Mean Serum Testosterone Concentrations Research Articles

Effect of Spirulina platensis Supplementation on Reproductive Parameters of Sahrawi and Jabbali Goat Bucks.

Spirulina platensis (SP) is a protein-rich dietary supplement that improves animal reproductive traits. This study investigated the effect of SP supplementation on puberty onset, semen characteristics, scrotal circumference (SC), libido, and hormone concentrations in Sahrawi and Jabbali bucks. The study was conducted in 36 bucks, divided into three groups (n = 6/group), for 70 days. The rations included the following: (1) Control feed (Con) with 14% crude protein and 11.97% MJ/kg DM energy; (2) Con with 2 g SP/head/day SP treatment (T1) and (3) Con with 4 g SP/head/day treatment (T2). The mean (±SEM) SC of both SP groups in the Sahrawi breed was significantly higher (p ≤ 0.05) compared to the Con. The mean of the semen volume significantly increased (p ≤ 0.05) in the SP group than in the Con group in both breeds. SP groups vs. Con groups had increased sperm concentration in Sahrawi bucks than Jabbali bucks. Mean serum luteinizing hormone (LH) and testosterone (Tes) concentrations in Jabbali bucks were significantly higher (p ≤ 0.05) in the SP groups compared to Sahrawi bucks. SP improved the SC, semen quality, libido, sperm concentration, and LH and Tes concentrations in both breeds. The results of the current study suggest that adding SP to the diet may have the ability to improve the semen quality of the local Omani bucks.

Effects of Varicocele Surgical Repair on Serum Hormone and Inhibin B Levels for Patients With Varicocele: A Systematic Review and Meta-Analysis.

Varicocele surgical repair can improve the function of the testis for patients with varicocele. We carried out a systematic review and meta-analysis to assess the effects of varicocele surgical repair on serum hormones and inhibin B levels in patients with varicocele. A literature search was performed in August 2022, and no language or geographic region restrictions were applied. The search included the following databases: PubMed, Embase, and Medline. A literature review was performed to identify all published clinical trials assessing serum hormone and inhibin B levels before and after varicocele surgical repair. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Eight articles were selected from 162 articles, including 452 patients. The combined analysis showed that after surgical treatment, mean serum testosterone, inhibin B, and sperm concentration levels increased compared with preoperative levels (p < .05). After surgical treatment, mean serum follicle-stimulating hormon (FSH), and Luteinizing hormone (LH) levels decreased compared with preoperative levels (p < .05). This meta-analysis demonstrates that varicocele surgical repair can improve testicular function, increase serum testosterone, and inhibin B levels and decrease serum FSH and LH levels in patients with varicocele. This might be related to the improvement of infertility. A large-scale multicenter randomized controlled study is needed for further confirmation.

PMON257 Oral Ingestion of Macronutrients Selectively and Variably Decrease Circulating Testosterone Concentration in Healthy Men

Abstract We have previously reported acute suppression of testosterone in men after oral ingestion of dextrose. In the present study, we aimed to explore a potentially similar effect in response to other macronutrients. Eleven healthy men (age: 33-70 yrs, BMI 20.4-31.5 kg/m2) were studied in random order after an overnight fast on 4 separate days, involving oral ingestion of 300 ml of either water (control), dextrose, protein, or lipid solutions. Sessions were 6.5 h long, starting at 0800-0900 hrs. Test meals were isocaloric (400 kcal) and were ingested after the 4th blood draw (30 min point). Blood was collected at 10-min intervals for testosterone (ng/dL), and LH (IU/L) measurements. Means of the 1st 4 pre-intervention measures were used as the first value in all the time series. Mean delta-serum (macronutrients-water) testosterone and LH concentrations sampled at 10-minute intervals over 6 hour period were adjusted to the corresponding 1st value to correct for among the sessions inconsistent baseline testosterone and LH measures. Compared to the water day (control), mean (± SE) serum testosterone concentrations (ng/dL) in 11 subjects decreased from 415 ± 36 (control) to 370 ± 31 (dextrose: P=0.009), 340 ± 28 (protein: p=0.002), and 355 ± 30 (lipid: p=0.01). Corresponding LH (IU/L) values for dextrose (3.16 ± 0.29), protein (3.17 ± 0.39), and lipid (3.07 ± 0.29) were not significantly different from the control day (3.3 ± 0.29). Mean delta-testosterone time series revealed decreased testosterone of 63 ng/dL at 130 min after dextrose, 80 ng/dL at 200 min after protein, and 10 ng/dL at 70 min after lipid ingestion. Duration of suppression was variable among the 3 macronutrients, but most prolonged for protein lasting for 320 min. As oppose to testosterone, delta-LH concentrations were more positive rather than negative, suggestive of a potential testicular insult. In conclusion, oral ingestion of all macronutrients decrease circulating testosterone concentration, which appear to be independent of LH secretion. The effect is more intense and prolonged after protein intake, and minimal with lipid ingestion. Future studies are required to define the etiology, and the macronutrient effect on more prolonged basis. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Low basal serum testosterone level is detrimental to the embryo implantation in the patients with severe endometriosis.

