Mean Serum Testosterone Levels Research Articles

Evaluating the Serum Zinc and Testosterone Levels of Carpenters in Enugu Metropolis, South East Nigeria: A Cross-sectional Study

Background: Exposure to wood dust remains a pervasive occupational hazard with significant health implications Aim: This study aims to investigate the impact of occupational exposure to wood dust on the zinc and testosterone levels of carpenters and to explore its potential implications for their fertility. Materials and Methods: This cross sectional study employed simple random sampling to recruit forty carpenters and forty administrative staff after obtaining informed consent. The ethics committee of the University of Nigeria Teaching Hospital approved of the study. Serum zinc was analyzed with atomic absorption spectroscopy while testosterone was analyzed with the Fluorescence Immunchromatogarphy. Graph pad prism version 7 was used to analyze the data obtained from the study and a p value of 0.05 was used to ascertain statistical significance. Results: The mean zinc level of the test group (48.80 ± 0.83) µg/dl is statistically significantly lower than the reference group (52.40 ± 0.79) µg/dl, (p=0.003). The mean serum testosterone level of the test group (4.11± 0.10) ng/ml is statistically significantly lower than the reference group (4.51 ± 0.11) ng/ml, (p=0.010). Conclusion: These findings may suggest that occupational exposure to wood dust could potentially influence the serum levels of Zinc and testosterone levels.

O-263 The risk of hypogonadism after microdissection testicular sperm extraction (micro TESE) in non-obstructive azoospermia (NOA) patients with various etiologies

Abstract Study question What is the risk factor of hypogonadism after micro TESE in NOA patients? Summary answer Klinefelter syndrome (KS), past history of cryptorchidism, preoperative testicular volume <8 ml or testosterone <287 ng/dL are significant risk factors of hypogonadism after micro TESE. What is known already Micro TESE combined with intracytoplasmic sperm injection (ICSI) is currently standard procedure to treat infertility in cases of NOA. Although many studies have reported the effectiveness of the treatment concerning about sperm retrieval rates (SRR) and the live birth rates, data on safety, especially on the risk of hypogonadism, are limited. Most previous studies, including our past study, regarding the risk of hypogonadism after TESE have been limited to relatively few in number of patients and the investigations only of the changes of mean serum testosterone levels. Study design, size, duration This study retrospectively investigated 535 NOA patients including 336 cases of unexplained NOA, 91 KS, 16 other chromosomal abnormalities, 31 azoospermia factor (AZF)c deletions, 31 past history of cryptorchidism, and 30 post anticancer chemotherapy, who had undergone micro TESE at our institution from September 2013 to August 2018. All of them had been examined serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels before and at least once in 1-3 months after micro TESE. Participants/materials, setting, methods In this study, hypogonadism was defined as total testosterone <250 ng/dL, which is established by the Japanese Society of Men’s Health as diagnostic criteria for late onset hypogonadism syndrome, and/or starting testosterone replacement therapy (TRT). We assessed risk factors of hypogonadism after micro TESE using indicators such as age, preoperative testicular volume and testosterone levels, past medical history, unilateral or bilateral, first time or not micro TESE. Main results and the role of chance In total of 535 men, FSH and LH after micro TESE significantly increased vs baseline (26.2 vs 29.9 IU/L, 9.6 vs 12.8 IU/L, respectively). On the other hand, testosterone levels significantly decreased after surgery (351.2 vs 297.5 ng/dL). Although postoperative hypogonadism was found in 42% (227/535), many of whom were cases of KS or preoperative testosterone levels <250 ng/dL. Sixteen men with KS, 3 men with unexplained NOA, and 2 men with past history of cryptorchidism started TRT because they complained clinical symptoms after micro TESE. Of the 21 men who started TRT, only 5 had new-onset low testosterone levels after micro TESE. According to the assessment of any association of various indicators and low postoperative total testosterone levels using multiple logistic regression analysis, significant risk factors of hypogonadism early after micro TESE were cases of KS (OR 11.4, 95% CI 4.4-29.9), preoperative testosterone levels <287 ng/dL (OR 7.5, 95% CI 4.7-12.0), preoperative testicular volume <8 ml (OR 3.9, 95% CI 2.3-6.4), past history of cryptorchidism (OR 2.9, 95% CI 1.1-7.8). Limitations, reasons for caution Most examinations of postoperative hormone levels were performed in short-term period after micro TESE, so we could only assess the risk of postoperative hypogonadism in a short time course in this cohort study. Wider implications of the findings The strength of the current study is that the risk factors of hypogonadism after micro TESE was assessed in a large population of NOA men with various etiologies. The results of this study provide useful clinical information about the risk of postoperative hypogonadism for NOA patients considering micro TESE. Trial registration number not applicable

