Free Testosterone Levels Research Articles

The effect of aqueous extract of orchid root on the structure of ovary and hypothalamic-pituitary-gonadal hormones in polycystic ovary syndrome rat model: An experimental study.

Some medical conditions, including polycystic ovarian syndrome (PCOs), may lead to infertility. In PCOs, hormonal imbalance is significant. Antioxidants such as natural antioxidants have many health benefits, including positive effects on hormone production. Since herbal medicines are more acceptable to people, the present study was designed to evaluate the effect of an aqueous extract of orchid (SA), with antioxidative effects, on the structure of the ovary and the hypothalamic-pituitary-gonadal axis hormones and free testosterone in PCOs rats. In this experimental study, 64 healthy female Wistar rats (180-200 gr) were randomly divided into 60 and 89 day control groups, PCOs, and 4 PCOs + SA groups that received 40, 80, 160, and 320 mg/kg of SA. Serum levels of gonadotropin-releasing hormone, estrogen, progesterone, testosterone, follicle-stimulating hormone, and luteinizing hormone were measured. In addition, the ovaries were extracted and examined histologically. The amount of primordial, primary, secondary, and Graafian follicles and serum levels of follicle-stimulating hormone and progesterone hormones decreased in PCOs groups, while atretic follicles and the serum levels of gonadotropin-releasing hormone, luteinizing hormone, estrogen, and free testosterone were increased. SA at different doses regulated hormonal and histological imbalances caused by PCOs, and 320 mg/kg was the most effective. The aqueous extract of orchids root can have a positive effect on the improvement of polycystic ovary syndrome. This effect can be achieved by regulating the level of sex hormones and correcting follicular abnormalities in the ovarian tissue.

The Association of Free Testosterone with Sarcopenic Obesity in Community-Dwelling Older Men: A Cross-Sectional Study.

Background and Objectives: Sarcopenic obesity, a clinical condition coexisting with obesity and sarcopenia, is associated with a high risk of functional impairment, reduced quality of life, and increased mortality. A decline in age-related free testosterone (FT) levels has been reported to be associated with decreased muscle mass and muscle strength and increased fat mass. However, the association between low FT levels and risk of sarcopenic obesity has not been well studied. This study aimed to investigate the direct association between low FT levels and sarcopenic obesity. Materials and Methods: This cross-sectional study used data of 982 community-dwelling men aged 70-84 years from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the criteria of the Asian Group for Sarcopenia (AWGS) 2019. Obesity was defined as a body fat mass ≥28.3%. Participants who met both sarcopenia and obesity criteria were defined as having sarcopenic obesity. Low FT levels were defined as FT levels <17.35 pmol/L according to the Endocrine Society Clinical Practice Guidelines. Results: The prevalence of sarcopenia, obesity, and sarcopenic obesity was significantly higher in the low-FT group than in the normal-FT group. Low FT levels were significantly associated with a higher risk of obesity (odds ratio [OR], 2.09, 95% confidence interval [CI], 1.11-3.92), sarcopenia (2.57, 95% CI 1.08-6.10), and sarcopenic obesity (3.66, 95% CI 1.58-8.47) compared with the healthy control group. The risk of low appendicular skeletal muscle mass index (ASMI) (1.78, 95% CI 1.04-3.02) and high fat mass (1.92, 95% CI 1.12-3.31) was significantly higher in the low-FT group than in the normal-FT group. Conclusions: This study showed that low FT levels were associated with a higher risk of sarcopenic obesity. Low FT levels were mainly related to body composition parameters such as low ASMI and high fat mass.

Hypogonadism among HIV-positive men who have sex with men in Taiwan: Prevalence and associated factors

BackgroundMale hypogonadism is not uncommon in people with HIV (PWH), with estimated prevalence ranging from 9% to 16%. Existing data are limited on the serum testosterone levels in PWH in Asian populations. MethodsWe enrolled HIV-positive men who have sex with men (MSM) and had been on stable antiretroviral therapy and MSM without HIV between February 2021 and November 2022. Serum free testosterone levels, sex hormone-binding globulins and other associated hormones were measured. Multiple linear regression analysis was performed to assess the association between serum free testosterone levels and clinical variables collected. ResultsA total of 447 MSM with HIV and 124 MSM without HIV were enrolled. Compared with MSM without HIV, MSM with HIV had a higher age (median, 41 versus 29.5 years) and prevalence of symptomatic hypogonadism (8.3% versus 1.6%). Among MSM who were aged <35 years, there were no significant differences in the serum free testosterone levels and prevalences of hypogonadism between the two groups. In multiple linear regression analysis, serum free testosterone level significantly decreased with advanced age (a decrease of 1.14 pg/mL per 1-year increase) and a higher body-mass index (BMI) (a decrease of 1.07 pg/mL per 1-kg/m2 increase), but was not associated with HIV serostatus. ConclusionWe found that MSM with HIV had a higher prevalence of symptomatic hypogonadism than MSM without HIV in Taiwan, which could be attributed to age difference. Serum free testosterone levels were negatively correlated with age and BMI, but did not show a significant correlation with HIV serostatus.

