Mean Testosterone Levels Research Articles

Characterizing clinical and hormonal profiles of acne in north African women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is the leading endocrine disorder in young women of childbearing age. Dermatological issues, particularly acne, are a major reason for medical consultations. The aim of this study is to determine the prevalence of PCOS in patients presenting with acne as their main dermatological complaint and to compare the metabolic and hormonal clinical characteristics of acne patients with PCOS to those with isolated acne. This was a prospective study with analytical aims, carried out in the Endocrinology Department and the Dermatology Department of Farhat Hached University Hospital in Sousse. The study included patients seeking treatment for acne from January 2023 to January 2024, divided into two groups: those with confirmed PCOS (G1) and those with isolated acne (G2). All patients underwent hormonal assessment and ovarian ultrasound. We conducted a study involving 212 patients. We found that 65.6% of acne patients had been diagnosed with PCOS. Nodular lesions were significantly more frequent in 'PCOS' (p = 0.02). Acne was linked with hirsutism, which was more prevalent in 'PCOS' (94.2% 'PCOS' vs. 67.1% 'isolated acne'), as well as androgenic alopecia (51% 'PCOS' vs. 21.9% 'isolated acne') (p < 10- 3). 'PCOS' showed evidence of biological hyperandrogenism, with a mean testosterone level of 0.72 ± 0.27 ng/mL, significantly higher than in 'isolated acne'. The LH/FSH ratio was greater than 1 in 72.7% of cases in 'PCOS', demonstrating a significant difference compared to 'isolated acne', where it was greater than 1 in 24.7% of cases (p < 10- 3). In our study, acne in 'PCOS' appeared to be more severe and was associated with hypertestosteronemia (p = 0.041) and hyperprolactinemia (p = 0.008). According to our results, phenotype A was the most likely to cause severe acne (p = 0.043). Our work is unique in that it brings to light this hidden aspect of the dermatological impact of PCOS, prompting physicians to screen for this endocrine disorder in all adult women seeking acne treatment.

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.

7802 A Review of 21 Cases of Kallmann Syndrome

Abstract Disclosure: T. Kashima: None. M. Ishimaru: None. E. Tanimoto: None. S. Fukui: None. C. Nakamura: None. N. Ujita: None. H. Miyagi: None. M. Igarashi: None. H. Doi: None. K. Yoshii: None. Y. Naiki: None. R. Horikawa: None. Kallmann syndrome is the most common form of hypogonadotropic hypogonadism. The incidence is estimated to be 1 in 10,000 birth boys and 1 in 50,000 birth girls. The goals of treatment for childhood puberty are to induce the progression of secondary sexual characteristics close to physiological sexual maturity, to improve psychosocial problems caused by delayed puberty, and to achieve fertility. Methods.Twenty-one patients (fifteen males and six females) with a diagnosis of Kallmann syndrome who visited our Department between August 2004 and November 2023 were included in the study. The electronic medical records were reviewed retrospectively. Results.The median age at first visit was 15 years and 11 months (13 years and 3 months to 17 years and 7 months). The chief complained were secondary sexual characteristics not yet developed, olfactory disturbance, amenorrhea, decreased growth rate, and micropenis. Three adults had symptoms of Kallmann's syndrome and were seen for close examination. 6 had a history of hearing loss. Family history included 2 cases of hypogonadotropic hypogonadism and a sibling with Sjogren-Larsson syndrome. 9 cases had genetic testing, including KAL1, KAL2, FGF8, IL17D, 1 case each, and 2 gene variants of CHD2.At the time of initial examination, the median testicular volume in males was 1.0 mL (1.0-3.0 ml). Five of the six female patients had no breast enlargement.Endocrine examination revealed that the mean basic LH and LHRH test peak values were 0.25 and 3.40 mIU/mL, respectively; the mean basic FSH and peak FSH values were 0.91 and 4.47 mIU/m, respectively; the mean testosterone level in males was 0.09 ng/mL; and the mean estradiol level in females was 5.58 pg/mL.For the 20 patients, excluding children, gonadotropins (HCG+rFSH) for men and estrogen patches for women were both started at low doses and titrated up to Kaufman therapy in women. Median age at initiation of treatment was 16 years and 5 months (14 years and 1 month to 18 years and 6 months). Bone density increased after the start of treatment. One patient diagnosed with micropenis in infancy was treated with testosterone for micropenis at 2 years and 5 months. Two male patients had a baby with their partners. Discussion.The age of diagnosis (age of first examination) is considerably older than the average age of onset of secondary sexual characteristics, so it is necessary to educate the public so that patients can be examined earlier. The patient's fertility was partially confirmed, and a smooth transition to adult/reproductive medical care can be expected through earlier intervention. Presentation: 6/1/2024

