Measurement Of Testosterone Research Articles

ELIGANT: a Phase 4, interventional, safety study of leuprorelin acetate (ELIGARD®) in Asian men with prostate cancer.

BackgroundThe incidence and mortality rate of men with prostate cancer have been increasing in Asia. ELIGARD® is a formulation of leuprorelin acetate whose safety and efficacy have been well-established in Western regions. However, limited safety data are available for Asian populations.MethodsELIGANT (ELIGard AsiaN sTudy) was a Phase 4, multicenter, prospective, single-arm, interventional study. Men with locally advanced or metastatic prostate cancer without concomitant chemotherapy, or another androgen receptor pathway inhibitor, were enrolled across Asia to receive ELIGARD® (22.5 mg subcutaneous depot injection) every 3 months for 15 months, with a follow-up visit at 18 months. The primary objective was to establish the safety of ELIGARD® in Asian men with hormone-dependent prostate cancer. The secondary objectives were to assess efficacy, via prostate-specific antigen (PSA) progression and testosterone levels, and health-related quality of life (HRQoL).ResultsIn total, 106 patients were included in the safety analysis set (SAF). The most common treatment-emergent adverse events (TEAEs) included PSA increase, cough, back pain, hot flush, anemia, and upper respiratory tract infection. TEAEs considered related to ELIGARD® were reported in 13.2% of patients (n=14), two of which were serious. In the full analysis set (FAS) (n=105), 81.2% (n=56) and 68.5% (n=61) of patients achieved a PSA reduction of ≥90% from baseline at 12 and 18 months, respectively. At 18 months, the numbers of patients with testosterone levels <20, 20–50, and >50 ng/dL were 65 (61.9%), 17 (16.2%), and two (1.9%), respectively; 20% had missing testosterone measurements. HRQoL remained stable throughout the study with minimal change from baseline at study completion.ConclusionsIn conclusion, the safety profile of ELIGARD® (22.5 mg) in Asian men with hormone-dependent prostate cancer is comparable to previous studies in Western regions.Trial RegistrationClinical trial registration number NCT03035032.

German version of the Hypogonadism Impact of Symptoms Questionnaire: Psychometric properties and association with testosterone levels.

In German, the 'Aging Males' Symptom Scale (AMS)' is available for the assessment of symptoms of hypogonadism in men of advanced age. An English questionnaire named 'Hypogonadism Impact of Symptoms' (HIS-Q), applicable also in young males has recently been developed in the United States. We intended to: (1) evaluate the psychometric properties of the German translation of the short form of the HIS-Q (HIS-Q-SF-D); (2) explore the association of individual patient scores with their respective serum testosterone levels. The HIS-Q-SF-D was completed by 174men attending an Andrology outpatient clinic. Test-retest reliability was excellent, with high test-retest correlations (r=0.883) and Cronbach`s Alpha of 0.948 for the total score. Convergent validity was supported by high Spearman`s correlation between the HIS-Q-SF-D total score and the AMS total score (r=0.817); also by the significant differences in the HIS-Q-SF-domain scores between males with total testosterone levels above and below 12nmol/l. Therefore, the HIS-Q-SF-D shows good psychometric properties. As shown by the ROC-analyses for testosterone above and below levels of 12nmol/l, the HIS-Q-SF-D cannot replace testosterone measurement for the establishment of the diagnosis of male hypogonadism.

Association of peripubertal blood lead levels with reproductive hormones and semen parameters in a longitudinal cohort of Russian men.