Evaluation of serum testosterone levels in pre-eclampsia

Background: Pre-eclampsia (PE) is a multi-system disorder that affects 3%–6% of human pregnancies and causes substantial maternal and foetal mortality and morbidity. Various studies have implicated testosterone as a causative factor in the pathogenesis of PE. The present study evaluated the association of serum testosterone levels with PE and maternal and foetal outcomes. Aim: The objectives of the study were to assess serum testosterone levels in PE compared to normotensive pregnant mothers, to look for its association with PE and to identify its utility as a biomarker for PE. Materials and Methods: A prospective cohort study was conducted in the 2nd trimester pregnant mothers (n = 110) attending the outpatient department at Vinayaka Mission’s Kirupananda Variyar Medical College Hospital, Salem. Serum testosterone, uric acid, high-sensitivity C-reactive protein (hsCRP) and creatinine were evaluated and compared amongst the pre-eclamptic and normal pregnant women. Results: The mean serum testosterone level was higher in PE women (2.625 ± 1.40 ng/dL) when compared to normal pregnant women (1.217 ± 0.258 ng/dL) (P < 0.001). Serum testosterone was found to be positively correlated with uric acid (r = 0.517, P < 0.001), hsCRP (r = 0.307, P < 0.001), systolic blood pressure (BP) (r = 0.480, P < 0.000) and diastolic BP (r = 0.544 P < 0.001). Receiver operating characteristic curve analysis for serum testosterone levels was done (area under the curve = 0.815), with sensitivity and specificity of 78.18% and 78.18%, respectively. Conclusion: This study attempted to identify the association between serum testosterone levels, PE and pregnancy outcomes in a small South Indian population. Serum testosterone levels were found to be significantly elevated in pre-eclamptic women compared to normal pregnancies and could be used as a predictive biomarker. Serum uric acid and hsCRP also showed a significant positive association with PE.

Incidence of breakthrough bleeding in transgender and gender-diverse individuals on long-term testosterone

BackgroundLittle is known about maintenance of amenorrhea in transgender and gender diverse individuals with uteri using long-term testosterone gender-affirming hormone therapy. Emerging data describes breakthrough bleeding in adolescents on long-term testosterone, as well as in adults seeking gender affirming hysterectomy. More studies are needed to better understand breakthrough bleeding patterns in transgender and gender diverse individuals on testosterone with uteri, including the frequency, timing, and etiology, and how these may differ in adults compared to younger populations. ObjectivesThe primary aim of this study was to characterize the incidence and patterns of breakthrough bleeding in a cohort of transgender and gender diverse individuals who had been on testosterone for greater than 12 months and had uteri in situ. Secondary aims included identifying the time to first bleed for those who experienced breakthrough bleeding as well as risk factors associated with breakthrough bleeding on testosterone. Study DesignThis was an IRB approved, single tertiary center, retrospective chart review of transgender and gender diverse individuals who had been on testosterone for at least one year. A primary survival analysis looking at the incidence of bleeding was combined with descriptive analyses and evaluation of factors associated with bleeding. ResultsOf the 279 patients included in the analysis, the median age of testosterone initiation was 22 years (IQR 19-41), with the median follow-up time 34 months (range 12-278). The absolute proportion of individuals who ever experienced breakthrough bleeding on testosterone was 34% (n=96, 95% CI [29, 40]). Patients who experienced breakthrough bleeding initiated testosterone at a younger age (20.5 vs 22.0 years, p=0.04), had lower mean serum testosterone levels (389.14 vs 512.7 ng/dL, p=0.001), were more likely to have a mean testosterone level <320ng/dL (52% vs 48% , p=.001), and had higher mean estradiol levels (62% vs 49%, p=0.003). Survival analyses estimated a breakthrough bleeding incidence rate of 0.09 per year (95% CI [.07-1.0]). While 58 people underwent a hysterectomy during the follow-up period, 64% of the cohort who maintained a uterus eventually experienced breakthrough bleeding. The median time to the initial bleeding episode was 22 (IQR 12-201) months after testosterone initiation. Conclusion(s)These results suggest a substantial fraction of transgender and gender diverse individuals using testosterone will experience at least one episode of breakthrough bleeding, even after their initial year using testosterone. We recommend that clinicians counsel all patients that breakthrough bleeding is a common occurrence, even after the first year on testosterone.

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.

A novel abiraterone acetate oral suspension for patients with metastatic prostate cancer: An open-label, phase 3, randomized trial.