Androgens have been reported to be associated with female fertility. The mean serum testosterone concentration in the patients with endometriosis was reported to be significantly lower than that without endometriosis. Our study was designed to investigate the influence of basal serum testosterone levels on the clinical outcome of in vitro fertilization (IVF) in the patients with III-IV stage endometriosis. This retrospective cohort study included 407 patients with III-IV stage endometriosis diagnosed by laparoscopic surgery. We studied the association of the basal serum testosterone level and the reproductive outcome of IVF. The basal serum testosterone concentration was significantly higher in the pregnant group of patients with III-IV stage endometriosis. The further analyses demonstrated that the implantation rate of the basal serum testosterone concentration < 0.305 ng/mL group was significantly lower than the testosterone ≥ 0.305 ng/mL group (24.1% vs. 32.7%, p=0.007). The clinical pregnancy and live birth rate of the basal serum testosterone < 0.305 ng/mL group were also lower than that of the testosterone ≥ 0.305 ng/mL group. Both initial and total dose of gonadotropins in the testosterone <0.305 ng/mL group are significantly higher than that of the testosterone ≥0.305 ng/mL group. Our study demonstrated, for the first time, that the basal serum testosterone <0.305 ng/mL had an adverse impact on pregnancy outcomes of IVF-embryo transfer in the patients with III-IV stage endometriosis. Besides, the basal serum testosterone is also helpful in making individual stimulation protocol for the patients with advanced endometriosis before entering IVF cycles.

Comparative studies on testis, epididymis and serum hormone concentrations in foxes, and hybrids during the pre-breeding period

Silver fox and blue fox belong to different genera, and the hybrid males are reproductively sterile. In the present study, there was a comparison of testicular and epididymal morphology and serum hormone concentrations among silver foxes, blue foxes, and the hybrids during the pre-breeding period, using 20 male silver foxes, 20 male blue foxes, 15 male HSBs (silver fox male × blue fox female hybrids) and 15 male HBSs (blue fox male × silver fox female hybrids), respectively. Hybrids had a smaller diameter of seminiferous tubules than pure-species males, and testes of hybrid males did not differ in mean size and relative weight from pure-species males. There were many Sertoli cells and spermatogenic cells in silver foxes and blue foxes, while numbers of spermatogonia and primary spermatocytes were less with no secondary spermatocytes in the hybrids. Furthermore, mean serum testosterone and estradiol concentrations in the hybrids were less, and FSH, LH, and PRL were greater than that in silver foxes and blue foxes (P < 0.05), suggesting that lesser concentrations of testosterone and estradiol and greater concentrations of FSH, LH and prolactin can inhibit the completion of spermatogenesis during the pre-breeding period. The results indicate that fox hybrid sterility may result from failures at the early stages of spermatogenesis.

Effects of testosterone administration and feeding level on reproductive activity in sexually inactive goat bucks

The aim of this study was to investigate the effect of the administration of testosterone to a well-fed or underfed sexually inactive goat bucks on their sexual behavior and semen characteristics. Twenty sexually experienced mixed-breed goat bucks (1.5 years of age) were randomly assigned to one of four treatments for a period of 71 days. Treatments consisted of diets with amount of nutrients to meet 1.0 times the nutrient maintenance requirements with the application of 25 mg testosterone every third day during 21 d (treatment 1T) or saline (treatment 1C). A third and fourth treatments received a diet 1/2 times the nutrient maintenance requirements with testosterone (1/2T) or saline (1/2C). Bucks on 1T and 1C had higher body weight, body condition score and scrotal circumference compared to 1/2T and 1/2C (P&lt;0.05). Also, bucks on 1T and 1/2T had higher sexual odor compared to 1C and 1/2C (P&lt;0.05). Mean serum testosterone concentrations were highest in 1T (4.78 ± 6.78 ng/ml) and lowest in 1/2C (0.56 ± 0.96 ng/ml; P&lt;0.01). Semen volume, sperm concentration, and mass motility were not affected by treatments, but sperm progressive motility was lower (P&lt;0.05) in 1/2C (46%) than the other treatments (52 to 57%). Courtship traits and mounts were more frequent (P&lt;0.05) in 1T compared with the other treatments. Likewise, bucks in the 1T group had the shortest latency to first mount (82 seconds) compared to other treatments (110 to 164 seconds). These results indicate that testosterone administration to well-fed sexually inactive bucks provokes clearly defined sexual activity during the non-breeding season. However, these benefits are overridden by underfeeding goat bucks.

Testicular responses to hCG stimulation at varying doses in men with spinal cord injury.