Kidney transplantation restores sex hormone profile and improves sexual function in ESRD patients with erectile dysfunction.

Erectile dysfunction (ED) and sex hormone profile disturbances are common in ESRD patients. To assess the effect of kidney transplant (KT) and Hemodialysis/peritoneal dialysis (HD/PD) on the serum sex hormone profile and sexual functions in ESRD patients with ED. A single-center, nonconcurrent cohort study included a hundred ESRD patients with ED, on regular HD/PD (group A, n = 50) and after KT (group B, n = 50) at Armed Forces Hospitals Southern Region, KSA. the mean age of patients was 47.3 ± 7.01 and 56.8 ± 9.6 years in groups A and B, respectively. The cohorts were comparable regarding patient demographics, apart from a higher incidence of comorbidities in group B. After KT the mean testosterone level was higher in Group B (13.64 ± 3.21 nmol/L vs 10.26 ± 3.26 nmol/L, p < 0.001). Similarly, LH and prolactin levels were lower in group B than in group A (p < 0.05). As regards sexual function, ED was reported in 92% of patients in group A compared to 42% in group B (p < 0.001). In groups A and B, mild ED was found in 48% and 14% of patients, while moderate ED was found in 16% and 8%, respectively. The mean total IIEF-15 score was 36.42 ± 9.33 and 43.87 ± 9.146 in groups A and B, respectively (p = 0.0001). Sexual desire and orgasm were significantly better in Group B. Our study showed that kidney transplantation could improve erectile function and restore normal sex hormone levels in ESRD male patients with ED, with better outcomes compared to HD/PD.

Uterine changes in transgender men receiving testosterone therapy.

Despite regular gender-affirming hormone therapy (GAHT), the presence of uterine bleeding can occur occasionally and cause profound discomfort. This study aimed to evaluate the histologic features and immunohistochemical expression of estrogen (ER), progesterone (PR), and androgen receptors (AR) in the endometrium and myometrium of transgender men receiving testosterone therapy and relate them to clinical and hormonal characteristics. Retrospective cross-sectional study. Thirty-four transgender men undergoing gender-affirming surgery were included. Clinical, sociodemographic, and laboratory data as well as anatomopathological and immunohistochemical findings were evaluated. The participants' mean age was 42.35 (SD, 10.00) years, and body mass index was 28.16 (SD, 5.52) kg/m2. The mean GAHT duration before surgery was 5.36 (SD, 3.24) years. The mean testosterone levels were 814.98 (SD, 407.13) ng/dL, and estradiol levels were 55.22 (SD, 25.27) pg/mL. The endometrium was atrophic in 61.8%, proliferative in 17.6%, and secretory in 20.6%. Immunohistochemical receptor analysis revealed that endometrial epithelial cells expressed ER (90%) and PR (80%), with a lower expression of AR (30%). In stromal tissue, the median ER, PR, and AR expression was lower than that in the epithelium (60%, 70%, and 25%, respectively). The myometrium showed high expression of PR (90%) and ER (70%), with the highest expression of AR (65%) being localized to this region. In the present study, GAHT induced an atrophic condition of the endometrium in two-thirds of the transgender men, with a limited AR expression in the endometrial region. The present results suggest that testosterone-based GAHT for a mean of 5 years is safe in transgender men achieving amenorrhea.