5052 Background: Abiraterone acetate (AA) is a first-line oral hormone therapy for metastatic prostate cancer (mPC), but the licensed formulation is limited by large tablet size, requirement to take on an empty stomach, and pharmacokinetic variability. TAVT-45, a novel formulation of AA granules for oral suspension, offers improved oral bioavailability (allowing dose reduction), decreased food effect, and may provide an option for the ~20-30% of patients with dysphagia. This Phase 3, open-label global study (NCT04887506) aimed to establish therapeutic equivalence between TAVT-45 granules and reference AA tablets (R-AA). Methods: Patients with castrate-resistant or castrate-sensitive mPC (mCRPC or mCSPC) were randomized 1:1 to receive TAVT-45 (1 sachet of AA granules [250 mg] in water or juice, twice daily) or R-AA tablets (2 x 500 mg once daily ≥1 h before or ≥2 h after food), plus prednisone (5 mg once [mCSPC] or twice [mCRPC] daily) for 84 days. Efficacy (serum testosterone and prostate-specific antigen [PSA]) and safety were assessed. Average serum testosterone concentrations on Days 9 &amp; 10 (primary endpoint, analyzed via analysis of covariance) were compared to show therapeutic equivalence. The key secondary endpoint was PSA-50 response (patients with ≥50% decrease in PSA from baseline at any time). mCRPC was the primary analysis population. Preliminary results are presented. Results: Of 107 randomized patients, 103 received TAVT-45 (n=54) or R-AA (n=49). The TAVT-45 and R-AA groups were well matched (mean [SD] age: 74.5 [8.45] and 74.9 [8.40] years; mCRPC: 61.1% and 61.2%). In mCRPC, serum testosterone concentrations fell rapidly from mean (SD) baseline of 9.7 (5.19) for TAVT-45 and 10.6 (7.32) ng/dL for R-AA, with all &lt;1 ng/dL by Day 9. Therapeutic equivalence between TAVT-45 and R-AA at Days 9 &amp; 10 was also shown in the full study population: Days 9 &amp; 10 average rounded-up least-squares mean serum testosterone levels were comparable (TAVT-45 [n=52]: 1.004 ng/dL; R-AA [n=47]: 1.015 ng/dL), and the geometric mean ratio between groups was 0.990 (90% CI: 0.978-1.002), with the 90% CI falling within 80.0–125.0% equivalence limits. No statistical difference between TAVT-45 vs R-AA was demonstrated for PSA-50 (mCRPC 85% vs 70%; mCSPC 90% vs 95%). The frequency of treatment-emergent adverse events (TEAEs) was similar between groups; most were mild or moderate. Serious TEAEs occurred in 5 TAVT-45 and 3 R-AA patients. There were two deaths in treated patients due to cardiorespiratory arrest (TAVT-45) and prostate cancer (R-AA); neither was considered related to study drug. Conclusions: This Phase 3 study demonstrates that TAVT-45, a novel AA formulation with improved bioavailability, yields similar testosterone/PSA responses and a comparable safety profile to R-AA, and as an oral solution, may be suitable for mPC patients with dysphagia. Clinical trial information: NCT04887506 .

(371) Testosterone Levels after Lung Transplant: An Analysis of the TriNetX Research Network

Abstract Introduction Men with end stage organ dysfunction or failure are more likely to have low testosterone. In the case of men with heart and kidney failure, improvement in testosterone levels are seen after successful transplantation. Limited data exists regarding the natural course of serum testosterone after lung transplant. Objective To report incidence of low testosterone in men prior to lung transplant and to determine changes in testosterone levels after transplantation. Methods We compiled all clinical data from the TriNetX research network, a globally federated health research network (with waiver from Western IRB) that provides de-identified clinical information from 58 heath care organizations, and over 80 million patients located within the United States. We selected male patients (aged ≥ 18) with a history of lung transplant and testosterone levels recorded before and after transplantation. All men who had a recorded prescription for testosterone therapy were excluded. For all patients, we collected clinical information including demographics, comorbidities, laboratory findings, and medication use. Patients were stratified by testosterone levels and grouped into those who had low serum testosterone versus those with normal levels, with a cut-off point of 300 ng/dL. Patient characteristics were compared using descriptive statistics. Propensity score matching was performed between the two groups to normalize differences in pre-operative characteristics. Mean serum testosterone levels before and after transplantation was compared using a paired T test to determine change in serum testosterone levels after successful transplantation. Results A total of 37 men were identified with history of lung transplant, and testosterone levels recorded before and after transplant. Average serum testosterone level in the year prior to lung transplantation was 301.57 +/− 163.25. After transplantation, average serum testosterone was 332.37 +/− 200.92, for a mean difference of 30.80 (p = 0.4815). Prior to transplantation, 24 (65%) men met criteria for low serum testosterone. After transplantation 17 (46%) men demonstrated serum testosterone less than 300 ng/dl. Among men with low serum testosterone, average testosterone levels in the year prior to lung transplantation was 203.29 +/− 66.57, and was 332.37 +/− 200.92 after transplantation (p = 0.0057). Conclusions Among men with low serum testosterone receiving lung transplant, transplantation was associated with rescue of low testosterone levels. Further research incorporating a larger cohort is required to determine which patients recover endocrine function after lung transplant and whether etiology of chronic lung disease results in different outcomes after transplantation with regards to serum androgen level and function. Disclosure No