The maintenance of long-term weight loss after semaglutide withdrawal in obese women with PCOS treated with metformin: a 2-year observational study.

Withdrawal of semaglutide is frequently followed by weight regain due to compensatory biological changes that prevent the maintenance of long-term weight loss. There are some studies implying that metformin might attenuate weight regain. The weight trajectory after discontinuation of short-term semaglutide treatment in obese women with PCOS who continued metformin treatment has not yet been evaluated. We explored changes in body weight, cardiometabolic and endocrine parameters in obese women with PCOS who continued treatment with metformin 2 years after discontinuation of short-term intervention with semaglutide. 25 women with PCOS and obesity, aged 33.7 ± 5.3 years (mean ± SD), were treated with once-weekly subcutaneous semaglutide 1.0 mg as an adjunct to metformin 2000 mg/day and lifestyle intervention for 16 weeks. At week 16, semaglutide was discontinued. Treatment with metformin 2000 mg/day and promotion of lifestyle intervention were continued during the 2-year follow-up period. Weight change, cardiometabolic, and endocrine parameters were assessed 2 years after semaglutide discontinuation. During semaglutide treatment phase, weight decreased from 101 (90-106.8) kg to 92 (83.3-100.8) kg. Two years after semaglutide withdrawal, weight was 95 (77-104) kg. The net weight loss 2 years after discontinuation of semaglutide remained significant when compared to baseline (p=0.003). At the end of the study, 21 out of 25 subjects had lower body weight compared to baseline. Improvements in cardiometabolic parameters including decrease in total and LDL cholesterol, fasting glucose, and glucose after OGTT that had been seen during semaglutide-treatment phase reverted towards baseline two years after semaglutide cessation. Free testosterone levels significantly decreased during semaglutide treatment from 6.16 (4.07-9.71) to 4.12 (2.98-6.93) nmol/l, (p= 0.012) and did not significantly deteriorate after semaglutide discontinuation. Two years after semaglutide withdrawal, women with PCOS who continued with metformin regained about one-third of the semaglutide-induced weight loss. At the end of the follow up, 84% of women had a lower body weight than at baseline.

The effect of overweight and obesity on the severity of manifestations of chronic nonbacterial prostatitis with an inflammatory component

BACKGROUND: Chronic prostatitis is one of the most common urological diseases of young and middle-aged men. The variety of pathogenetic mechanisms and clinical manifestations, the tendency to recurrence necessitates the search for new methods of examination and monitoring of this disease. AIM: To identify the characteristics of the clinical manifestations of chronic non-bacterial prostatitis with an inflammatory component in men of the first period of adulthood, depending on the body mass index. MATERIALS AND METHODS: A comprehensive urological examination was carried out on 150 men with CNVC in the first period of adulthood, aged 22 to 35 years. All patients were assessed for hormonal status, as well as anthropometric parameters. RESULTS: Men with normal body mass index had milder clinical symptoms of prostatitis compared with overweight and obese patients. The results of laboratory studies demonstrated a more pronounced inflammatory process and dysfunction of the prostate in patients with a higher body mass index. Analysis of hormonal status revealed high levels of total and free testosterone and low levels of estradiol in men with normal body mass index. The content of sex hormone-binding globulin was significantly lower in obese patients. Overweight and obese men also had larger prostate volume according to TRUS. CONCLUSIONS: More severe manifestations of prostatitis are associated with an increase in body mass index.

Symptomatic androgen deficiency and sexual dysfunctions in male patients receiving alectinib for ALK-positive advanced non-small 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 non-small 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.

Interplay of combat deployment harassment, testosterone concentrations and post-deployment suicide risk in male veterans.