Are peripubertal blood lead levels (BLLs) associated with semen parameters and serum reproductive hormones among young Russian men? We observed a suggestion of lower ejaculate volume with higher peripubertal BLL but no associations of BLLs with reproductive hormones measured throughout adolescence or with other sperm parameters measured at adulthood. Lead is a known reproductive toxicant and endocrine disruptor. Previous literature has shown associations between high lead exposure and poorer semen quality both in occupationally and environmentally exposed men. However, to our knowledge, no longitudinal studies have explored the association of childhood lead exposure with semen parameters and reproductive hormones in young men. The Russian Children's Study is a prospective cohort study that enrolled 516 boys at age 8-9 years in 2003-2005 and followed them annually for 10 years. BLLs were measured at entry and lifestyle and health questionnaires were completed. Reproductive hormones were measured in blood samples collected every 2 years. Among the 516 boys enrolled, 481 had BLLs measured at entry. Of these, 453 had at least one measurement of serum testosterone, follicle stimulating hormone (FSH) or luteinizing hormone (LH) (median = 5 samples per boy) and 223 had semen samples collected ∼10 years after enrolment. Semen assessment included ejaculated volume, sperm concentration, progressive motility and total sperm count, and parameters were categorized using published andrology standards for low semen quality based on sperm count and motility. Linear mixed models were used to examine the associations of log-transformed BLLs (and BLL categories) with reproductive hormones and semen parameters, adjusting for potential confounders. Among the 223 young men with peripubertal BLLs and at least one semen sample (total samples = 438), the median (interquartile range) BLL was 3 (2, 5) µg/dl and 27% had BLL ≥5 µg/dl. Overall, 49% of the semen samples fell below reference levels for sperm count and/or motility. Men with peripubertal BLL ≥5 µg/dl had significantly lower ejaculated volume than those with BLL <5 µg/dl (mean = 2.42 vs 2.89 ml, P = 0.02), but this difference was attenuated in adjusted models (mean = 2.60 vs 2.83 ml, P = 0.25). No associations were observed between BLL measured at age 8-9 years and reproductive hormone levels or sperm parameters, including sperm concentration, total count, progressive motility and total progressive motile sperm count, or with the probability of having low semen quality based on sperm count/motility. Only a subset of the original cohort participated in the semen quality portion of the study, although inverse probability weighting was used to account for possible selection bias. BLLs were only measured at a single time in peripuberty, and other exposure time periods, including later or longer-term childhood exposure, may be more predictive of semen quality. The young men were also exposed to other chemical contaminants before and during pubertal development. While semen volume often receives less attention than other sperm parameters, it is an important component of male fertility. Additional prospective studies covering different exposure windows and including other seminal plasma biomarkers are warranted to explore our finding of potentially lower ejaculated volume with higher BLLs and to confirm the lack of associations for other semen parameters among youth exposed to environmental BLLs. Funding was provided through grants R01ES0014370 and P30ES000002 from the National Institute of Environmental Health Sciences, grant R82943701 from the U.S. Environmental Protection Agency, and grant 18-15-00202 from the Russian Science Foundation (O.S and Y.D.). All authors report no competing interests. N/A.

The effect of nonylphenol exposure on the stimulation of melanomacrophage centers, estrogen and testosterone level, and ERα gene expression in goldfish

The present study tried to measure the formation of melanomacrophage centers (MMCs) in various organs of male and female goldfish exposed to nonylphenol (NP) and aimed to assess its relationship with the main sexual hormones, estrogen receptor expression, and the pigment content of the MMCs. Immature goldfish were exposed to 10−6 and 10−7 M NP for 25 days. After obtaining blood for measuring testosterone and estrogen (E2) levels, tissue samples were collected from various organs for histological studies, quantifying pigments using ImageJ software and chemical analysis, and measuring ERα gene expression. Results showed that the order of forming MMCs in various organs exposed to NP was liver > spleen > kidney, and the order of ERα gene expression was liver > testes > spleen > kidney in the male, and liver > spleen > kidney > ovaries in the female. Among the three pigments present in MMCs after exposure to the two doses of NP, melanin was more obvious (especially in the liver) and increased mostly in a dose-dependent manner in both sexes (especially in the male). Chemical analyses confirmed these results. Measurement of testosterone and E2 level in male and female goldfish showed that NP had more effect on the concentration of these hormones in male fish, indicating more endocrine-disrupting potential of NP against the male fish. Generally, the increase of melanin content of melanomacrophage centers coincided with the increase of ERα gene expression and decrease of testosterone level in goldfish after exposure to NP.

Comprehensive Sex Steroid Profiling in Multiple Tissues Reveals Novel Insights in Sex Steroid Distribution in Male Mice.