Hypogonadism in men with obstructive sleep apnea and its related risk factors

Background Sleep-related breathing disorders, including obstructive sleep apnea (OSA), have been linked to altered hypothalamic–pituitary–gonadal axis. Hypoxia, sleep fragmentation. and decreased deep sleep time in patients with OSA affect the hypothalamic–pituitary–gonadal axis, including serum luteinizing hormone (LH) and testosterone levels. Purpose To study serum levels of LH and testosterone in men with OSA and to investigate the possible risk factors that could affect their levels. Patients and methods This was a prospective cohort case–control study. The case group included 16 adult patients diagnosed with OSA confirmed by polysomnography. The control group included 16 matched healthy participants. Both groups were subjected to history taking, clinical examination, and investigations, including the Epworth sleepiness scale, BMI, neck circumference measurement, and serum levels of LH and testosterone. Results Patients with OSA had significantly higher mean levels of serum LH compared with healthy controls (P=0.031). The mean serum level of testosterone was lower in the OSA group compared with the matched controls; however, this difference was statistically insignificant (P=0.192). Among the studied risk factors for altered hormonal levels in patients with OSA, there was a significant positive correlation between desaturation index and serum LH levels (P=0.046) and a significant negative correlation between Epworth sleepiness scale and serum testosterone levels (P=0.025). Conclusion Our findings suggest that OSA in men is associated with a dysfunction in the hypothalamic–pituitary–gonadal axis, represented as high levels of serum LH. Although serum levels of testosterone were lower in patients with OSA, the study was underpowered to show a statistically significant difference.

PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY

You have accessJournal of UrologyCME1 Apr 2023PD26-07 TESTOSTERONE IS ASSOCIATED WITH ABDOMINAL BODY COMPOSITION DERIVED FROM COMPUTED TOMOGRAPHY: A LARGE CROSS SECTIONAL STUDY Ji Hyung Yoon, Chongsuk Chae, Taekmin Kwon, Sungchan Park, Kyung Hyun Moon, Sang Hyeon Cheon, and Seong Cheol Kim Ji Hyung YoonJi Hyung Yoon More articles by this author , Chongsuk ChaeChongsuk Chae More articles by this author , Taekmin KwonTaekmin Kwon More articles by this author , Sungchan ParkSungchan Park More articles by this author , Kyung Hyun MoonKyung Hyun Moon More articles by this author , Sang Hyeon CheonSang Hyeon Cheon More articles by this author , and Seong Cheol KimSeong Cheol Kim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003304.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A close relationship exists among testosterone, metabolic syndrome, and abdominal body composition. However, few studies have evaluated the relationship between testosterone and abdominal body composition after adjusting for metabolic syndrome. We evaluated the association between serum testosterone and abdominal body composition based on abdominopelvic computed tomography measurements after adjusting for individual metabolic syndrome components in a large cohort who voluntarily underwent health examinations. METHODS: We performed a cross-sectional study using subjects who underwent a general health examination with abdominopelvic computed tomography and testosterone measurements at our hospital between March 2014 and June 2019. Body composition was evaluated with abdominopelvic computed tomography. To confirm an association between testosterone and abdominal body composition, we conducted linear regression analysis. The effect of abdominal body composition was adjusted for important clinical factors such as age, albumin, and metabolic components in the multivariable regression analysis. RESULTS: Overall, 1,453 subjects were included in the primary analysis. The mean age of the study participants was 55.2±8.4 years, and the mean serum testosterone level was 4.36±1.73 ng/ml. In the univariable linear regression analyses, the loge-transformed testosterone had a negative correlation with hemoglobin A1c (unstandardized β=-0.060, p<0.001) and C-reactive protein ≥2.0 mg/dL (unstandardized β=-0.381, p<0.001). All metabolic syndrome components had a negative correlation with the loge-transformed testosterone. Regarding abdominal body composition, subcutaneous fat area index (unstandardized β=-0.048, p<0.001), visceral fat area index (unstandardized β=-0.026, p<0.001), total abdominal muscle area index (unstandardized β=0.110, p<0.001), and normal attenuation muscle area index (unstandardized β=0.076, p<0.001) had an association with the loge-transformed testosterone. After adjustment for age, individual metabolic syndrome components, albumin, hemoglobin A1c, and C-reactive protein ≥2 mg/dL, we found that subcutaneous fat area index (unstandardized β=-0.042, p<0.001), total abdominal muscle area index (unstandardized β=0.115, p<0.001), normal attenuation muscle area index (unstandardized β=0.070, p<0.001), and loge-transformed lower attenuation muscle area index (unstandardized β=0.140, p=0.002) had an association with loge-transformed testosterone level. CONCLUSIONS: After adjusting for individual metabolic syndrome components, testosterone was significantly associated with subcutaneous fat, but not visceral fat. In addition, testosterone was positively correlated with abdominal muscle regardless of qualitative features such as fat-rich and fat-free. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e737 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ji Hyung Yoon More articles by this author Chongsuk Chae More articles by this author Taekmin Kwon More articles by this author Sungchan Park More articles by this author Kyung Hyun Moon More articles by this author Sang Hyeon Cheon More articles by this author Seong Cheol Kim More articles by this author Expand All Advertisement PDF downloadLoading ...