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 &amp;lt;8 ml or testosterone &amp;lt;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 &amp;lt;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 &amp;lt;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 &amp;lt;287 ng/dL (OR 7.5, 95% CI 4.7-12.0), preoperative testicular volume &amp;lt;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

Correlation of testosterone and ESR2 in prostate cancer

Introduction: Prostate cancer (PCa), as the second most frequent cancer in males, has a significant challenge in determining differential diagnosis and prognosis of aggressive or non-aggressive prostate cancer. For functioning correctly, the prostate needs sex steroid hormones, which are also factors in the initiation and progression of carcinogenesis. Risk and Gleason score upgrading can be predicted by preoperative plasma testosterone levels in men with prostate cancer undergoing radical prostatectomy. Not only testosterone but estrogen also has roles in prostate cancer carcinogenesis. Estrogen Receptor 2 (ESR2) gene has been found to encode ER-β, which has an anti-proliferative effect on prostate tissue. This study aims to look up any correlation between testosterone and ESR2 in prostate cancer. Methods: This is an analytic cross-sectional study. We conducted a quantitative real-time polymerase chain reaction (qPCR) examination involving 15 benign prostate hyperplasia (BPH), 10 non-metastasized PCa, and 21 PCa patients for determining ESR2 expression from formalin-fixed paraffin-embedded (FFPE) prostate cancer tissue with known testosterone level in our institution. Data were analyzed using statistical tests with a significance of p &lt;0.05. Results: The mean testosterone level and ESR2 expression are 785 ng/dl and 236.4 ng/dl 4.6 8.2, respectively, in BPH and PCa. Statistically, there was an inverse correlation between testosterone and ESR2 levels in prostate cancer (p&lt;0.05). Conclusion: This study found lower testosterone correlates with ESR2 modulation.

Network analysis of comorbid aggressive behavior and testosterone among bipolar disorder patients: a cross-sectional study

Testosterone has complex effects on psychological traits and behavior; it is associated with social dominance and competition and is a potential human sex pheromone. This study aimed to investigate the associations between testosterone levels, aggressive behavior, and manic symptoms using a network analysis among bipolar disorder (BD) patients in psychiatric emergency departments (PED). Data from January 2021 and March 2022 BD patients in PED were analyzed. Manic symptoms were assessed using the Young Mania Rating Scale (YMRS). Aggression was assessed with subscale of the PANSS scale (PANSS-AG). The undirected network structures of testosterone levels, aggressive behavior, and manic symptoms were estimated, and centrality and bridge centrality indices were examined. Network stability was examined using the case-dropping procedure. The Network Comparison Test (NCT) was conducted to evaluate whether network characteristics differed by gender. We recruited a total of 898 BD patients, with the mean YMRS score as 13.30 ± 9.58. The prevalence of level II aggression was 35.6% (95%CI = 32.5%–38.7%), level III aggression was 29.5% (95%CI = 26.3%–32.6%), and level VI aggression was 7.0% (95%CI = 5.4%–8.8%). The male participants had a mean testosterone level of 391.71 (Standard Deviation (SD):223.39) compared to 36.90 (SD:30.50) for female participants in the whole sample. Through network analysis, “Increased motor activity-energy” emerged as the central symptom, with the highest centrality expected influence, followed by “Emotional Instability” and “Disruptive/aggression behavior”. Notably, “Emotional Instability” appeared to be the bridge symptom linking manic symptoms to aggressive behavior. Within the flow network model, “Speech rate and amount” exhibited the strongest positive correlation with testosterone levels, followed closely by “Disruptive/aggression behavior”. The constructed network model demonstrated robust stability, with gender showing no significant impact on the structure. In this study, “Increased motor activity-energy” stood out as the most influential symptom, and “Speech rate and amount” acted as the main bridge symptom linking testosterone levels, aggressive behavior, and manic symptoms. Targeting the central and bridge symptoms may improve the outcomes of aggression interventions implemented among BD patients in psychiatric emergency care.