Many combat veterans exhibit suicidal ideation and behaviour, but the relationships among experiences occurring during combat deployment and suicidality are still not fully understood. In this study, we tested the hypothesis that harassment during a combat deployment is associated with post-deployment suicidality and testosterone function. Male combat veterans who made post-deployment suicide attempts and demographically matched veterans without a history of suicide attempts were enrolled in the study. Demographic and clinical parameters of study participants were assessed and recorded. Study participants were interviewed by a trained clinician using the Mini-International Neuropsychiatric Interview (MINI), the Deployment Risk and Resilience Inventory (DRRI) – Relationships within unit scale, the Scale for Suicidal Ideation (SSI), and the Brown–Goodwin Aggression Scale. Free testosterone levels were assessed in morning blood samples. DRRI harassment scores were higher and free testosterone levels were lower among suicide attempters in comparison with non-attempters. In the whole sample, DRRI harassment scores positively correlated with SSI scores and negatively correlated with free testosterone levels. Free testosterone levels negatively correlated with SSI scores. Aggression scale scores positively correlated with DRRI harassment scores among non-attempters but not among attempters. Our observations that harassment scores are associated with suicidality and testosterone levels, and suicidality is associated with testosterone levels may indicate that there is a link between deployment harassment, testosterone function and suicidality.

(PM-18) EXPLORING THE CONNECTIONS BETWEEN HYPERSEXUALITY AND SEX HORMONE: A PRELIMINARY STUDY IN BRAZILIAN MEN

Abstract Introduction Compulsive sexual behavior disorder (CSBD) or hypersexual behavior has gained global attention due to its adverse impact on health. However, there is just a few data on sex hormones of people reporting CSBD/hypersexual behavior. Objective Here, we investigate correlations between CSBD/hypersexual behavior and sex hormone in a sample of 34 Brazilian men who met the diagnostic criteria for CSBD/hypersexual disorder. Methods After ethical approval, participants provided informed consent and were assessed through the Instrument of Investigation of CSBD Diagnostic Criteria – ICD11, Hypersexual Disorder Screening Inventory (HDSI), Compulsive Sexual Behavior Inventory (CSBI), Sexual Compulsivity Scale (SCS), and Childhood Trauma Questionnaire (CTQ). Additionally, participants' basal blood levels were evaluated. Results The sample had a mean age of 38.2 years (SD ± 10.05). The median hormone levels of total testosterone 484 ng/dL [356;560], free testosterone 372 pmol/L [285;472], prolactin 9.50 ng/mL [8.30;13.4], estradiol 23.9 pg/mL [23.9;27.5], SHBG 26.7 nmol/L [21.8;33.5], FSH 4.10 IU/L [2.8;5.3], and LH 2.90 IU/L [2.18;3.85]. Mean scores for HDSI, CSBI, SCS, and CTQ were 23.2 (SD ± 3.80), 66.3 (SD ± 8.26), 33.7 (SD ± 4.14), and 37.6 (SD ± 8.03), respectively. Spearman's correlation analyses showed a positive correlation between total with free testosterone levels (Rho: 0.87); Total testosterone levels with SHBG (Rho: 0.59); a negative correlation between total and free testosterone levels with SCS score (Rho: –0.38; Rho: –0.35, respectively); a negative correlation between LH levels and CTQ total scores (Rho: –0.63); a negative correlation between CSBI with SCS scores (Rho: –0.58). Conclusion Our data shows the first exploration between hypersexuality and sex hormones in a Brazilian men sample, supporting previous findings about a relationship of testosterone levels with SCS scores in hypersexual individuals. Financing FAPESP.

(O-05) ESTRADIOL LEVELS IN MEXICAN MEN WITH ERECTILE DYSFUNCTION

Abstract Introduction and Objective Erectile dysfunction is associated with various psychological and physiological causes, including hormone levels such as testosterone. The role of estradiol in male sexual function is controversial, and studies reporting its impact on erectile function have been inconsistent. The aim of this study was to describe the levels of testosterone and estradiol in Mexican men with erectile dysfunction, based on the severity of dysfunction. Materials and Methods Hormonal levels of TSH, T3, T4, LH, FSH, total and free testosterone, and estradiol were measured in men over 18 years of age with erectile dysfunction, attending a clinic in Mexico. Clinical variables were analyzed, estimating measures of central tendency and dispersion for numerical variables, and absolute and relative frequencies for categorical variables. The proportion of men with abnormal levels of estradiol and testosterone was calculated based on the severity of erectile dysfunction. Results A total of 70 participants were included. The average age was 53.9 years old (+/- 11.8); 18.5% had severe dysfunction, 65.7% had moderate dysfunction, 14.2% had mild to moderate dysfunction, and 1.4% had mild dysfunction. 35.7% were diabetic, and 34.2% were hypertensive. 62.8% had abnormal levels in at least one of the evaluated hormones: 5.7% had low TSH levels; 2.8% had low T3 levels; 1.4% had low T4 levels; 5.7% had low and 7.1% had high total testosterone levels; 12.8% had low and 2.8% had high free testosterone levels; 17.1% had high prolactin levels; 1.4% had low and 10% had high LH levels; 5.7% had high FSH levels. Estradiol level was high in 6 men (8.5%), 1 had mild-moderate and 5 moderate dysfunction; 8 men had low estradiol levels (11.42%), 1 had mild-moderate, 4 moderate and 3 severe dysfunction. Conclusions Alteration on the levels of Estradiol was common in the analyzed group of patients with erectile dysfunction, especially in men with moderate dysfunction, observed in 12.8% of them. Financing Boston Medical Group.

