past, and never statin users. We considered dose and duration of use. Analyses were adjusted for age, BMI, cardiovascular disease, diabetes mellitus, hypertension, and estradiol levels. We identified 577 current (mean age 64.1 years), 148 past (mean age 64.6 years), and 3441 never (mean age 64.6 years) statin users. Adjusted for all covariables, current statin use of 1-≤ 6 months or >6 months was significantly associated with lower total testosterone levels as compared to non-users (β -1.24, 95% CI -2.17, -0.31, and β -1.14, 95% CI -2.07, -0.20 respectively). Current use of 1-≤ 6 months was also associated with significantly lower non-SHBG-bound testosterone levels (β -0.42, 95% CI -0.82, -0.02). There was a trend toward lower testosterone levels at higher statin doses both for total (P(trend) 2.9 × 10(-5)) and non-SHBG-bound (P(trend) 2.0 × 10(-4)) testosterone. No association between past statin use and testosterone levels was found. We showed that current use of statins was associated with significantly lower serum total and non-SHBG-bound testosterone levels. The clinical relevance of this association should be further investigated.

Effect of resveratrol on restoring spermatogenesis in experimental cryptorchid mice and analysis of related differentially expressed proteins

The present study aimed to evaluate the effect of trans-Resveratrol on spermatogenesis. Male Kunming suckling mice (10 days old) were surgically rendered cryptorchid and subcutaneously injected with trans-Resveratrol at doses of 5, 10, 20, and 40 µg/g/day as groups I, II, III, and IV, respectively, for 35 days. Animals in the control group received 10 µL/mouse/day of olive oil. Serum estradiol, testosterone, FSH, and LH levels were measured on day 45. Tissue analysis and sperm morphological abnormalities analysis were done. Results showed that in the control group and group I only spermatogonia and primary spermatocytes were present, whereas spermatogenesis was totally restored in groups II, III, and IV. Sperm counts in groups III and IV were remarkably higher than the control group (P<0.05). The morphological abnormalities in resveratrol-treated groups were higher than the mature mice. Serum estradiol levels in the resveratrol-treated groups were not significantly different from the control group, but were lower than the mature mice (P<0.05). There was no significant difference in serum testosterone levels between the resveratrol-treated groups and mature mice, but the levels in the resveratrol-treated groups was significantly lower than the control group (P<0.05). No significant influence of trans-Resveratrol was observed on serum FSH levels in all cryptorchid mice. Serum LH levels in groups I, II, and III were higher than the control group. These results indicate that trans-Resveratrol restores spermatogenesis in cryptorchid mice. In addition, proteomic analysis between the 20 μg/g/day resveratrol-treated group and the control group was carried out, and five kinds of proteins (BAF250, ZFP261, CHD1L, RBBP9, and SOHLH2) were identified. The expression of SOHLH2 increased, while that of BAF250, ZFP261, CHD1L, and RBBP9 decreased in the 20 µg/g/day resveratrol-treated group, indicating that SOHLH2 may contribute to testicular germ cell differentiation.

Relationship of serum testosterone levels with cognitive function in chronic antipsychotic-treated male patients with schizophrenia.

Some evidence suggests that testosterone might be involved in the cognitive impairments of schizophrenia. We assessed major cognitive domains and serum testosterone levels in male long-term inpatients with schizophrenia. This study aimed to test whether testosterone in serum was abnormal in patients, and whether it was related to the cognitive impairment of schizophrenia. Serum testosterone levels in male schizophrenics (n = 80) and normal controls (n = 40) were measured by immunoassay. All patients were assessed for performance on executive functions, sustaining and focusing of attention, memory functions, and verbal fluency using the Digit Cancellation Test (DCT), Semantic Fluency Test, Spatial Span (SS), Trail Making Test, part A (TMT-A), Block Design, and Paced Auditory Serial Addition Test. Serum testosterone levels in schizophrenic patients were similar to control subjects (P > 0.05). We found that serum testosterone levels were significantly correlated with total time taken (in seconds) in the DCT (r = 0.261, P < 0.05) and SS score (r = -0.240, P < 0.05) in schizophrenic patients. Moreover, backward linear regression revealed that testosterone levels significantly predicted performance in DCT (β = 0.240, P = 0.028) and SS score (β = -0.207, P = 0.047) in patients. Our findings suggest that there is no significant difference in serum testosterone levels between groups, and that serum testosterone levels are associated with the spatial memory and attention deficits in chronic antipsychotic-treated male patients with schizophrenia.