Study designProspectiveObjectivesTo test whether provocative stimulation of the testes identifies men with chronic spinal cord injury (SCI), a population in which serum testosterone concentrations are often depressed, possibility due to gonadal dysfunction. To accomplish this objective, conventional and lower than the conventional doses of human chorionic gonadotropin (hCG) were administered.MethodsThirty men with chronic SCI [duration of injury >1 year; 18 and 65 years old; 16 eugonadal (>12.1 nmol/l) and 14 hypogonadal (≤12.1 nmol/l)] or able-bodied (AB) men [11 eugonadal and 27 hypogonadal] were recruited for the study. Stimulation tests were performed to quantify testicular responses to the intramuscular administration of hCG at three dose concentrations (i.e., 400 IU, 2000 IU, and 4000 IU). The hCG was administered on two consecutive days and blood was collected for serum testosterone in the early morning prior to each of two injections; subjects returned on day 3 for a final blood sample collection.ResultsThe average gonadal response in the SCI and AB groups to each dose of hCG was not significantly different in the hypogonadal or eugonadal subjects, with the mean serum testosterone concentrations in all groups demonstrating an adequate response.ConclusionsThis work confirmed the absence of primary testicular dysfunction without additional benefit demonstrated of provocative stimulation of the testes with lower than conventional doses of hCG. Our findings support prior work that suggested a secondary testicular dysfunction occurs in a majority of those with SCI and depressed serum testosterone concentrations.

Reproductive hormonal profile patterns among male partners of infertile couples at the University of Ilorin teaching hospital

Background: Seminal fluid analysis (SFA) is the most important investigation of the infertile males but limited in revealing the etiologies of the various spermatozoa abnormalities observed on microscopy. Increasing prevalence of male infertility and the challenges of diagnosis require biochemical investigations such as reproductive hormonal profile. Aims: The aim of this study is to determine the reproductive hormonal profile patterns among infertile males in Ilorin. Settings and Design: This was a descriptive, cross-sectional study. Materials and Methods: A total of 130 male partners of infertile couples served as subjects and 50 fertile males as controls. Serum reproductive hormonal assay was done using ELISA method. Statistical Analysis Used: Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used. Normally distributed data were expressed as mean ± standard deviation. Results: The mean age of the subjects who were majorly civil servants was 38.6 ± 6.6 years. The prevalence of reproductive endocrinopathies in this study was 46.9%. Mean serum concentrations of follicle-stimulating hormone, luteinizing hormone, and prolactin were elevated in our subjects than control. Mean serum testosterone concentration was significantly lower in our infertile subjects. Patterns of hormonal profile abnormalities among our subjects were 2 (1.5%) with hypogonadotropic hypogonadism, 15 (11.5%) with hypergonadotropic hypogonadism, 23 (17.7%) with hypergonadotropic normogonadism, 21 (16.2%) with normogonadotropic hypogonadism, and 69 (53.1%) with normogonadotropic normogonadism. This showed 59 (45.4%) subjects with primary testicular failure/resistance and 2 (1.5%) with secondary testicular failure. Twenty (15.4%) of the subjects had hyperprolactinemia. Conclusions: Reproductive hormonal profiling of male partners of infertile couples is an important adjuvant to SFA, in diagnosis and monitoring responses to treatment.

Polymer-delivered subcutaneous leuprolide acetate formulations achieve and maintain castrate concentrations of testosterone in four open-label studies in patients with advanced prostate cancer.

To determine whether luteinising hormone-releasing hormone (LHRH) agonist, ATRIGEL® polymer-delivered, subcutaneous, leuprolide acetate (ADSC-LA), formulations suppressed serum testosterone to concentrations of ≤20ng/dL. Data from four open-label, fixed-dose studies were evaluated. Male patients aged 40-86years with advanced prostatic adenocarcinoma, whom had not undergone prior androgen-deprivation therapy (ADT), were treated with a depot formulation of ADSC-LA: 7.5mg (1-month, 120 patients), 22.5mg (3-month, 117 patients), 30mg (4-month, 90 patients), or 45mg (6-month, 111 patients). Serum testosterone was sampled at screening, baseline, 2, 4, 8h after dosing, 1, 2, 3, and 7days, and every week until the next dose, at which time, the sampling schedule repeated until the end of study (24weeks for 1- and 3-month formulations, 32weeks for 4-month, and 48weeks for the 6-month). The primary analyses were mean serum testosterone concentrations and proportion of patients who achieved concentrations of ≤20ng/dL. The mean (SE) serum testosterone concentrations at the end of study were consistently ≤20ng/dL in each study, at 6.1 (0.4), 10.1 (0.7), 12.4 (0.8), and 12.6 (2.1)ng/dL for the 1-, 3-, 4-, and 6-month formulations, respectively. A high proportion of patients (94%, 90%, 92%, 96% for the 1-, 3-, 4-, and 6-month formulations, respectively) achieved testosterone concentrations of ≤20ng/dL within 6weeks, and 90-97% of patients in all studies maintained concentrations of ≤20ng/dL from weeks 6-24. Recent studies have shown improved outcomes in patients with prostate cancer who consistently attained a more rigorous level of testosterone suppression (≤20ng/dL) with ADT than the historical standard (≤50ng/dL). All doses of ADSC-LA rapidly achieved and maintained mean serum testosterone to the more rigorous target concentration of ≤20ng/dL. These data suggest that ADSC-LA delivers equivalent testosterone suppression as achieved by surgical castration.