Effects of depot medroxyprogesterone acetate, the copper IUD and the levonorgestrel implant on testosterone, sex hormone binding globulin and free testosterone levels: ancillary study of the ECHO randomized clinical trial

BackgroundRobust information on relative effects of hormonal contraceptives on endogenous androgens is important for understanding beneficial and adverse effects, method choice and development of new methods.MethodsIn this ancillary study at the East London, South Africa site of the ECHO multicentre randomized trial, we compared effects of three contraceptive methods on serum androgen levels among contraceptive users aged 18 to 35 years. Participants were allocated by centrally-managed randomization to open label depot medroxyprogesterone acetate (DMPA-IM), copper intrauterine device (IUD) or levonorgestrel implant.The primary outcome was free testosterone at 6 months.ResultsWe analysed stored baseline and 6-month serum samples in 398/615 participants (DMPA-IM 131/205, IUD 135/205 and implant 132/205). Median testosterone levels at baseline were DMPA-IM 0.82, IUD 0.9 and implant 0.87 nmol/L; at 6 months, DMPA 0.68 (lower than IUD, mean percentage difference 28.35, (p < 0.001), IUD 0.86 (unchanged) and implant 0.66, lower than IUD, mean percentage difference − 22.98, p < 0.001).Median SHBG levels at baseline were DMPA 52.4, IUD 50.5 and implant 55.75 nmol/L; at 6 months, DMPA 40.65, lower than IUD (mean percentage difference 21.19, p = 0.005), IUD 49.1 (unchanged), and implant 23.35 nmol/L, lower than IUD (mean percentage difference − 50.04, p < 0.001 and than DMPA (mean percentage difference − 39.45, p < 0.001).Free testosterone levels at baseline were DMPA 10, IUD 12 and implant 11 pmol/L; at 6 months, DMPA 11, less than IUD (mean percentage difference 13.53, p = 0.047), IUD 12 and implant 14, higher than IUD (mean percentage difference 14.15, p = 0.038) and than DMPA, (mean percentage difference 29.60, p < 0.001).ConclusionsThis is the first randomized trial to show lower SHBG and higher free testosterone with the levonorgestrel implant than with DMPA, and contrasts with reports of increased SHBG with combined oral ethinyl estradiol/levonorgestrel use, and reduced androgens (and impaired sexual function) reported with the etonorgestrel implant. The higher free testosterone with the LNG implant might improve sexual function, mood and bone health as well as increasing side-effects such as acne and hirsutism, and is consistent with the greater sexual activity (with respect to multiple sex partners, new sex partner and unprotected sex) with the implant compared with DMPA documented in the ECHO study.ECHO trial registrationClinicalTrials.gov, number NCT02550067 15/09/2015.Plain English summaryContraception, or family planning, is central to the role of women in societies. It is most important to have accurate information on the relative side-effects of various contraceptive options in order to empower women to make informed choices regarding their preferred method.Hormonal contraceptives contain various forms of the female sex hormones, estrogens and/or progestogens. These hormones have direct effects on the users, as well as modifying the levels of the users’ own circulating sex hormones, both the ‘female’ and the ‘male’ sex hormones (androgens).In this study, consenting participants requesting contraception, were allocated randomly to receive either depot medroxyprogesterone acetate (DMPA-IM) a 3-monthly progestogen injection, the copper intrauterine device (IUD), a non-hormonal contraceptive inserted within the womb, or the levonorgestrel implant, a device placed under the skin which releases a progestogen for 5 years.We measured the participants’ androgen levels after 6 months, and found for the first time that the active form of testosterone (free testosterone) was 29% higher with the implant than with DMPA-IM. The level with the IUD was intermediate, and significantly different from the other two methods.This finding is relevant to the effects experienced by users of these methods, because free testosterone has effects on sexual function, bone health and mood, as well as on conditions such as acne and hair distribution patterns.