Varicocele Treatment and Serum Testosterone

Varicoceles are an abnormal dilation of the pampiniform plexus within the spermatic cord that can impair spermatogenesis and testosterone production in the testes through a variety of theorized mechanisms. Nearly 15% of the male population is affected by varicocele, though most men are entirely asymptomatic. Among men presenting with infertility, the incidence of varicocele has been observed to be as high as 35–40%. Varicoceles are the most commonly identified abnormalities in men presenting with infertility, and, when associated with abnormal semen parameters, present the urologist with an opportunity for intervention. Serum testosterone levels have been demonstrated to be lower on average among patients with varicoceles and data have suggested that varicocelectomy improves mean serum testosterone levels postrepair. Nonetheless, there are no current guideline indications for varicocelectomy for men with symptomatic hypogonadism, and it is not yet known whether the reported improvement in serum testosterone with surgical intervention is clinically meaningful. In this review, we discuss the most up-to-date literature on the mechanisms by which varicoceles are purported to impair both spermatogenesis and testosterone production as well as the effect of varicocelectomy on serum testosterone levels.

A study of retinal changes in women with polycystic ovarian syndrome.

To compare the optical coherence tomography (OCT)-based retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness at the posterior pole, and total macular thickness of women with the polycystic ovarian syndrome (PCOS) versus healthy reproductive age group females. The study included 110 eyes of 55 diagnosed cases of PCOS (study group) and 110 eyes of 55 healthy reproductive age group (15-49 years) females (control group). All patients underwent a detailed ophthalmological evaluation followed by an OCT to measure their retinal thicknesses. The body mass index (BMI) of patients was noted and compared with the retinal thickness. Also, the lipid profile and serum testosterone levels of PCOS patients were recorded. The retinal thicknesses in the two study were similar and there was no statistically significant difference. However, on stratification with BMI, it was seen that in patients with BMI>30 kg/m2, the superior Retinal Nerve Fibre Layer (RNFL) was significantly thicker in the PCOS group as compared with the control group (P = 0.0006). The mean serum testosterone level in patients with PCOS was 141.3 ± 23.2. Also, 65.45% of patients had a serum testosterone level of more than 70 ng/dL. The mean HDL cholesterol in patients with PCOS was 38.1 ± 15.6. The mean LDL cholesterol in PCOS patients was 98.4 ± 21.7, and the mean total cholesterol in PCOS patients was 153.6 ± 27.3. Androgens have a trophic action on nerves, which could explain the increased RNFL thickness in these patients.

Evaluation of Serum Testosterone Levels Following Three Months of SA3X (Spilanthes acmella) Supplementation.

Introduction: Low testosterone is usually associated with erectile dysfunction (ED). SA3X (Spilanthes acmella) has proven to be effective in alleviating symptoms of ED, which could be due to an alteration in serum testosterone levels. This study was carried out to evaluate the change in testosterone levels in participants with ED supplemented with SA3X for three months.Materials and Methods: A group of 326 sexually active men aged 25-60 years was investigated from November 2021 to May 2022 in Hyderabad. The participants were subjected to supplementation with SA3X capsules for three months, and a follow-up was done at the end of six months with serum testosterone assessment in each visit. The change in testosterone level was assessed using a mixed model repeated measures analysis.Results: A significant increase was observed in the mean serum testosterone levels by the end of the second month (323.91 ± 13.76 ng/dL vs. 309.84 ± 14.11 ng/dL; p=0.03) and third month (332.27 ± 12.85 ng/dL vs. 309.84 ± 14.11 ng/dL; p<0.01) of SA3X therapy. The adjusted mean change in testosterone levels was found to be 22.43 ng/dL at the end of the three-month therapy. It was also observed that the change in testosterone levels was significantly lower in participants having diabetes mellitus, hypercholesterolemia, and a history of substance abuse. However, participants on phosphodiesterase-5 inhibitors had an increased change in testosterone levels.Conclusion: Supplementation with SA3X capsules for three months increases the serum testosterone levels. However, causality cannot be ascertained owing to the longitudinal nature of the study, and further controlled trials are required for the same.