Serum testosterone as predictor of pathological stage in prostate cancer

Aim: The aim of our study is - To assess whether parameter as serum testosterone can be used to predict the pathological stage of the disease. To determine whether serum testosterone can be used as prognostic marker for the carcinoma prostate. To evaluate the efficacy of serum testosterone as a rapid tool in the diagnosis and prognosis of prostate carcinoma. Materials and Methods: A total of 30 patients of carcinoma prostate as a case and 30 patients of BPH as a control. Clinical staging done by CT/MRI. Pathological staging done after radical prostectomy. Serum, testosterone analyzed by radioimmunoassay. Statistical analysis was done using statistical software SPSS version 10.0. Data was found to be normally distributed. Statistical analysis was performed using student’s ‘t’ test with statistical significance at 400 ng/dl and 30% patients have serum testosterone < 200 ng/dl. Remaining 30% have serum testosterone in between 200-399 ng/dl. Mean preoperative serum testosterone level in study group were 315.30±49.66 ng/ml and in control group the mean preoperative serum testosterone level were 369.83±51.12 ng/dl. The mean serum testosterone concentration is lower in carcinoma prostate patients as compared to the BPH patients. The mean difference in both the group were statistically significant (p=0.018). In organ confined disease, the mean preoperative serum testosterone level were 411.14±11.50 ng/ml and in non organ confined disease the mean preoperative serum testosterone level were 329.33±71.57 ng/dl. The mean serum testosterone level is lower in non organ confined as compared to the organ confined disease. The mean difference in both organ and non organ confined disease were statistically significant (p=0.008). Conclusion: We conclude that patients with carcinoma prostate have statistically significant correlation between pretreatment total testosterone level and pathological stage. In our study total testosterone emerged as an independent predictor of ex

Ameliorative effect of androgen therapy tear on film stability in castrate female rats

Background Prevalence of dry eye is significantly inceasing in postmenopausal women than that in men, suggesting that sex hormone plays a role in the pathogenesis of dry eye. In addition, dry eye might become worse following estrogen therapy in postmenopausal women. However, whether application of androgen can ameliorate dry eye is being concerned. Objective This study was to investigate the effect of androgen on tear film of ovariectomized female rats. Methods Forty-eight 3-month-old sexually mature female Wistar rats were randomized into the normal control group, sham group, ovariectomy (OVX) model group and testosterone-injected group. OVX models were established by bilateral ovaries enucleation in the rats of the model group and testosterone-injected group, and then androgen (3.75 mg/kg) was intramuscularly injected since 5 months after OVX at 3-day interval for 6 weeks. Only intraperitoneal fat was cut off in the sham group. In 6 weeks after injection of androgen, serum androgen concentration detected and Schirmer Ⅰtest (SⅠt), tear film break-up time (BUT) were performed. The rats were sacrificed to prepare the corneal and conjunctival samples. The expression of MUC5AC in conjunctival tissue was examined by immunofluorescence staining, and the microstructure of corneal cellular surface was observed under the scanning electron microscope before and 6 weeks after application of androgen. Animals in this study were treated in accordance with Animal Experimentation Ethic Committee Guidelines of Southern Medical University and the study protocol was approved by Ethic Committee of this University. Results The mean serum testosterone concentration was (1.83±0.12)ng/ml, and SⅠt or BUT was (3.63±0.26)mm/5 minutes or (3.73±0.38)seconds, respectively, in the OVX model group, which was significantly declined in comparison with (2.56±0.14)ng/ml, (7.47±0.66)mm/5 minutes or (9.57±0.76)seconds in the normal control group (all at P=0.000). However, the serum testosterone concentration was (3.38±0.24)ng/ml, SⅠt was (6.37±0.45)mm/5 minutes and BUT was (7.54±0.55)seconds in the testosterone-injected group, which was significantly higher than that in the OVX model group (all at P=0.000). The positive staining of MUC5AC in rat conjunctival tissue weakened in the OVX model group compared with the normal control group, and the fluorescence intensity in the testosterone-injected group was stronger than that in the OVX model group. Regularly arranged microvilli and cell metabolism hiatus on the surface of corneal cells were seen in the normal control group and the sham group; while the microvilli were shorter and irregularly arranged, and the cell metabolism hiatus were disappeared in the OVX model group. However, microvilli and cell metabolism hiatus were close to normal ones in the testosterone-injected group. Conclusions Deterioration of tear secretion and instability of tear film are are probably associated with the lower serum androgen levels in castrated female rats. Systemic supplement of androgen can promote tear secretion, improve tear film stability and alleviate ocular surface damage. Key words: Dry eye/therapy; Tears/secretion; Ovariectomy; Androgens/drug therapy; Disease models, animal; Rats, Wistar; Female