(202) Comparative Study of the Efficacy of Avanafil and Atorvastatin Daily Dose in Management of Vasculogenic Erectile Dysfunction

Abstract Introduction Erectile dysfunction (ED) is defined as the “consistent inability to attain or maintain a penile erection, or both, sufficient for adequate sexual relations”. ED is not only a medical problem but affects the marital relations and patient's self-esteem and causes the quality of life to decrease. which in turn causes the patient to go into depression or develop anxiety. In the past, erectile dysfunction was considered, in most cases, to be a purely psychogenic disorder, but current evidence suggests that more than 80% of cases have an organic aetiology. Causes of organic erectile dysfunction can now be broadly divided into nonendocrine and endocrine. Of the nonendocrine aetiologies, vasculogenic (affecting blood supply) is the most common and can involve arterial inflow disorders and abnormalities of venous outflow (corporeal veno-occlusion). Avanafil is a second-generation phosphodiesterase type 5 inhibitor approved for erectile dysfunction by the FDA on 2012 and by EMA in 2013. With a high selectivity for phosphodiesterase type 5 isoform AND faster onset of action compared with other PDE5 inhibitors, it offers more tolerability and less adverse events. Atorvastatin is 3-hydroxy-methylglutaryl (HMG)-CoA reductase inhibitor act on the rate-limiting step in cholesterol biosynthesis (the conversion of HMG-CoA to mevalonate) and are effective in treating dyslipidemia. statins reverse endothelial dysfunction by decreasing the action of oxidized low-density lipoprotein (LDL) on endothelial cells, resulting in an increase of NO activity. Objective is to evaluate and compare the efficacy of avanafil and atorvastatin daily dose in management of patients with vasculogenic erectile dysfunction. Methods A 60 adult heterosexual males complaining of vasculogenic erectile dysfunction proven by penile duplex were collected from outpatient andrology clinics of Al-Azhar University Hospitals. The patients were divided into two treatment groups: (Group A): 30 patients received daily dose of 100 mg avanafil. (Group B): 30 patients received daily dose of 40 mg atorvastatin, The main outcome measures and the difference in penile duplex ultrasound results and IIEF-EF scores between the two groups are evaluated and compared at the end of the study, Age of patients between 20 and 50 years, established diagnoses of Vasculogenic erectile dysfunction, Normal lipid profile, Normal Total and Free testosterone levels and No contraindications to the study medications were included criteria. However patients who failed to fulfill any of the inclusion criteria, psychogenic or neurogenic erectile dysfunction, dyslipidemia Patients with Renal or Hepatic insufficiency and Patients with advanced cardiovascular diseases such as heart failure and coronary artery disease on antianginal drugs especially nitrates were excluded. Results Our study revealed statistically significant improvement in Penile Doppler ultrasonography parameters (PSV, EDV&amp; RI) and IIEF-EF scores in avanafil group compared to atorvastatin group. Conclusions avanafil 100 mg daily dose leads to significant improvement in men with vasculogenic erectile, while atorvastatin 40 mg caused no significant differences, neither positively nor adversely. In summary, avanafil at dose of 100 mg can be a therapeutic appropriate choice in cases of vasculogenic ED. Disclosure No.

Effects of Korean Versus Western Diets on Reproductive Function in Young Korean Men: A 12-Week Randomized Parallel Clinical Trial.

Studies report that diet may have contributed to a 50-60% decrease in human sperm quality over the past few decades. Unhealthy lifestyles affect the structure of spermatozoa, affecting the male reproductive potential. This study aimed to compare the effects of Korean and Western diets on reproductive function in young male Koreans. Study participants were provided either the Korean Diet (KD group) or the Western Diet (WD group) for 12 weeks. Semen quality parameters such as volume, motility, cell count, and sex hormone levels were evaluated. Sexual function was assessed using the International Index of Erectile Function and the Male Sexual Health Questionnaire. Efficacy and safety evaluations were conducted at baseline, 8 weeks, and 12 weeks. The KD group demonstrated a significantly increased sperm motility after 8 weeks relative to baseline but decreased after 12 weeks. In contrast, sperm motility in the WD group significantly decreased after 8 weeks compared with baseline and remained constant after 12 weeks. Statistically, a near-significant difference was observed between groups (p = 0.057). Similarly, free testosterone levels in the KD group increased after 12 weeks compared with baseline, whereas that in the WD group decreased. The free testosterone levels in the KD group were significantly higher than those in the WD group (p = 0.020). There were no statistically significant differences in other sex hormone and sexual function questionnaires between the groups. None of the participants reported any severe side effects, and no significant alterations in clinical diagnostic test values were detected. The results of the study strongly reveal that KD positively affects sperm motility and male hormone levels in young men, indicating potential benefits for reproductive function.