A comprehensive atlas of sex steroid distribution in multiple tissues is currently lacking, and how circulating and tissue sex steroid levels correlate remains unknown. Here, we adapted and validated a gas chromatography tandem mass spectrometry method for simultaneous measurement of testosterone (T), dihydrotestosterone (DHT), androstenedione, progesterone (Prog), estradiol, and estrone in mouse tissues. We then mapped the sex steroid pattern in 10 different endocrine, reproductive, and major body compartment tissues and serum of gonadal intact and orchiectomized (ORX) male mice. In gonadal intact males, high levels of DHT were observed in reproductive tissues, but also in white adipose tissue (WAT). A major part of the total body reservoir of androgens (T and DHT) and Prog was found in WAT. Serum levels of androgens and Prog were strongly correlated with corresponding levels in the brain while only modestly correlated with corresponding levels in WAT. After orchiectomy, the levels of the active androgens T and DHT decreased markedly while Prog levels in male reproductive tissues increased slightly. In ORX mice, Prog was by far the most abundant sex steroid, and, again, WAT constituted the major reservoir of Prog in the body. In conclusion, we present a comprehensive atlas of tissue and serum concentrations of sex hormones in male mice, revealing novel insights in sex steroid distribution. Brain sex steroid levels are well reflected by serum levels and WAT constitutes a large reservoir of sex steroids in male mice. In addition, Prog is the most abundant sex hormone in ORX mice.

Associations of Serum Testosterone and Sex Hormone-Binding Globulin With Incident Cardiovascular Events in Middle-Aged to Older Men.

The influence of testosterone on risk for cardiovascular events in men is uncertain. Previous observational studies of sex hormones and incident cardiovascular disease in men have reported inconsistent findings, limited by cohort sizes and different selection criteria. To analyze associations of serum total testosterone and sex hormone-binding globulin (SHBG) with incident cardiovascular events in men. Cohort study. UK Biobank prospective cohort. Community-dwelling men aged 40 to 69 years. Testosterone and SHBG were assayed, and free testosterone was calculated. Cox proportional hazards regression was done, with outcomes of incident myocardial infarction (MI), hemorrhagic stroke (HS), ischemic stroke (IS), heart failure (HF), and major adverse cardiovascular events (MACE), adjusted for sociodemographic, lifestyle, and medical factors. Of 210700 men followed for 9 years, 8790 (4.2%) had an incident cardiovascular event. After adjustment for key variables, lower total testosterone concentrations (quintile 1 vs. quintile 5) were not associated with incident MI (fully adjusted hazard ratio [HR], 0.89 [95% CI, 0.80 to 1.00]), HS (HR, 0.94 [CI, 0.70 to 1.26]), IS (HR, 0.95 [CI, 0.82 to 1.10]), HF (HR, 1.15 [CI, 0.91 to 1.45]), or MACE (HR, 0.92 [CI, 0.84 to 1.00]). Men with lower calculated free testosterone values had a lower incidence of MACE (HR, 0.90 [CI, 0.84 to 0.97]). Lower SHBG concentrations were associated with higher incidence of MI (HR, 1.23 [CI, 1.09 to 1.38]) and lower incidence of IS (HR, 0.79 [CI, 0.67 to 0.94]) and HF (HR, 0.69 [CI, 0.54 to 0.89]), but not with HS (HR, 0.81 [CI, 0.57 to 1.14]) or MACE (HR, 1.01 [CI, 0.92 to 1.11]). Observational study; single baseline measurement of testosterone and SHBG. Men with lower total testosterone concentrations were not at increased risk for MI, stroke, HF, or MACE. Calculated free testosterone may be associated with risk for MACE. Men with lower SHBG concentrations have higher risk for MI but lower risk for IS and HF, with causality to be determined. Western Australian Health Translation Network, Medical Research Future Fund, and Lawley Pharmaceuticals.

Testicular effects of a postnatal GnRH antagonist in domestic cats.