Treatment of pain in fibromyalgia patients with testosterone gel: Pharmacokinetics and clinical response

To test our hypothesis that testosterone deficiency plays an important role in chronic pain, a Phase I/II pilot study was initiated with 12 fibromyalgia patients to verify that a daily dose for 28days with transdermal testosterone gel would 1) significantly and safely increase mean serum testosterone concentrations from low baseline levels to mid/high-normal levels, and 2) effectively treat the pain and fatigue symptoms of fibromyalgia. Pharmacokinetic data confirmed that serum free testosterone concentrations were raised significantly above baseline levels, by assessment of maximum hormone concentration (Cmax) and area under the curve (AUC) parameters: free testosterone Cmax was significantly raised from a mean of 2.64pg/mL to 3.91pg/mL (p<0.05), and 24hour free testosterone AUC was significantly raised from a mean of 35.0pg-hr/mL to 53.89pg-hr/mL. Assessment of the typical symptoms of fibromyalgia by patient questionnaire and tender point exam demonstrated significant change in: decreased muscle pain, stiffness, and fatigue, and increased libido during study treatment. These results are consistent with the hypothesized ability of testosterone to relieve the symptoms of fibromyalgia. Symptoms not tightly related to fibromyalgia were not improved.

A low-testosterone state associated with endometrioma leads to the apoptosis of granulosa cells.

Although endometriosis is suspected to be a cause of premature ovarian insufficiency (POI), the mechanism(s) underlying this process have not been elucidated. Recently, androgens were shown to promote oocyte maturation and to play a role in folliculogenesis. In addition, several reports have documented low testosterone levels in the follicular fluid obtained from endometriosis patients. We therefore examined whether the low levels of serum testosterone are associated with the apoptosis of granulosa cells in follicles obtained from endometriosis patients. Serum samples were collected from 46 patients with endometriosis and from 62 patients without endometriosis who received assisted reproductive therapy. Specimens of the ovaries obtained from 10 patients with endometrioma were collected using laparoscopy. The mean serum testosterone concentration in the patients with endometriosis was significantly lower than that observed in the patients without endometriosis. Furthermore, high expression of a pro-apoptotic Bcl-2 member, BimEL, in the follicles was found to be associated with a low serum testosterone level. We clarified the underlying mechanisms using a basic approach employing human immortalized granulosa cells derived from a primary human granulosa cell tumor, the COV434 cell line. The in vitro examination demonstrated that testosterone inhibited apoptosis induced by sex steroids depletion via the PI3K/Akt-FoxO3a pathway in the COV434 cells. In conclusion, we elucidated the mechanism underlying the anti-apoptotic effects of testosterone on granulosa cells, and found that a low-testosterone status is a potentially important step in the development of premature ovarian insufficiency in patients with endometriosis.

Testosterone replacement therapy and bone mineral density in men with hypogonadism.