Erectile Function in Men during the COVID-19 Pandemic

This research focused on two age groups of men (under 40 and over 40 years) and their sexual function during the COVID-19 pandemic. Somatic examinations, including the measurement of hormone levels, were conducted on all patients. The subjects also completed two questionnaires and provided personal history data. The first questionnaire covered the evaluation of erectile function, while the second assessed psychosocial trauma and stress. The results in the first group (men under 40 years of age) showed a correlation between prolactin values and erectile function score results (R = 0.54), between erectile function score results and trauma and psychosocial stress symptoms (R = 0.49) and also between prolactin values and trauma and psychosocial stress symptoms (R = 0.53). The results in the second group (men over the age of 40) showed a correlation between prolactin values and erectile function score results (R = 0.42), between erectile function score results and trauma and psychosocial stress symptoms (R = 0.54) and between free testosterone level and erectile function score results (R = 0.32). These findings support the hypothesis of a different impact of stress on the development of erectile dysfunction in men under 40 and over 40 years of age during COVID-19.

Effect of SARS-CoV-2 viral infection on male sexual hormones levels post COVID-19 exposure: A systematic review and meta-analysis.

The COVID-19 can affect human testicles, thus will interfere the production of important male sexual hormone such as testosterone. Our study provides scientific evidence through systematic reviews and meta-analyses that focus on the effects of SARS-CoV-2 virus infection on male sexual hormonal disorders in patients post-exposure to COVID-19. This meta-analysis was made in accordance with the PRISMA guidelines. The outcomes of this study were the level of total testosterone, free testosterone, LH and FSH. Chi-square and I2 tests were used to evaluate heterogeneity between studies. The standardized mean deviation (SMD) with 95% CI were used and analysis was performed using the Review Manager 5.4 software. The four included studies reported a total of 256 patients with COVID-19 with time of follow-up time post COVID-19 varying from one month to 7 months. The mean age distribution in the study was 34-57 years old. Total testosterone level (SMD = -158.71; 95% CI= -205.30 - -112.12; p<0.00001) was significantly higher at follow-up post COVID-19, while LH (SMD = 0.40; 95% CI = 0.15-0.65; p=0.002) was lower. The free testosterone level and FSH level showed no significant difference between baseline and after following up post COVID-19. At follow up, the total testosterone level in patients with SARS-CoV-2 infection appeared to be elevated while LH was lower compared to the baseline.

(256) Effect of Early Varicocelectomy Intervention on Male Hormone Levels in Adolescent Males

Abstract Introduction Varicoceles can be found in approximately 15% of the adult male population and are known to impact male fertility. Varicoceles may develop during adolescence and increase in size as these males undergo puberty. According to current guidelines, it is recommended to monitor young asymptomatic patients and consider surgical intervention if they develop testicular size discrepancies, fertility issues, abnormal semen analyses, or experience significant pain. However, the effect of varicoceles on sex hormones and management in young males is poorly understood. Objective To evaluate the impact of early surgical intervention for varicoceles with a microsurgical varicocelectomy on hormone levels and safety profiles in adolescent males. Methods A retrospective review was conducted on 67 patients between the ages of 10 and 17 years old who had a grade 2 (G2) or grade 3 (G3) varicocele, and underwent microsurgical varicocelectomy between November 2021 and May 2023. Patient demographics, varicocele laterality and grade, surgical data, and pre-and post-operative hormone levels were collected as well as post-operative complications. Hormonal panel was collected before 11AM using LCMS and included total testosterone (TT), free testosterone (FT), percent free testosterone (%FT), estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (P), and sex hormone-binding globulin (SHBG). Statistical analyses were conducted using SAS System. Results A total of 67 patients had complete data (96% had G3 varicoceles). Preoperative FT was statistically significant between varicocele grades 2 and 3 (p=0.03) with G3 varicoceles having lower preop FT levels. Pre-operative hormone levels for G2 varicoceles were: TT 550ng/dL (std 177ng/dL), FT 126ng/dL (std 27), E2 33 (std 2.64), FSH 3.53 (std 1.27) and LH 5.06 (std 3.53). Pre-op levels for G3 varicoceles: TT 437ng/dL (std 199ng/dL), FT 71.3 (std 42.2), E2 25.2 (std 9.64), FSH 4.34 (std 3.3) and LH 3.73 (std 1.9). Post operatively TT levels improved in G3 varicocelectomy patients with a postop mean TT 445ng/dL (std 109ng/dL), however this did not meet statistical significance. There was no statistically significant difference between postoperative hormone panel labs between varicocele grades. There were no complications in any of the patients and no recurrence of varicoceles. Conclusions Our study evaluated the impact of early surgical intervention for G2 and G3 varicoceles on hormone levels in adolescent males. The results showed a significant difference in preoperative Free T levels between G2 and G3 varicocele patients possibly indicating the impact of varicocele grade on FT levels in adolescents. Early surgical intervention for G3 varicoceles appears to be safe with resultant improvements in TT levels with no increased risk of complications. Further investigations to explore the potential benefits of early surgical treatment in adolescent patients with varicoceles evaluating hormonal profiles in larger cohorts. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast and BK Ultrasound.