Evaluation of Some Hormones Total Antioxidant Capacity and Malondialdehyde Levels in Polycystic Ovarian Syndrome Women attending the gynecology Clinic at Nnewi

Polycystic ovarian syndrome (PCOS), marked by oxidative stress and hormonal imbalances, causes infertility, insulin resistance, and diverse health problems. It not only affects physical health but also can strain marriages and lead to divorce, posing a notable societal issue. The levels of hormones (Estradiol (E2), Dihydroepiandrosterone sulfate (DHEA), luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone (PROG) Testosterone (TEST)), total antioxidant capacity (TAC) and Malondialdehyde (MDA) in PCOS Women attending the gynecology Clinic at Nnewi were investigated. This cross-sectional study had 45 participants with PCOS as a test group and 45 participants without PCOS as the control group between the ages of 18-50 recruited. All the biochemical parameters were determined by enzyme-linked immunoassay technique. Data was expressed as Mean ± standard deviation. The differences in parameters studied between the PCOS group (test) and the control group were evaluated using an independent t-test. Statistical significance was set at p-value &lt; 0.05. Result showed significant higher differences in the mean serum levels of DHEA (87.40±65.90), LH (34.7±36.1), FSH (19.61±14.73) and Testosterone (3.04±1.36) in women with PCOS compared with the control (1.035±0.54),( 20.76±18.1), (13.2±10.19), and (3.04±1.36)(p&lt; 0.05) respectively. A higher significant difference exists in the mean serum MDA values of the test group (women with PCOS compared with the control group(p&lt;0.05). This study concluded that oxidative stress and hormone imbalance occurred among participants with PCOS attending the gynecology clinic of Nnamdi Azikiwe University Teaching Hospital in Nnewi. Keywords: PCOS, Estradiol, DHEA, luteinizing hormone, FSH, progesterone, Testosterone, TAC

Modulatory Effect of Jatropha tanjorensis Ethanol Leaf Extract and Vitamin E on Some Reproductive Hormone in Lead-Treated Male Wistar Rats

Heavy metals such as Lead (Pb) in the environment could pose serious reproductive health issues resulting in infertility. Jatropha tanjorensis (JT) from previous studies has been proven to enhance reproductive parameters. This study examined the effects of Jatropha tanjorensis alongside vitamin E on some reproductive parameters in male rats. 40 rats male rats were assigned into 8 groups (n=5): Control, Lead treated group, low dose JT, high dose JT, Vitamin E control, lead + low dose JT, lead + high dose JT, lead + vitamin E groups. Administration was done for 14 days. Mean testosterone level was seen to significantly increase (p&lt;0.05) in all treated groups and vitamin E group in combination with lead when compared to normal control group and Pb control. FSH levels was seen to increase significantly (p&lt;0.05) in all JT treated groups and vitamin E treated group when compared to Pb control but no significant difference was observed when all treated groups was compared to normal control. Also from the study, LH level increased significantly (p&lt;0.05) in high dose JT when compared with every other treated groups. JT and vitamin E administration was able to reduce the negative effect exerted by lead on the various reproductive parameters analyzed.

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 &lt; 0.001). Serum testosterone was found to be positively correlated with uric acid (r = 0.517, P &lt; 0.001), hsCRP (r = 0.307, P &lt; 0.001), systolic blood pressure (BP) (r = 0.480, P &lt; 0.000) and diastolic BP (r = 0.544 P &lt; 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.

Low Serum Testosterone as a Poor Prognostic Marker in Urethral Stricture: A Single-Center Prospective Longitudinal Study.