Osteoporosis is a skeletal disorder characterized by reduced bone strength and consequent increased fracture risk [1]; such fractures can be associated with increased morbidity and mortality. Men with hip fractures have a mortality rate two to three times higher than that of women [2,3]. In epidemiologic data on Korean subjects, the prevalence of osteoporosis was reported to be 7.8% in men and 37.0% in women aged 50 years or over [4]. The incidence of hip fractures in Koreans over 50 years of age was 146.4 per 100,000 women and 61.7 per 100,000 men in a recent report [5]. Nevertheless, the risk of mortality one year postfracture has been shown to be approximately 1.4 to 2.1 times higher in men than it is in women. Previous reports found that osteoporosis was underdiagnosed and undertreated in men. Also, a secondary cause of osteoporosis is common in men, such as glucocorticoid excess, hypogonadism, or alcohol excess [6]. Sex steroids are major determinants of bone turnover and modelling from adolescence into old age. Therefore, hypogonadism prior to puberty is associated with low bone mineral density due to inadequate bone accretion. Meanwhile, adult-onset hypogonadism leads to increased bone resorption and accelerated bone loss. For example, Kallmann and Klinefelter syndromes, pituitary and hypothalamic tumors, and androgen deprivation therapy for prostate cancer can all lead to hypogonadism, and are associated with low bone mineral density (BMD) and an increased risk of fractures [7,8,9,10]. A number of studies have demonstrated the effect of testosterone on BMD in men with acquired hypogonadism or in aging men with low testosterone levels, although no data are available on fracture prevention. Behre et al. [11] showed that testosterone therapy significantly increased BMD in 72 hypogonadal men regardless of age. They also found that BMD can be normalized and maintained within normal range by continuous, long-term testosterone replacement. In aging men with low or borderline testosterone levels, the effect of testosterone therapy on BMD appears to be related to baseline testosterone levels; testosterone treatment increased BMD only in men whose baseline levels were below the reference range. Basurto et al. [12] found that 12 months of testosterone administration increased spine and total hip BMD in men aged 60 or older with serum testosterone levels <320 ng/dL. Recently, Aversa et al. [13] reported that long-acting testosterone undecanoate in middle-aged men with late-onset hypogonadism (testosterone <320 ng/dL) significantly increased spine and femoral BMD after 3 years. Another study showed that spine BMD increased to a similar extent in a testosterone-treated group compared to a placebo group after 3 years (4.2%±0.8% vs. 2.5%±0.6%, P=not significant); however, among men with pretreatment testosterone levels below 200 ng/dL, testosterone therapy significantly increased spine BMD (5.9%±2.2%) compared to placebo-treated patients [14]. The Endocrine Society guidelines recommend testosterone therapy for symptomatic men with classical androgen deficiency syndromes to improve sexual function, sense of well-being, and BMD [15]. Also, Endocrine Society guidelines on osteoporosis in men also recommend testosterone therapy alone for hypogonadal men (serum testosterone levels <200 ng/dL) at modest or borderline risk of fracture [16]. Several studies found that men whose serum testosterone level is 200 to 300 ng/dL or below are at higher risk for bone loss and fracture and have a favorable response to testosterone treatment [14,17,18]. In addition, the Endocrine Society guidelines recommend combination treatment with an agent with proven antifracture efficacy (e.g., bisphosphonate or teriparatide) for men who need testosterone therapy for hypogonadism and who have a high fracture risk [16]. Recently, Lee et al. [19] investigated the effect of testosterone replacement therapy on BMD in 21 men with hypogonadotropic hypogonadism due to pituitary tumor surgery. They reported that the mean serum testosterone concentration increased from 157±126 ng/dL at baseline to 337±243 ng/dL after 56 months of treatment. Also, there was significant improvement in lumbar spine BMD after 56 months compared with baseline values (from 1.067±0.155 to 1.116±0.177 g/m2, P=0.028). A nonsignificant decrease in femoral neck BMD (from 0.908±0.148 to 0.875±0.212 g/m2, P=0.677) was also observed. They did not find any significant correlation between change in serum testosterone levels and lumbar spine BMD. This study had several limitations, it was retrospective in nature, only a small number of patients were included, and they had no placebo control group. Nevertheless, the results were meaningful because the authors examined the long-term effects of testosterone treatment on BMD (up to 99 months) in Korean men with acquired hypogonadism. Also, this study suggested testosterone treatment was an effective method of increasing lumbar spine BMD in hypogonadal middle-aged men whose BMD was normal to within mild osteopenic range. Further studies are needed to investigate the effects of testosterone therapy on fracture prevention in acquired hypogonadism or aging men with low serum testosterone concentration.

Effect of oral injection of tramadol, sildenafil and combined of tramadol and sildenafil on serum testosterone level for Wistar breed male rats

Introduction:Testosterone is the main sexual hormone in human males, and has a pharmacological effect on the physiology of sexual function. It is known that suppression of testosterone in eugonadal adult males leads to reduced sexual desire and activity, and may result in erectile dysfunction. Tramadol is rapidly and almost completely absorbed after oral administration but its absolute bioavailability is only 65–70% due to first-pass metabolism. Sildenafil citrate is a water soluble citrate salt that was firstly synthesized by Pfizer in United Kingdom to treat hypertension and angina pectoris. Interestingly, this drug exhibited a different pharmacological effect, a marked penile erection, and became the first-line treatment option to erectile dysfunction. Aim of the work :the main work goal of this search was to measure and compare between mean serum testosterone concentrations after oral injection of tramadol, sildenafil , and combination of tramadol and sildenafil beside healthy subjects.Investigated Parameter: quantitative analysis of Free Testosterone ELISA Kit in serum by The Calbiotech, Inc. 10461 Austin Dr, Spring Valley, CA U.S.A., depending on McCann, D., et al 1985.Results In the present study, the results of GT group revealed that administration of tramadol 50 mg /Kg/day for 10, 20 days and 30 days indicated that the measured testosterone levels were lower than the (GC) control group, and the decrease in testosterone mean concentrations in GT3, than GT2, than GT1. In our research GS group administration of sildenafil 50 mg /Kg/day for 10, 20 and 30 days groups indicated that increase testosterone levels than that in control GC group, and there was an increase in testosterone mean concentrations in GS3, than GS2, than GS1. The present study reveled in GT&amp;S administration of tramadol 50 mg /Kg/day combined with sildenafil 50 mg /Kg/day that the mean serum testosterone concentrations in (GT&amp;S1), (GT&amp;S2) and (GT&amp;S3), were decrease than in the mean serum testosterone concentrations (GC), but this decrease in the mean serum testosterone concentrations in (GT&amp;S1), (GT&amp;S2) and (GT&amp;S3), were quite higher than mean serum testosterone concentrations in GT1, GT2, and GT3, also and there were a decrease in mean testosterone mean concentrations in (GT&amp;S3) than that in (GT&amp;S2) and (GT&amp;S1)conclusion: tramadol administration decrease testosterone levels, while sildenafil increase testosterone levels, while the combination between tramadol &amp; sildenafil decrease testosterone levels.