(166) Safety of Flibanserin in Men with Hypoactive Sexual Desire Disorder

Abstract Introduction Flibanserin possesses unique properties and displays selective agonistic and antagonistic activity against serotonin receptors. Originally, its primary application was in the treatment of hypoactive sexual desire disorder (HSDD) in women, where it showed promising results in improving sexual desire. However, as our understanding of its mechanism of action has expanded, researchers have begun to explore its potential utility in treating HSDD in males. This emerging trend has led to an increased interest in the use of flibanserin as a potential therapeutic option for men experiencing a decline in sexual desire. Objective We aimed to elucidate the demographic profiles, clinical attributes, and comprehensive safety implications of men receiving off-label flibanserin at our institution. Methods A retrospective analysis encompassing a cohort of men who initiated flibanserin treatment between July 2022 and July 2023 was performed. Basic demographic information, levels of total and free testosterone, pertinent medical history, scores from the International Index of Erectile Function (IIEF) and Patient Health Questionnaire-9 (PHQ-9), and overall manifestation of side effects were collected. Descriptive statistics were performed. Results A total of 26 patients were identified, with a mean age of 57.9 years (range, 31–80 years). Among these patients, seven had a prior diagnosis of depression and had previously received treatment with selective serotonin reuptake inhibitors (SSRIs). The mean levels of total testosterone and free testosterone were found to be 611.3 ng/dL and 116.8 pg/mL, respectively. Notably, a significant majority of patients (22 of 26 [81.4 %]) were diagnosed with erectile dysfunction. Importantly, all patients exhibited euthyroid status. The mean baseline score on the PHQ-9 was 5.30 (ranging, 0–17), indicating mild depressive symptoms, whereas the mean IIEF total score was 40 (range, 6–67). Furthermore, the mean score on the IIEF-desire subdomain was 5.65 (ranging: 2–10), reflecting relatively diminished levels of sexual desire. Upon conducting a follow-up assessment at the 3-month mark, it was observed that seven patients discontinued flibanserin medication, with reasons such as ineffectiveness and high cost being cited as the primary factors. Notably, only one patient (3.8%) discontinued the medication because of side effects. Conclusions In summary, our study sheds light on the fundamental characteristics associated with off-label utilization of flibanserin in men with HSDD, underscoring the increasing interest in investigating its potential therapeutic advantages within this specific population. However, additional research is warranted to comprehensively elucidate the clinical benefits and potential risks of flibanserin administration in men. Such investigations will contribute to a more thorough understanding of its efficacy and safety profile. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast Investor: Sprout.

The Effects of Myo-Inositol and D-Chiro-Inositol in a Ratio 40:1 on Hormonal and Metabolic Profile in Women with Polycystic Ovary Syndrome Classified as Phenotype A by the Rotterdam Criteria and EMS-Type 1 by the EGOI Criteria

Setting: Insulin resistance (IR) and compensatory hyperinsulinemia are considered contributing factors toward polycystic ovary syndrome (PCOS). Objectives: This study evaluates the frequency of metabolic abnormalities in PCOS patients and the effects of myo-inositol (MI) and D-chiro-inositol (DCI), in a 40:1 ratio on hormonal and metabolic parameters. Participants: Thirty-four women with PCOS phenotype A (endocrine-metabolic syndrome [EMS-type 1]) between the ages of 20–40. Design: Open prospective study with phenotype A (EMS-type I, n = 34) supplemented with 2,255 mg/day of inositol (MI and DCI in a 40:1 ratio) for 3 months. Methods: The following were measured before and after treatment: serum levels of follicular stimulating hormone, luteinizing hormone (LH), estradiol, total and free testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), anti-Müllerian hormone, glucose, insulin, HOMA-IR, and body mass index (BMI). Results: 55.9% of the enrolled patients were overweight or obese, 50% affected by IR, 17.6% with a history of gestational diabetes mellitus, and 61.8% had familial diabetes mellitus. At the conclusion of the study, BMI (p = 0.0029), HOMA-IR (p < 0.001) significantly decreased, along with decreased numbers of patients with elevated insulin levels. The supplementation resulted in decreased total testosterone (p < 0.001), free testosterone (p < 0.001), FAI (p < 0.001), and LH (p < 0.001); increased SHBG (p < 0.001) and estradiol (p < 0.001). Limitations: The present analysis was limited to a 12-week follow-up, which precluded a long-term evaluation of the effects of MI and DCI combination. Also, this period was insufficient to achieve and analyze clinical changes such as restoration of the menstrual cycle, restoration of reproductive function, and clinical manifestations of hyperandrogenism. Conclusions: Supplementation improved metabolic and hormonal profile in PCOS phenotype A (EMS-type I) patients. This builds upon previous work that demonstrated that combined inositol treatment may be effective in PCOS. The study presented herein, used a reduced concentration than in prior literature; however, a significant change in hormonal and metabolic parameters was still observed.