The aim of this study was to describe the histological effects of two high postnatal doses of the potent third-generation GnRH antagonist, acyline in the domestic cat testicle. Secondly, the physical, endocrine, and steroidogenic findings of this pharmaceutical protocol are also reported. Twelve postnatal littermate male kittens were administered acyline in a dose of 2.2 mg/100 g SC weekly for 2 weeks (ACY; n = 6), or placebo (PL; n = 6). All the animals were followed up until puberty when they were castrated. Serial faecal samples were collected until the age of 10 weeks for testosterone (T) measurement. The kittens achieved puberty without either age (236.5 ± 19.7 vs. 221.7 ± 23.7 days) or body weight (3.05 ± 0.15 vs. 2.78 ± 0.28 kg, P > 0.05) differences between ACY and PL, respectively. Acyline suppressed faecal T concentrations for 3 weeks (P < 0.01). From the fourth week on, both groups had low concentrations up to the end of the follow-up period (P > 0.05). Histological assessment of the testes showed that ACY cats presented a reduced height of the epithelium (P < 0.01) due to the diminished number of germinal cells accompanied by an enlarged luminal area (P < 0.01) with cellular debris (P < 0.01). The immunostaining of P450c17 also appeared partially diminished in ACY testes.

The importance of association between sexsteroids deficiency, reduction of bone mineral density and falling risk in men with implications in medical rehabilitation

Introduction. Endocrino-metabolic rehabilitation represent one of the most complex sector in clinical medicine, regarding functional rehabilitation. Sex hormones deficiency plays an important role in the etiology of osteoporosis in men. At the same time, with age, the trophic role of androgens on muscle decreases and determines an increased frequency of falls. The objective of our study is to determine the association between sexsteroids deficiency, reduction of bone mineral density (BMD) and falling risk in men. Methods. Our retrospective cross-sectional study included 146 men aged between 65–85 years with low BMD (study group) and 121 men with normal BMD (control group). The measurement of Total testosterone (Tt), free testosterone (Tf) and estradiol (E2) serum levels was performed using the immunoassay or the immunoenzymatic methods. Femoral neck and lumbar spine BMD was determined using Dual-energy X-ray absorptiometry (DEXA). The risk of falls was assessed by Tandem Standing, Up &amp; Go, Chair – Rising and walking speed tests. Results. We found a significantly association between Tf and E2 deficiency and low BMD (p=0.007). Also, in men with reduced BMD (study group) we observed significant lower levels of Tf (p&lt;0.001) and E2 (p=0.003) compared to control group. E2 deficiency was associated significantly with low BMD and increased fall risk (p=0.001). At the same time the results highlighted significant lower levels of Tf in patients with BMD reduction and increased risk of falls (p=0.002). Tt deficiency was not associated with BMD reduction (p=0.088) or increased risk of falling (p=0.277). Conclusions. This research revealed a significant association between male sexsteroids deficiency, low BMD and increase of falling risk, with implications in rehabilitation program. The risk of ostoporosis and for falling in man can be estimated by determining serum Tf and E2 levels. Keywords: sexsteroids deficiency; bone mineral density; falling risk,

Individual Differences in Testosterone and Self-Control Predict Compulsive Sexual Behavior Proneness in Young Males.

The ability to control sexual urges and impulses is essential to achieve individual and social harmony. Failing to regulate sexual behavior can lead to the interference with daily life goals, sexual diseases transmission and moral violations, among others. The dual control model of sexual response proposes that an imbalance between sexual excitation and sexual inhibition mechanisms may lead to sexual dysregulation, thereby explaining problematic sexual behavior. Interindividual differences in self-control and testosterone levels are likely to modulate sexual regulation mechanisms, but these individual features have scarcely been studied in the context of compulsive sexual behavior. This study investigated the role of sexual excitation and inhibition, self-control and testosterone levels in predicting individuals’ proneness to display compulsive sexual behavior. Seventy healthy young males provided a saliva sample for testosterone measurements and filled in questionnaires on self-control, sexual excitation, sexual inhibition, sexual compulsivity and sexual behavior. High testosterone levels and low self-control were associated with higher sexual compulsivity scores. Additionally, testosterone levels and sexual inhibition negatively predicted the frequency of sexual behavior with a partner. The results of our study highlight the joint role of psychological traits and testosterone levels in compulsive sexual behavior proneness, providing implications regarding the prevention and treatment of this condition in young males.