Factors Influencing Patient Decisions to Initiate and Discontinue Subcutaneous Testosterone Pellets (Testopel) for Treatment of Hypogonadism

A variety of modalities for testosterone replacement therapy (TRT) are available, including topical gels, injections, and Testopel subcutaneous testosterone pellets (STP). STP are becoming more commonly utilized in the United States; however, patient preferences, expectations, and usage patterns regarding this therapy remain poorly characterized. To identify factors influencing patients' decisions to initiate or discontinue STP. A total of 175 men from an academic urology clinic who were currently using or who had previously used STP for hypogonadism received a 32-item electronic survey. Assessment of the impact of convenience, efficacy, side effects, cost, and symptom relief on initiation and discontinuation of STP. One hundred and thirteen men (64.6% response rate) of mean age 51.4 years who previously underwent a mean of 2.8 STP implant procedures completed the survey. Fifty-nine (52.2%) and 40 (35.4%) men had switched to STP from topical gel and injection therapy, respectively, whereas 14 (12.4%) men initially started TRT with STP. Convenience (68.8%) was the most important factor in patients' decision to start STP, while cost of the previous form of TRT (14.7%) was least important. At the time of the survey, 32 men (28.3%) had discontinued STP therapy. Cost of therapy (50%) was the primary factor in discontinuing STP. There was no difference in serum testosterone levels between men who continued STP and those who discontinued therapy (642.8 vs. 629.0 ng/dL, P = 0.83). Overall, 68.1% of patients continued STP therapy at the time of survey completion. Convenience is the most important factor in a patient's decision to initiate STP; however, physician recommendation also plays a substantial role. Cost was the primary reason for discontinuation. Upon survey completion, greater than two-thirds of respondents elected to continue STP therapy. STP are a viable treatment option for hypogonadal men seeking a convenient and efficacious alternative modality of TRT.

1518 FACTORS INFLUENCING PATIENT DECISIONS TO INITIATE AND DISCONTINUE TESTOPEL® SUBCUTANEOUS TESTOSTERONE PELLETS FOR TREATMENT OF HYPOGONADISM