Introduction Androgens play a key role in modulating periurethral and preputial vascularity, cavernosal smooth muscle integrity, and penile growth. As a result, low testosterone may adversely affect the severity and outcome of urethral stricture patients. So, to find out the hormonal influence on the clinical outcome of urethral stricture we conducted a prospective longitudinal study at our institute. Methods The study was conducted at the Department of Urology, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India, from February 2023 to September 2023. This study was approved by the Institutional Ethics Committee atIPGMER, Kolkata with the approval number IPGMER/IEC/2023/436. Hormonal levels in patients with diagnosed non-traumatic urethral stricture were compared with patients without stricture. Patients with any overt hormonal abnormality or androgen-secreting tumor were excluded. A morning 10 cc blood sample was collected for testosterone, follicle-stimulating hormone, luteinizing hormone, and thyroid-stimulating hormone. The association of hormonal levels was measured in both groups and compared statistically. Any association of hypogonadism (testosterone <300 ng/dL) with respect to length, severity, and recurrence of urethral stricture was also studied. Results Forty patients with urethral stricture and same number of patients without stricture were included in the study. The mean testosterone level was found to be significantly low in patients with stricture (386 ng/dL vs 660 ng/dL). The age-wise distribution also showed low mean testosterone compared to patients without stricture. The incidence of hypogonadism is also found to be higher in stricture patients (47.5% vs 27.5%). It was also observed low testosterone is more prevalent in pan-anterior stricture (10/40) and long-segment stricture(>2 cm). Patients with stricture were also followed up for 6 months for recurrence of symptoms. Thirteen patients had recurrence. Patients with recurrence had significantly low serum testosterone (272 ng/dL vs 440 ng/dL). Conclusion Our study documented stricture patients with low serum testosterone have poor outcomes. Low testosterone level is strongly associated with longer stricture and increased risk of stricture recurrence.

Efficacy and Safety of Radiotherapy Plus Relugolix in Men With Localized or Advanced Prostate Cancer

Combination androgen deprivation therapy (ADT) with radiotherapy is commonly used for patients with localized and advanced prostate cancer. To assess the efficacy and safety of the oral gonadotropin-releasing hormone antagonist relugolix with radiotherapy for treating prostate cancer. This multicenter post hoc analysis of patients with localized and advanced prostate cancer receiving radiotherapy in 2 randomized clinical trials (a phase 2 trial of relugolix vs degarelix, and a subset of the phase 3 HERO trial of relugolix vs leuprolide acetate) included men who were receiving radiotherapy and short-term (24 weeks) ADT (n = 103) from 2014 to 2015 and men receiving radiotherapy and longer-term (48 weeks) ADT (n = 157) from 2017 to 2019. The data were analyzed in November 2022. Patients receiving short-term ADT received relugolix, 120 mg, orally once daily (320-mg loading dose) or degarelix, 80 mg, 4-week depot (240-mg loading dose) for 24 weeks with 12 weeks of follow-up. Patients receiving longer-term ADT received relugolix, 120 mg, orally once daily (360-mg loading dose) or leuprolide acetate injections every 12 weeks for 48 weeks, with up to 90 days of follow-up. Castration rate (testosterone level <50 ng/dL [to convert to nmol/L, multiply by 0.0347) at all scheduled visits between weeks 5 and 25 for patients receiving short-term ADT and weeks 5 and 49 for patients receiving longer-term ADT. Of 260 patients (38 Asian [14.6%], 23 Black or African American [8.8%], 21 Hispanic [8.1%], and 188 White [72.3%] individuals), 164 (63.1%) received relugolix. Relugolix achieved castration rates of 95% (95% CI, 87.1%-99.0%) and 97% (95% CI, 90.6%-99.0%) among patients receiving short-term and longer-term ADT, respectively. Twelve weeks post-short-term relugolix, 34 (52%) achieved testosterone levels to baseline or more than 280 ng/dL. Ninety days post longer-term ADT, mean (SD) testosterone levels were 310.5 (122.4) (106.7) ng/dL (relugolix; n = 15) vs 53.0 ng/dL (leuprolide acetate; n = 8) among the subset assessed for testosterone recovery. Castration resistance-free survival was not statistically different between the relugolix and leuprolide acetate cohorts (hazard ratio, 0.97; 95% CI, 0.35-2.72; P = .62). Adverse events grade 3 or greater for short-term or longer-term relugolix (headache, hypertension, and atrial fibrillation) were uncommon (less than 5%). The results of these 2 randomized clinical trials suggest that relugolix rapidly achieves sustained castration in patients with localized and advanced prostate cancer receiving radiotherapy. No new safety concerns were identified when relugolix was used with radiotherapy.