Compliance Issues in Managing 21 Hydroxylase Deficiency and their Short/Long-Term Consequences.

ObjectiveTo report a case of untreated classic 21 hydroxylase (OH) deficiency congenital adrenal hyperplasia (CAH) in a transgender patient resulting in pulmonary embolisms (PEs) and bilateral adrenal masses.MethodsA 36-year-old male (birth sex: female) presenting with bilateral PEs in the setting of long-standing, untreated classic 21OH CAH was also found to have bilateral adrenal masses (unconfirmed myelolipomas).ResultsFurther history revealed a known diagnosis of CAH. The patient had been treated with glucocorticoid and mineralocorticoid replacement in childhood but stopped taking these medications against medical advice. During his hospital admission, he was noted to have elevated 17-hydroxyprogesterone, low cortisol with elevated ACTH levels, and male-level testosterone measurements. CT of the abdomen/pelvis revealed a 23 cm mass in the left renal fossa and a 2.5 cm mass in the right renal fossa consistent with bilateral adrenal myelolipomas. The patient attended follow-up in clinic, but declined any further hormonal treatment as he identified as male and felt further treatment was unnecessary.ConclusionThis case demonstrated the unique long-term effects of untreated classic CAH due to 21OH deficiency, including bilateral adrenal myelolipoma, adrenal compensation to the point of producing male-level androgens, and possibly PEs. Treatment with hydrocortisone was recommended to suppress ACTH and it was planned that the patient would eventually start on testosterone (although this would have been complicated by his bilateral PEs). Potential aetiologies for the PEs included vascular compression of the renal artery (which could explain the elevated EPO/erythrocytosis contributing to hypercoagulability) or the renal vein by the adrenal mass.LEARNING POINTSGender dysphoria in patients with congenital adrenal hyperplasia (CAH) is not uncommon.Adrenal enlargement can allow untreated CAH patients to compensate.Pulmonary embolisms can be a consequence of treating as well as untreated CAH.

Clinical characteristics and comorbidities associated with testosterone prescribing in men.

Testosterone replacement therapy (TRT) is recommended for the treatment of symptomatic hypogonadism in men. Data on prescription behaviours are, however, limited and conflicting. The objective of this study was to investigate clinical characteristics associated with the likelihood of being prescribed TRT by general practitioners (GP) in North-West London (NWL). Retrospective cohort study using Discover database of GP-registered patients in NWL between 2015 and 2019. We identified 20,299 men aged ≥18 years with serum total testosterone measurement (TT) and without prior TRT prescription records. We determined whether TRT was subsequently commenced, while analysing clinical characteristics related to hypogonadism. Of all men having TT measurement, 19,583 (96.4%) were not commenced on TRT (Group A) and 716 (3.5%) men were commenced on TRT (Group B). Men prescribed TRT (Group B) had higher mean age, body mass index (BMI) and higher risks of hypertension, depression type 2 diabetes and ischaemic heart disease; conversely, men in Group B had lower mean pretreatment TT and were less likely to have prostate cancer. Four-hundred and thirty-six men (24.3%) with TT < 8 nmol/L and symptoms of low libido were not prescribed TRT. Our study highlights several factors which may influence the decisions made by clinicians when initiating TRT in primary care. Clearer guidance for clinicians may help to improve the consistency of treatment of men with hypogonadism.

Lower Circulating Sertoli and Leydig Cell Hormone Levels During Puberty in Obese Boys: A Cross-sectional Study.