Two Innovative Pharmaceutical Forms of Leuprorelin: Results from 818 Patients with Advanced Prostate Cancer

This study set out to examine the efficacy and tolerability of two innovative implant forms of leuprorelin acetate in men with advanced hormone-dependent prostate cancer in everyday clinical practice. Data were collected from 818 patients (from 273 centers across Germany) who were pretreated with slow-release luteinizing hormone-releasing hormone (LHRH) agonist formulations and who were about to be switched to the leuprorelin implants. Patients received three injections of 1- or 3-month leuprorelin implant and physicians were asked to complete a case report form specific to each of the three clinic visits. Documented parameters included laboratory measurements, such as testosterone and prostate-specific antigen (PSA) levels, adverse events, and patient- and physician-rated assessments of the therapy. Compared with baseline, a significant decrease in both testosterone and PSA levels were measured after the first and second injections of leuprorelin implant. These results were confirmed for both the 1-month and 3-month implants in separate analyses. Switching, without treatment interruption, from Trenantone® (Takeda Pharma GmBH, Aachen, Germany) to the leuprorelin implant resulted in a significant decrease in the mean serum testosterone concentrations (P < 0.05) and a nonsignificant increase in the proportion of patients reaching castrate testosterone levels, while the number of patients with PSA values ≤ 4 ng/mL significantly increased (P = 0.045). Similar results were obtained for patients previously treated with goserelin who switched to leuprorelin implant. For 94% of patients, treating physicians rated the efficacy of leuprorelin implant as "very good" or "good." Treatment with leuprorelin implant was well tolerated, with only 61 adverse events reported in 42 (5.1%) patients. Patients and physicians rated the tolerability of leuprorelin implant as "very good" or "good" in 95% and 91% of cases, respectively. These results confirm the efficacy, tolerability, and ease of use of the leuprorelin implants among a large population of men with advanced, hormone-dependent prostate cancer treated in a clinical practice setting.

Seasonal variation in serum testosterone, testicular volume and semen characteristics in coatis (Nasua nasua)

The objective was to characterize seasonal changes in serum testosterone concentration, testicular volume and sperm quantity and quality in captive coatis (Nasua nasua) from Pantanal, MT, Brazil. Sampling was done once monthly for 1 y. Mean (± SEM) serum testosterone concentrations (767.37 ± 216.2 ng/ml) and total and progressive sperm motility (79.6 ± 3.9%; 3.8 ± 0.3, on a scale of 0 to 5) peaked in July. The highest combined testis volume (10.3 ± 0.4 cm3) and sperm concentration (403 million ± 102 sperm/ml) occurred in August, at the peak of the winter breeding season. No seasonal effects on percentages of morphologically normal sperm, acrosome integrity, or live sperm were detected; however, the percentage of secondary sperm defects was higher in the winter. In conclusion, intricate relationships between testosterone concentration, testis volume, semen concentration and total and progressive sperm motility with high levels of breeding activity were observed during the dry season in the winter (June, July, August), followed by a subsequent decline in these activities during the wet season (i.e., summer: December, January, February). There was no seasonal pattern for production of functionally intact and morphologically normal sperm.

Effect of progestins on serum hormones, semen production, and agonistic behavior in the gerenuk (Litocranius walleri walleri)