ASSOCIATION OF POLYCYSTIC OVARY SYNDROME AND THYROID DYSFUNCTION AMONG REPRODUCTIVE WOMEN: A CROSS-SECTIONAL STUDY

Objective: Polycystic ovarian syndrome (PCOS) is became most common problem in the reproductive age group women who seem to be adversely affected by associated thyroid dysfunction. Ovarian failure and pregnancy-related complications leaded by both factors. The study helps to explore the incidence and etiology of diverse thyroid conditions among PCOS individuals. Methods: This prospective single‑center study with 40 female patients with hyperandrogenism, hirsutism, oligo‐anovulation, and polycystic ovaries patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and Ferriman–Gallwey score with comprised the study population. Normal female subjects were studied as the control population who had normal thyroid function and without PCOS. By measuring of serum thyroid-stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and testosterone can evaluate thyroid function. Along with ultrasound was performed to confirm the PCOS. By SPSS version 19 Chi-square test and t-test were determined. Results: This case–control study revealed that a statistically significant higher prevalence of PCOS patients was found to have higher mean TSH values that were 5.33±2.51 μIU/mL, the mean for T3 and T4 was 154±138 μg/dL and 11.27±8.47 μg/dL, respectively. The mean FSH values were 07.27±4.49 μIU/mL, the mean LH was 84.27±38.49 μIU/mL, the mean estrogen 342±202 pg/mL, the mean progesterone values were 14.2±8.9 ng/mL and the mean testosterone levels were 69.73±9.28 ng/mL. Conclusion: Thyroid dysfunction shows a high prevalence in PCOS patients. Dysfunction can be treated which helps to manage infertility associated with PCOS.

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.

The effect of physical exercise during competitions and in simulated conditions on hormonal-neurophysiological relationships in kickboxers.

K1-format kickboxing is a widely followed combat sport that requires intense physical exercise. However, research into the body's response to this type of combat is sparse. This study aims to assess the alterations in hormone levels and brain activity in elite kickboxers following an actual K1 bout and compare these changes with those observed in a control group engaged in a simulated fight exercise with a punchbag. The study included 100 male professional kickboxers, randomly divided into two groups: an experimental group (K1 fight) and a control group (simulated fight with a punchbag). Blood samples were obtained before and after exercise to evaluate testosterone (T) and cortisol concentrations (C). Concurrently, brain activity was recorded using quantitative electroencephalography (QEEG). After the activity in the experimental group mean testosterone level slightly, non-significantly decreased from 13.7 nmol/l to 12.4 nmol/l, while mean cortisol significantly (p < 0.001) increased from 313 to 570 nmol/l. In the control group after the exertion against a punchbag mean cortisol significantly (p < 0.001) increased from 334 to 452 nmol/l and testosterone increased non-significantly, from 15.1 to 16.3 nmol/l. In both groups, the testosterone/cortisol ratio (T/C ratio) showed significantly lower levels after the intervention (p < 0.001 and p < 0.032) in the experimental and control group respectively. The comparison of groups after exercise revealed significantly higher cortisol levels (experimental group x = 570 nmol/l; control group x = 452 nmol/l) and a significantly lower T/C ratio (experimental group x = 2.7; control group x = 3.9), (p = 0.001) in the experimental group. Significantly higher brain activity was found in selected leads after a bout (experimental group). Furthermore, in the experimental group, significant associations of weak to moderate strength were found between hormone fluctuations and selected areas of brain activity (p < 0.05). K1-format kickboxing induces a stress response, evident in the sharp changes in cortisol and testosterone levels. A notable observation was the inverse direction of changes in both hormones. Brain activity analysis indicated the potential influence of raised cortisol concentrations on specific brain areas. This study augments our understanding of the physiological responses during K1 kickboxing bouts and may inform the future evolution of this sport.