Impacts of Androgen Abuse and Overtraining on Endocrine Profile in Bodybuilders

Abuse of androgens and overtraining expose bodybuilders to multifactorial stress influences related to endocrine activity. Endocrine responses in 23 bodybuilder athletes were investigated after a strength training period, during which they were taking high doses of androgenic-anabolic steroids. Serum concentrations of TSH, T3, and T4 were unchanged significantly. Serum LH and FSH concentrations decreased dramatically (P&lt;0.05). In addition, low mean concentration of serum testosterone was recorded, with more substantial reduction in participants of elder ages. The multiple regression model used in this analysis supported this inference. On the other hand, a positive association was observed between levels of blood lipids (total cholesterol, triglyceride) and the outcome predictor (mean serum testosterone level). The results also suggested a negative correlation between testosterone level and each of age and HDL level. The current study shows that excessive bodybuilding exercise has an impact on the hypothalamic–pituitary–thyroid (HPT) axis in top-level athletes. Also, simultaneous usage of anabolic steroids induces extreme shifts in the hypothalamic-pituitary–gonadal (HPGA) axis, which is reflected as changes in testosterone level, development of the overtraining syndrome, and adverse influences on hormonal control.

Comparison of the sex hormones\u2019 serum level in women with recurrent aphthous stomatitis and healthy population: a cross-sectional study

BackgroundIn this study, we aimed to evaluate the sex hormonal serum level in patients with recurrent aphthous stomatitis and compare them with healthy participants.MethodsThis cross-sectional study was done on patients with recurrent aphthous stomatitis who had referred to Shiraz Dental Faculty, Oral and Maxillofacial Medicine Department during 2018–2019. The non -menopause women with recurrence of at least 3 lesions per year were enrolled in this study. The mean serum level of FSH, LH, PRL (prolactin), testosterone, DHT (Dihydrotestosterone), DHEA-S (Dehydroepiandrosterone sulfate), estradiol and progesterone of 30 participants in each group of case and control were measured and compared. The data were analyzed by SPSS version 18 and independent T-test, Mann–Whitney U test, Spearman’s correlation coefficient test, Chi-square test and Fisher’s test.ResultsThe mean serum level of DHEA-S in patients with recurrent aphthous stomatitis (RAS) was significantly lower than the control group (p value = 0.02). In addition to DHEA-S, the mean serum level of testosterone was lower in the evaluation group although this difference was not significant (p value = 0.057). Considering the effect of age on the mean serum level of sex hormones, our results revealed that only DHEA-S mean serum level was decreased by increasing the age of participants in patients with RAS (p value = 0.018). The number of participants with abnormal range of testosterone (p value < 0.0001) and progesterone (p value = 0.037) serum level was significantly more in patients with RAS. The frequency of RAS in a year did not show a significant relationship with the serum level of the evaluated hormones.ConclusionThe patients with RAS had a lower serum level of DHEA-S. The mean serum level of testosterone and progesterone was significantly abnormal in RAS patients.

Testosterone Therapy With Subcutaneous Injections: A Safe, Practical, and Reasonable Option.

Injections with intramuscular (IM) testosterone esters have been available for almost 8 decades and not only result in predictable serum testosterone levels but are also the most inexpensive modality. However, they are difficult to self-administer and associated with some discomfort. Recently, subcutaneous (SC) administration of testosterone esters has gained popularity, as self-administration is easier with this route. Available data, though limited, support the feasibility of this route. Here we review the pharmacokinetics and safety of SC testosterone therapy with both long- and ultralong-acting testosterone esters. In addition, we provide guidance for clinicians on how to counsel and manage their patients who opt for the SC route. Systematic review of available literature on SC testosterone administration including clinical trials, case series, and case reports. We also review the pharmacology of testosterone absorption after SC administration. Available evidence, though limited, suggests that SC testosterone therapy in doses similar to those given via IM route results in comparable pharmacokinetics and mean serum testosterone levels. With appropriate training, patients should be able to safely self-administer testosterone esters SC with relative ease and less discomfort compared with the IM route. Although studies directly comparing the safety of SC vs IM administration of testosterone esters are desirable, clinicians should consider discussing the SC route with their patients because it is easier to self-administer and has the potential to improve patient adherence.