The use of progestins to suppress endogenous testosterone production to reduce agonistic behavior and prevent semen production was studied in gerenuk. Five male gerenuk (20 months to 3 years of age), housed as a bachelor group, were treated with 3 monthly injections of medroxyprogesterone acetate (MPA; 2.5-20 mg/kg), followed by a melengestrol acetate implant (MGA; 0.3 g/kg) for 2 months. Blood samples collected monthly were assayed for serum testosterone and cortisol using enzyme-linked immunoassays. Quantitative behavioral data were collected for 30 min 3/week starting 1 month before treatment. Body weight, testes volume, and semen traits were measured before treatment, after MPA treatment, and after MGA treatment. Results showed lower (P<0.05) mean serum testosterone concentrations after MPA (4.34 pg/ml) and MGA (5.02 pg/ml) treatment compared to pre-treatment values (65.9 pg/ml) in four of five gerenuk. The remaining sub-adult gerenuk had low testosterone initially (4.9 pg/ml) that did not decrease further with treatment (1.4 and 7.8 pg/ml for MPA and MGA, respectively). Mean serum cortisol concentrations decreased markedly after treatment with MPA (6.0+/-3.7 ng/ml) and MGA (0.8+/-0.3 ng/ml). Cortisol concentrations were regained rapidly post-treatment (42.8+/-4.8 ng/ml) and were not significantly different from the pre-treatment value (60.6+/-12.6 ng/ml; P>0.05). The mean incidence of combined aggressive/dominant behaviors (horning, sparring, supplanting, threat) was not different before and after treatment. Body weight, total numbers of spermatozoa produced per ejaculate, percent motility, and percent normal spermatozoa declined maximally 8 months after treatment. Mean testes volume decreased (P<0.05) after MGA treatment (10.53 cm(3)vs. 11.96 cm(3) pre-treatment). Elevated hepatic enzymes and bile acids were seen in three of five animals after progestin treatment and anorexia was noted in two males after MGA implant removal, however two of three males had elevated liver enzymes before progestin treatment began. Results show that reducing serum testosterone concentration does not seem to modify agonistic behavior in bachelor gerenuk groups. Zoo Biol 26:245-257, 2007. (c) 2007 Wiley-Liss, Inc.

Obesity and Sex Steroids during Gonadotropin-Releasing Hormone Agonist Treatment for Prostate Cancer

To evaluate effects of obesity on sex steroid levels during treatment with a gonadotropin-releasing hormone agonist in men with prostate cancer. Forty-nine hormone-naïve men with recurrent or locally advanced prostate cancer were included in the analyses. All subjects were treated with leuprolide 3-month depot for 48 weeks. Serum levels of estradiol, sex hormone-binding globulin, total testosterone, and free testosterone were assessed at baseline, 24 weeks, and 48 weeks. Subjects were categorized by body mass index (BMI) and percent body fat. Pretreatment serum sex hormone-binding globulin and total testosterone levels were significantly lower in overweight and obese men than in men with normal BMI. In the overall study population, mean serum testosterone concentrations decreased from 372 +/- 18 ng/dL at baseline to 13 +/- 1 ng/dL at week 48 (P < 0.001). Free testosterone decreased from 6.75 +/- 0.33 ng/dL at baseline to 0.21 +/- 0.02 ng/dL at week 48 (P < 0.001). During treatment with leuprolide, obese men had significantly higher total and free testosterone levels than men with normal BMI. Compared with normal men, total and free testosterone levels during treatment were 1.8-fold and 2.3-fold higher in obese men. Similar results were observed when subjects were categorized by body fat. Despite lower pretreatment serum testosterone levels, obese men have higher total and free testosterone levels during leuprolide treatment than men with normal BMI. These differences may contribute to the association between obesity and increased prostate cancer mortality.

Randomized Placebo-Controlled Trial of Metformin for Adolescents With Polycystic Ovary Syndrome

To determine whether metformin or placebo could, in conjunction with healthy lifestyle counseling, decrease serum testosterone levels and related aberrations in adolescents with hyperandrogenism, hyperinsulinemia, and polycystic ovarian syndrome. Randomized, placebo-controlled, double-blind trial. Pediatric university teaching hospital. Twenty-two adolescents aged 13 to 18 years with hyperinsulinemia and polycystic ovarian syndrome. Participants were randomly assigned to take a 12-week course of either metformin or placebo. Pretreatment and posttreatment oral glucose tolerance tests, fasting lipid profiles, and clinical measurements. There was a significant decline in mean serum testosterone concentration with metformin (-38.3 ng/dL) compared with placebo (-0.86 ng/dL) (95% confidence interval, -infinity to -0.29 for the mean difference between groups). At completion, the relative risk of menses was 2.50 times higher in the metformin group compared with the placebo (95% confidence interval, 1.12 to 5.58). Measures of insulin sensitivity, including insulin area under the curve and HOMA (homeostasis model assessment), demonstrated improvement only with metformin, but these did not reach statistical significance. High-density lipoprotein cholesterol levels increased by 6.98 mg/dL with metformin vs a decrease of -2.33 mg/dL with placebo (95% confidence interval, 0.78 to 18.23 for the mean difference between groups). There were no significant changes in body mass index, hirsutism, triglyceride levels, or total and low-density lipoprotein cholesterol levels. Metformin significantly lowered total testosterone concentrations, increased the likelihood of menses, and improved high-density lipoprotein cholesterol levels without affecting measures of insulin sensitivity or body weight.