Does testosterone influence the association between sleep and frailty in men: results from the European Male Aging Study

BackgroundPrevious studies have suggested an association between sleep disturbance and frailty. The mechanism is unknown, although it has been suggested that hormonal factors may play a role.MethodsThe aim was to determine the association between sleep duration, sleep quality and frailty, and to determine whether testosterone influenced this association. Males aged 40–79 years were recruited from eight European centres to the European Male Aging Study (EMAS). Subjects completed an interviewer-assisted questionnaire including questions regarding sleep quality and duration. Sleep quality was scored 0–20 and categorised as 0–4, 5–9, 10–14, and 15–20, with higher scores indicating poorer quality. A 39-component frailty index (FI) was constructed. Total testosterone levels were measured. The association between sleep duration, sleep quality and the FI was assessed using negative binomial regression, with adjustment for putative confounders including testosterone level.ResultsTwo thousand three hundred ninety-three participants contributed data to the analysis. The mean age was 63.3 years and mean sleep duration was 7.01 h. The mean frailty index was 0.15. Mean testosterone levels declined with decreasing sleep quality. After adjustment, compared to those with a sleep score of 0–4, the FI was 57% (95% CI 38%, 78%) higher among those with a sleep score of 15–20. After adjustment compared to those with normal sleep duration (6–9 h), those with a short (< 6 h) and long (≥ 9 h) sleep duration had a 16% (95% CI 6%, 28%) and 11% (95% CI 0%, 23%) higher FI, respectively. Adjustment for testosterone did not influence the strength of either association.ConclusionFrailty is associated with impaired sleep quality and sleep duration. The association cannot, however, be explained by variation in testosterone levels.

Low Testosterone Levels Predict Sarcopenia Showing an Effect on Prognosis in Patients with Cirrhosis: A Retrospective Study

Background: Sarcopenia and low serum testosterone levels are both associated with increased mortality in patients with advanced liver disease. Sarcopenia is a major stumbling block of liver cirrhosis and adversely affects other outcome variables. Objective: The aim of this study is to compare testosterone levels between sarcopenia and non-sarcopenia cirrhosis patients, to compare serum testosterone levels with cirrhosis severity (Child-Pugh Score), evaluate the correlation between serum testosterone levels and L3 SMI Index (Sarcopenia), the correlation between serum testosterone levels with other prognostic markers of cirrhosis (MELD score). Method: An observational study of 131 prospectively collected liver cirrhosis patients, who met the inclusion and exclusion criteria, was conducted in the Department of Gastroenterology, National Institute of Medical Sciences and Research, NIMS University, Jaipur, Rajasthan, India, be-tween August 2019 and July 2021. Spearman’s correlation coefficient was used to evaluate the correlation between testosterone levels and L3 SMI. Results: The mean testosterone level in sarcopenia patients was significantly lowered compared to non-sarcopenia patients (152.05 ± 90.48 vs. 364.28 ± 73.55; p = 0.05). The mean testosterone level was highest in Child A than in Child B and lowest in Child C, which was statistically significant (383.50 ± 54.41 vs. 225.06 ± 58.43 vs. 83.38 ± 25.49, p = 0.05). There was a significantly positive correlation between serum testosterone levels and L3 SMI index by MRI (r = 0.619 and p-value &lt;0.000). There was a significant negative correlation between the MELD score and serum testosterone levels. Conclusion: Serum testosterone levels were significantly lower in sarcopenic as compared to non-sarcopenic patients. Serum testosterone levels progressively decreased as liver disease severity increased. There was a significant positive correlation between serum testosterone levels and L3-SMI Index (Sarcopenia).