Evaluating the Effects of Noise Pollution on the Levels of Blood Cortisol, Testosterone, and Thyroid in Male Wistar Rats

Background: Noise pollution is a global problem causing changes in the secretion of various hormones and consequently affecting social well-being and quality of life in cities. Objectives: This study aimed to investigate the effect of noise pollution on the levels of testosterone, thyroid, and cortisol hormones in male rats. Methods: In this experimental study, a total of 70 male Wistar rats (200 - 250 g) were randomly assigned into one control and six experimental groups, with 10 rats in each group. Experimental groups were exposed to noise with different intensity (dB) and time (min) as follows: (I) 60 dB, 30 min; (II) 60 dB, 60 min; (III) 85 dB, 30 min; (IV) 85 dB, 60 min; (V) 110 dB, 30 min; (VI) 110 dB, 60 min; (VII) controls. Animals in the experimental groups were exposed to noise in an acoustic chamber designed for this purpose for 50 days. The Noise.exe software was used to generate noise, and the sound level meter (model TES 1358) was used to determine the accuracy of the intensity and frequency of sound. To determine plasma levels of the hormones, appropriate research and commercial kits were used, which were based on the ELISA method. To determine the concentration of hormones other than TSH, human assay kits were used. All statistical tests were performed in SPSS software version 21. Results: Serum levels of cortisol in the 110-dB (30 and 60 min), 65-dB (60 min), and 85-dB (60 min) groups were significantly higher than the control group (P ≤ 0.05). Also, cortisol levels in the 65-dB and 85-dB (30 minutes) groups were higher than the control group; however, the increase was not significant (P &gt; 0.05). The levels of T4, T3, and TSH in the 60-dB and 85-dB groups were significantly lower than in the control group (P ≤ 0.05). The serum levels of T4, T3, and TSH hormones in the 110-dB group were insignificantly lower than the control group (P &gt; 0.05). The serum level of testosterone in the 110-dB group was significantly lower than the control group (P ≤ 0.05). The mean serum levels of testosterone in the 65-dB and 85-dB groups were insignificantly lower than the control group (P &gt; 0.05). Conclusions: Based on this study, exposure to noise pollution increased cortisol secretion and decreased T4, T3, TSH, and testosterone levels in rats. As this hormonal imbalance may create direct and indirect effects, studies and strategies are recommended to control the imbalance of hormones in the polluted environments.

COMPARISON OF METFORMIN AND ORAL CONTRACEPTIVE PILLS IN THE TREATMENT OF POLYCYSTIC OVARIAN SYNDROME

Objective: To compare metformin and oral contraceptive pills in terms of mean change of serum testosterone levels and body mass index in polycystic ovarian syndrome.&#x0D; Study Design: Quasi experimental study.&#x0D; Place and Duration of Study: Department of Gynecology and Obstetrics, Sargodha Medical College, Sargodha Pakistan, from Apr to Dec 2019.&#x0D; Methodology: A total of 64 patients presenting with polycystic ovarian syndrome between 15-35 years were included. All patients were divided into two groups i.e. group 1 received oral contraceptive pills, and group 2 received metformin. Patients were clinically evaluated at baseline and 6 months after initial presentation to address the primary aim of evaluating the change in mean serum testosterone levels and body mass index after treatment.&#x0D; Results: The mean age of patients was 20.30 ± 4.92 years. The mean body mass index of patients at presentation was 30.32 ± 2.66 kg/m2. The mean reduction in the level of testosterone in group 1 was 5.14 ± 0.35ng/ml while in group 2 it was 2.58 ± 0.41 ng/ml (p˂ 0.001) which was statistically significant. Mean decrease in body mass index in group 1 was 1.51 ± 0.71 kg/m2 while in group 2 was 1.29 ± 0.46 kg/m2 (p=0.148) which was statistically insignificant.&#x0D; Conclusion: Oral contraceptive pills were better than metformin in terms of mean decrease in serum testosterone levels in women presenting with polycystic ovarian syndrome while the mean reduction in body mass index in both the groups was similar.

Subclinical left ventricular dysfunction in men under androgen deprivation therapy for prostate cancer, revealed by speckle‐tracking‐derived parameters, repolarization, and myocardial injury markers

ObjectiveTo analyze global left ventricular longitudinal strain (GLS), mechanical dispersion (MD), electrocardiographic repolarization, and myocardial injury markers changes during androgen deprivation therapy (ADT) and subsequent hypogonadism in men with advanced prostate cancer.MethodsWe included 31 patients 69.7 ± 7.3 years old, in sinus rhythm, with stable cardiac conditions and evaluated them by echocardiography, electrocardiography, and blood sampling for high sensitivity cardiac troponin I (hs‐cTnI), and N‐terminal pro‐brain natriuretic peptide (NTproBNP), at ADT initiation (M0) and after 6 months of treatment (M1). Peak longitudinal strain by speckle‐tracking echocardiography was assessed in 17 left ventricular segments and averaged to GLS. Standard deviation of time intervals from the start of Q/R on electrocardiogram to peak longitudinal strain in the 17 segments (MDSD), and the difference between the longest and shortest time‐to‐peak strain intervals (MDdelta) were calculated as indices of MD. Fridericia corrected electrocardiographic repolarization parameters were analyzed as follows: QT interval (QTc), mean and maximum values of Tpeak‐Tend interval (Tpe), and Tpe/QT ratio, Tpe dispersion (Tped).ResultsSignificant impairments of the following parameters were registered between M0 and M1: GLS (%) (−16.93 ± 3.89; −14.43 ± 3.57, P < .001), MDSD (ms) (77.4 ± 21.4; 89 ± 27, P = .004), MDdelta (ms) (225.3 ± 78.3; 259.9 ± 108.4, P = .02), QTc (ms) (458.8 ± 43.4; 485.6 ± 45.1, P = .01), maxTpe/QT (0.246 ± 0.04; 0.268 ± 0.04, P = .01), maxTpe (ms) (105.4 ± 23.2; 119.5 ± 26.4 P = .01), meanTpe (ms) (83.3 ± 16.8; 90.7 ± 19.3, P = .02), and hs‐cTnI (ng/mL) (4.6 ± 5.4; 5.4 ± 6.4, P = .01). Mean serum testosterone level at M1 was 0.1 ± 0.13 ng/mL. The patients’ clinical cardiological status remained stable during follow‐up.ConclusionsADT and subsequent hypogonadism induce subclinical alterations in GLS, MD, electrocardiographic repolarization parameters, and hs‐cTnI during the first 6 months of treatment.