Evaluation of the Incidence of Low Testosterone Levels in Young Male Adults with Moderate to Severe Obesity-Single-Centre Study from India.

With the increase in obesity epidemic among Asians, it is necessary to evaluate the impact of obesity on this population. Low testosterone levels are known to be associated with obesity. This is the 1st study from Asia to evaluate incidence and magnitude of hypotestosteronemia in young adults with BMI more than 32.5kg/m2 defined as moderate to severe obesity in Asians. One hundred thirty-four male patients with BMI more than 32.5kg/m2, between 18 and 30years old who visited a single bariatric facility between 2017 and 2020, were evaluated with BMI, total and free testosterone levels and clinical features of gynecomastia, hypogonadism, and thinning of pubic and armpit hair. Statistical analysis was performed using SPSS, Spearman's correlation coefficient, and ANOVA test. 60.4% of patients (84/134) had low testosterone levels (< 300ng/dl) and 23.9% (32/134) had levels between 300 and 400ng/dl. 89.6% patients (120/134 had gynecomastia, 60.4% (81/134) had thinning of pubic and arm pit hair, and 62.7% (84/134) had hypogonadism. Testosterone levels showed a decreasing trend with increasing BMI, but it was not statistically significant. Obesity is one of the important etiologies of hypotestosteronemia and its manifestations in young adults. The actual incidence may be significantly higher than what is reported in the literature. High-quality research is required to address questions of diagnosis and best treatment options.

The effect of gonadoliberin analog treatment in precocious puberty on polycystic ovarian syndrome prevalence in adulthood.

The study group consists of 24 women (median age 22 88 years, median BMI 23.5) treated with GnRHa for central precocious puberty in childhood. The control group includes 40 women (median age 23 years, median BMI 25.6) diagnosed with isolated premature thelarche and not using GnRHa in the childhood. Anthropometric measurements, ultrasound examination of minor pelvis and hormonal profile were performed. PCOS diagnosis was based on Rotterdam criteria. The study confirmed a higher prevalence of PCOS in the study group (50%) than in the control group (10%); p=0.0006. Significant, linear correlation between free testosterone levels and ovarian size was found in the study group (R=0.45 p= 0.03). GnRHa therapy during childhood may have a potential influence on incidence of PCOS in the adulthood. Therefore, in this group of patients long-term follow-up focused on screening for PCOS would seem beneficial.

The impact of oral isotretinoin on ovarian functions of acne patients complaining of polycystic ovarian syndrome: a prospective study

BackgroundWomen have polycystic ovarian syndrome (PCOS) at higher rates than any other endocrine condition with an average incidence rate of 6 to 8%. Acne is an immune mediate common condition frequently affecting adolescents and adults and is often associated with PCOS. The objective of the study was to assess the impact of oral isotretinoin on ovarian functions of acne patients suffering from PCOS. Forty women with a clinical diagnosis of acne as well as PCOS participated in this prospective clinical trial. Participants were given oral doses of isotretinoin ranging from 0.5 to 1 milligram per kilogram (mg/kg), for a total of 120 to 150 mg/kg. To establish baseline values of hormone levels, on days 2–5 of the menstrual cycle, venous blood samples were obtained. Moreover, global acne grading system (GAGS), follicle count, and bilateral ovarian volumes were evaluated both before and after isotretinoin treatment.ResultsA significant reduction in global acne score from pre-treatment levels to post-treatment levels was observed (11.58 ± 5.857 vs. 1.65 ± 1.369). Ovarian volume was significantly reduced from 10.26 ± 1.539 before treatment to 8.74 ± 1.436 after treatment on the right side (P < 0.001) and from 11.08 ± 1.564 before treatment to 9.36 ± 1.479 after treatment on the left side (P < 0.001). A significant reduction in free testosterone level and hirsutism scores were observed after treatment (P < 0.001; P < 0.01 respectively.ConclusionIsotretinoin may exert beneficial effects in hyperandrogenic women with PCOS and needs to be further evaluated by large multicentre controlled trials.