The Pathological and Ultrasonographic Evaluation of the Chemical Castration in Dogs using Calcium Chloride Injection.

Many researchers have been curious about the chemical sterilization method, which may be a choice of castration. The 20% calcium chloride ethanolic solution can prevent animals from some tumors and control the side effects of surgical castration. This experiment divided 12 male mixed-breed dogs into sham and chemical groups (n=6). Normal saline and 20% calcium chloride (20 ml/testis) were injected in the sham and chemical group's testis, respectively. Ultrasonography and related scoring were operated at 0-, 7-, 14-, and 2-days post-injection to evaluate echogenicity and measure the left testes' dimensions. Blood samples were taken on days 0, 7, 14, and 21 of the experiment evaluating the superoxide dismutase (SOD), glutathione peroxidase (GPx), and testosterone levels. The semen in the left epididymis of the chemical group was aspirated on day 21 post-injection for counting the sperm numbers. The testes of all dogs were surgically removed at 21 days post-injection, and the left one was put in formaldehyde for tissue processing. The intertubular edema, necrosis of the seminiferous tubules, neutrophil infiltration, and calcification was scored. The average dimensions of the chemical groups' left testes significantly decreased 7, 14, and 21 days after injection. The echogenicity of the testes decreased in the chemical group. A significant echogenicity difference was observed between the first day and the 7th and 14th day in ultrasonography. Calcium chloride injection failed to reduce the mean testosterone levels on all experimental days compared to day zero. Otherwise, the sperm number in the left testes of the chemical group decreased on day 21 post-injection. The degree of intertubular edema with neutrophil infiltration and severe tubular necrosis in the chemical group was significantly higher than in the sham group on the experimental days, including 7, 14, and 21. The mild calcification in the chemical group is likely the reason for higher echogenicity on day 21. The scrotum was swelled and ulcerated in the chemical group. Ultrasound is effective in demonstrating the castration ability of calcium chloride in the chemical method. Due to the inflammatory clinical effects, the chemical method is recommended in dogs only when surgical methods are unavailable.

Testosterone as a biomarker of colorectal cancer in the South Indian population

Colorectal cancer (CRC) is a highly life-threatening disease associated with a significant mortality rate. It has been proposed that testosterone levels may play a role in predisposing individuals to such devastating conditions. Testosterone primarily governs the maturation of the male reproductive system while also exerting physiological effects in both genders. In the present study, we investigated testosterone levels in CRC patients among the South Indian population. Blood samples were collected in the hospitals in Tamil Nadu, South India, and a cohort of healthy controls was selected for comparative analysis. A total of 130 subjects participated in the study, consisting of 65 CRC patients and an equal number of healthy controls. Approximately 7 mL of blood was collected from each subject for radioimmunoassay. The results of radioimmunoassay on the blood samples were analyzed using SPSS to assess differences between discrete and continuous data variables. Chi-square and t-tests were conducted for statistical evaluation. CRC patients exhibited significantly (P &lt; 0.0001) reduced mean testosterone levels (06.68 &amp;plusmn; 2.15 nmol/L) compared to controls (22.54 &amp;plusmn; 8.85 nmol/L). Further stratification by smoking status revealed that non-smoker CRC patients had lower testosterone levels (06.81 &amp;plusmn; 2.21 nmol/L) than non-smoking controls (10.15 &amp;plusmn; 2.48 nmol/L), with a statistically significant difference (P &lt; 0.0001). Adjusting for alcohol consumption, CRC patients displayed decreased mean testosterone levels (06.31 &amp;plusmn; 2.30 nmol/L) compared to controls (07.96 &amp;plusmn; 2.45 nmol/L), and this difference was found to be significant (P &lt; 0.022). These findings support the notion that reduced testosterone levels serve as a critical risk biomarker in the pathogenesis of CRC.