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Nonsurgical Therapy1 Apr 20131518 FACTORS INFLUENCING PATIENT DECISIONS TO INITIATE AND DISCONTINUE TESTOPEL® SUBCUTANEOUS TESTOSTERONE PELLETS FOR TREATMENT OF HYPOGONADISM Abhinav Khanna, Saneal Rajanahally, Ryan Smith, Robert Coward, Jason Kovac, Marshall Gonzales, and Larry Lipshultz Abhinav KhannaAbhinav Khanna Houston, TX More articles by this author , Saneal RajanahallySaneal Rajanahally Houston, TX More articles by this author , Ryan SmithRyan Smith Houston, TX More articles by this author , Robert CowardRobert Coward Houston, TX More articles by this author , Jason KovacJason Kovac Houston, TX More articles by this author , Marshall GonzalesMarshall Gonzales Houston, TX More articles by this author , and Larry LipshultzLarry Lipshultz Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2996AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A variety of modalities for testosterone replacement therapy (TRT) are available, including topical gels, injections, and Testopel® subcutaneous testosterone pellets (STP). STP are becoming more commonly utilized, but patient preferences and usage patterns surrounding this therapy remain poorly characterized. We sought to identify factors influencing patients' decisions to initiate or discontinue STP and to describe their experiences with this modality. METHODS A total of 175 men from a large academic urology clinic who were currently using or had previously used STP for hypogonadism received a 32-item electronic survey. Statistical analyses were performed using chi-square and Student's t-test for categorical and continuous variables, respectively. Statistical significance was defined at p<0.05. RESULTS One-hundred-one men (response rate 57.7%), mean age 51.4 (range 25-76), completed the survey. Forty-nine (48.5%) and 40 (39.6%) men switched to STP from topical gel and injection therapy, respectively, while 12 (11.9%) men initially started TRT with STP. Convenience (80.4%) was the most important factor in patients' decision to start STP, while cost of the previous form of TRT (29.9%) was least important. Physician recommendation (81.3%) and possible transference to others (50%) were the most common reasons to switch to STP from a gel, while the gel characteristics (33.4%) were the least common. Similarly, users switching from injection therapy cited physician recommendation regarding STP (80.0%) as their primary reason for initiating STP therapy, while pain of injections (32.5%) was the least common. At the time of the survey, 31 men (31.9%) had stopped using STP. Of these, 15 (48.4%) went back to a previously used method, 8 (25.8%) switched to a previously unused method, and 8 (25.8%) stopped using TRT completely. Cost of therapy (60.0%) was the primary factor in discontinuing STP. There was no difference in serum testosterone levels between men who continued STP and those who discontinued them (704.9 vs 757.6 ng/dL, p = 0.53). CONCLUSIONS Convenience is the most important factor in a patient's decision to initiate STP; however, physician recommendation also plays a substantial role. Despite the potential disadvantages of gel and injection therapies, patients do not cite these as primary reasons for switching to STP. Cost was the primary factor in discontinuing STP. STP is a viable treatment option for hypogonadal men seeking an easy and dependable alternative modality of TRT. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e622 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abhinav Khanna Houston, TX More articles by this author Saneal Rajanahally Houston, TX More articles by this author Ryan Smith Houston, TX More articles by this author Robert Coward Houston, TX More articles by this author Jason Kovac Houston, TX More articles by this author Marshall Gonzales Houston, TX More articles by this author Larry Lipshultz Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Serum testosterone levels are related to cognitive function in men with schizophrenia

Sex steroids such as oestrogen and testosterone are potent neurodevelopmental hormones that also play a role in neuromodulation and neuroprotection of the mature brain. Sex steroid hormones may also be involved in the pathophysiology of schizophrenia as reduced circulating sex steroid levels and changes in brain sex steroid receptors are found in people with schizophrenia compared to controls. In men with schizophrenia, recent studies have documented an inverse correlation between serum testosterone and negative symptoms. Our study sought to confirm whether men with schizophrenia had lower levels of testosterone relative to controls and to determine whether lower testosterone levels were related to higher symptom severity and impaired cognition. Circulating serum hormone levels (testosterone, oestrogen, and prolactin), cognitive function and symptoms were assessed in 29 chronically ill men with schizophrenia or schizoaffective disorder. Twenty healthy men were recruited as a comparison group. A series of regression analyses were performed to determine the extent to which circulating sex steroid hormone levels predict cognition and symptoms in men with schizophrenia. We did not find a significant difference in serum testosterone levels between groups. However, circulating testosterone levels significantly predicted performance on verbal memory, processing speed, and working memory in men with schizophrenia. With the exception of an effect of oestrogen on verbal memory, circulating sex steroid levels did not predict cognitive function in healthy men. Testosterone levels were not related to positive or negative symptom severity, but testosterone influenced excitement/hostility levels in our schizophrenia sample. The results suggest that circulating sex steroids may modulate cognitive deficits associated with schizophrenia.