Sperm DNA integrity in adult survivors of paediatric leukemia and lymphoma: A pilot study on the impact of age and type of treatment

Male childhood cancer survivors (CCS) show reduced fertility, mostly due to low sperm count. The links between DNA damage caused by cancer and its treatment, pubertal stage at diagnosis and future infertility are still unclear. This Canadian pilot study analysed reproductive parameters and sperm characteristics in adult survivors of childhood leukaemia and lymphoma, divided into 2 groups according to whether cancer diagnosis occurred before or after puberty. They were compared to age-matched men with no history of cancer. No differences were observed in mean serum testosterone and FSH levels, but 4 CCS had FSH levels >8 U/ml. No differences in average sperm count or motility were observed across groups, but 5 of the 13 CCS were affected by azoo/oligozoospermia, regardless of the time at cancer diagnosis. Analysis of sperm chromatin and DNA integrity revealed no differences among the groups. The authors observed a significant negative correlation between sperm count and the cumulative dose of alkylating agent, determined by the cyclophosphamide equivalent dose, and a strong positive correlation between the cumulative dose of anthracyclines and the DNA fragmentation index. A limitation of the study is the small sample size, which makes it difficult to generalize the results. It is noteworthy that both groups of CCS had a similar prevalence of azoo/oligozoospermia, supporting the hypothesis that the prepubertal testis is not protected from damage in children who undergo cancer treatment.

Correlation of levels of serum testosterone and dhea-s in patients of acne vulgaris

Acne is one of the most commonest dermatological disorders in young patients. 1. It is a disease of the pilosebaceous follicular unit. 2. Endocrine mechanisms control the components of sebocyte function—namely lipid synthesis, proliferation and differentiation. 3. Androgens upregulate the sebaceous glandular function by binding to the nuclear androgen receptors (ARs). Highest density of these androgen receptors have been demonstrated in sebaceous glands.The mechanisms suggested in acne include: Increased circulating levels of androgens, Increased free androgen levels, Increased local metabolism of androgens in skin and increased tissue sensitivity to androgens.This case control study was conducted In the department of dermatology, venerology and leprosy, shadan institute of medical sciences, Hyderabad from February 2019-february-2020. A total of 50 patients (25 males and 25 females) of moderate to severe acne vulgaris resistant to conventional treatment were included in the study A total of 50 patients (25 males and 25 females) of moderate to severe acne vulgaris resistant to conventional treatment were included in the study Age range: 14 to 35 years patients who were receiving any systemic drugs, oral contraceptives or hormonal therapy, pregnant and lactating. 50 age and sex matched healthy acne free subjects were also part of the study.Venous blood samples were collected for the assay of serum testosterone, dehydroepiandrosterone-sulfate (DHEA-S) and androstenedione (A4A) between 0800-0900 hours. For testosterone assay three samples were collected at 20 minute intervals and pooled together. Immediately after collection the red cells were separated and the sera were stored at - 20°C till assay. In females, the samples were collected only in the first half of the follicular phase of the menstrual cycle. All hormones were measured by radioimmunoassay using standard techniques with commercially obtained kits. All patients included in the study had moderate to severe acne. The commonest lesions encountered were pustules and nodules while cysts were present in 10/25 males and 11/25 females. 32/50 patients had acne lesions also on the trunk. The mean duration of acne was 2.6 years (range 1 to 6 years). A history of partial or no response to conventional treatment was present in all the patients. Mild to moderate degree of hirsutism was present in 7/25 female patients; of whom 4 also had oligomenorrhea. No other sign of virilisation was observed in any female patient. In males with acne the mean serum testosterone levels were only marginally elevated but their DHEA-S levels were significantly higher than in controls.