Comparison of serum testosterone levels in prostate cancer patients

Introduction: The prostate secretes enzymes and nutrients to promote sperm motility. Recent reports suggest that the prostate may also secrete testosterone, which is believed to be a fuel for prostate tumour growth. The aim of this study was to determine if a difference in serum testosterone levels exists between men on luteinizing hormone releasing-hormone (LHRH) agonists who have undergone radical prostatectomy, radiation or hormone therapy as primary prostate cancer treatment.Methods: Serum testosterone levels were evaluated in 165 consecutive prostate cancer patients using LHRH analogues for &gt;3 months. We excluded patients receiving either radiation or chemotherapy at time of time of testosterone measurement. Patients were classified based on primary treatment: (1) radical prostatectomy; (2) radiation; or (3) primary hormone therapy. We used one-way ANOVA to compare testosterone levels. Pearson correlation was used to correlate testosterone with prostate-specific antigen (PSA) and time on LHRH agonists. Multivariable linear regression was used to predict serum testosterone levels.Results: The median (interquartile range) serum testosterone levels were 1.4 (1-1.9), 1.3 (1-1.625) and 1.25 (0.9-1.525) nmol/L for radical prostatectomy, radiation and primary hormone therapy groups, respectively. There was no statistically significant difference in testosterone levels between the groups (p = 0.3). No correlation was found between testosterone and PSA levels or time on LHRH (r = 0.02 and r = 0.01), respectively. Multivariable linear regression showed that none of the clinical variables were predictors ofserum testosterone levels.Conclusion: Our study suggests that primary treatment does notaffect serum testosterone levels among men using LHRH analogues.

Comparison of serum testosterone levels in prostate cancer patients receiving LHRH agonist therapy with or without the removal of the prostate

: The prostate secretes enzymes and nutrients to promote sperm motility. Recent reports suggest that the prostate may also secrete testosterone, which is believed to be a fuel for prostate tumour growth. The aim of this study was to determine if a difference in serum testosterone levels exists between men on luteinizing hormone releasing-hormone (LHRH) agonists who have undergone radical prostatectomy, radiation or hormone therapy as primary prostate cancer treatment. : Serum testosterone levels were evaluated in 165 consecutive prostate cancer patients using LHRH analogues for >3 months. We excluded patients receiving either radiation or chemotherapy at time of time of testosterone measurement. Patients were classified based on primary treatment: (1) radical prostatectomy; (2) radiation; or (3) primary hormone therapy. We used one-way ANOVA to compare testosterone levels. Pearson correlation was used to correlate testosterone with prostate-specific antigen (PSA) and time on LHRH agonists. Multivariable linear regression was used to predict serum testosterone levels. : The median (interquartile range) serum testosterone levels were 1.4 (1-1.9), 1.3 (1-1.625) and 1.25 (0.9-1.525) nmol/L for radical prostatectomy, radiation and primary hormone therapy groups, respectively. There was no statistically significant difference in testosterone levels between the groups (p = 0.3). No correlation was found between testosterone and PSA levels or time on LHRH (r = 0.02 and r = 0.01), respectively. Multivariable linear regression showed that none of the clinical variables were predictors of serum testosterone levels. : Our study suggests that primary treatment does not affect serum testosterone levels among men using LHRH analogues.

Improvement in scalp hair growth in androgen‐deficient women treated with testosterone: a questionnaire study

BackgroundAndrogens are thought to have an adverse effect on female scalp hair growth. However, our clinical experience of androgen replacement therapy in women with androgen deficiency, in which hair loss was seldom reported, led us to question this concept.ObjectivesTo evaluate the effect of subcutaneous testosterone therapy on scalp hair growth in female patients.MethodsA total of 285 women, treated for a minimum of 1 year with subcutaneous testosterone implants for symptoms of androgen deficiency, were asked to complete a survey that included questions on scalp and facial hair. Age, body mass index (BMI) and serum testosterone levels were examined.ResultsOut of the 285 patients, 76 (27%) reported hair thinning prior to treatment; 48 of these patients (63%) reported hair regrowth on testosterone therapy (responders). Nonresponders (i.e. no reported hair regrowth on therapy) had significantly higher BMIs than responders (P = 0·05). Baseline serum testosterone levels were significantly lower in women reporting hair loss prior to therapy than in those who did not (P = 0·0001). There was no significant difference in serum testosterone levels, measured 4 weeks after testosterone implantation, between responders and nonresponders. No patient in this cohort reported scalp hair loss on testosterone therapy. A total of 262 women (92%) reported some increase in facial hair growth.ConclusionsSubcutaneous testosterone therapy was found to have a beneficial effect on scalp hair growth in female patients treated for symptoms of androgen deficiency. We propose this is due to an anabolic effect of testosterone on hair growth. The fact that no subject complained of hair loss as a result of treatment casts doubt on the presumed role of testosterone in driving female scalp hair loss. These results need to be confirmed by formal measurements of hair growth.