Alterations in semen characteristics and circulating Sertoli and Leydig cell hormones have been described in obese male adults. Whether hormonal alterations occur before adulthood has not been fully evaluated. We describe circulating Sertoli and Leydig cell hormone levels in overweight-obese (ow/ob) boys through childhood and adolescence in a cross-sectional study. Monocentric study in the Pediatric Endocrinology Unit of Angers University Hospital. Three hundred and fifty-one obese and overweight boys aged 5-19 years underwent physical examination, dual-energy X-ray absorptiometry for body composition, oral glucose tolerance test on insulin and glucose, and measurements of follicle-stimulating hormone, luteinizing hormone, anti-Müllerian hormone (AMH), inhibin B, testosterone, and estradiol. Hormonal levels were compared with normative data obtained from 652 healthy nonoverweight nonobese boys of similar age or Tanner stage. Median inhibin B and testosterone levels during puberty were significantly lower in ow/ob than in healthy boys (1) from age >12 years and thereafter for inhibin B, and (2) from age >14 years and thereafter for testosterone. At Tanner stages 4 and 5, 26%, 31%, and 18% of inhibin B, testosterone, and AMH values were below the 5th percentile in ow/ob subjects (P < .01). In multiple regression analyses, estradiol and total bone mineral density Z-score were negative predictors of inhibin B, fat mass percentage was a negative predictor of testosterone, and insulin was a negative predictor of AMH. Lower Sertoli and Leydig cell hormone levels during puberty were observed in the ow/ob boys.

Testosterone, signal coloration, and signal color perception in male zebra finch contests.

Many animals use assessment signals to resolve contests over limited resources while minimizing the costs of those contests. The carotenoid-based orange to red bills of male zebra finches (Taeniopygia guttata) are thought to function as assessment signals in male-male contests, but behavioral analyses relating contest behaviors and outcomes to bill coloration have yielded mixed results. We examined the relationship between bill color and contests while incorporating measurements of color perception and testosterone (T) production, for an integrative view of aggressive signal behavior, production, and perception. We assayed the T production capabilities of 12 males in response to a gonadotropin-releasing hormone (GnRH) challenge. We then quantified the initiation, escalation, and outcome of over 400 contests in the group, and measured bill color using calibrated photography. Finally, because signal perception can influence signal function, we tested how males perceive variation in bill coloration, asking if males exhibit categorical perception of bill color, as has been shown recently in female zebra finches. The data suggest that males with greater T production capabilities than their rivals were more likely to initiate contests against those rivals, while males with redder bills than their rivals were more likely to win contests. Males exhibited categorical color perception, but individual variation in the effect of categorical perception on color discrimination abilities did not predict any aspects of contest behavior or outcomes. Our results are consistent with the hypotheses that T plays a role in zebra finch contests and that bill coloration functions as an aggressive signal. We suggest future approaches, based on animal contest theory, for how links among signals, perception, and assessment can be tested.

Using mass spectrometry to overcome the longstanding inaccuracy of a commercially-available clinical testosterone immunoassay

Accurate measurement of testosterone is important for the diagnosis of gonadal disorders in men, women, and children. Testosterone measurement has limited accuracy at low concentrations by most commercially available immunoassays. We aimed to develop an LC-MS/MS assay to address the inaccuracy of the in-house immunoassay observed over the past decade and to replace it with the new assay. Testosterone in serum/plasma was extracted with commercial supported liquid extraction plates. Method validation was performed following the CLSI C62-A guideline. A total of 126 samples were used for method comparison between the Beckman UniCel DxI immunoassay and LC-MS/MS. Results by immunoassay were 20% lower compared with LC-MS/MS and had minimal correlation (R2 = 0.403) with LC-MS/MS below 100 ng/dL. When comparing specimens from the Accuracy-Based Survey from the College of American Pathologists, the newly developed assay agreed well with the CDC reference measurement procedure. In summary, immunoassay measurement of testosterone can be significantly inaccurate, especially at low concentrations. The newly developed LC-MS/MS assay provides accurate results across the entire measurable range.

A longitudinal study on the psychological and physiological predictors of burnout in NCAA collegiate swimmers

The purpose of the current study was to examine the ability of psychosocial constructs and biomarker measures of overtraining and stress to predict athlete burnout, as mediated by training distress, during a 6-week intense training period. Twenty-three females and 17 male NCAA swimmers completed measures, before training (baseline), of athlete identity, academic identity, mental toughness, pain attitude, and controlling coaching behaviors. Training distress was assessed at 3 weeks. Serum measurement of creatine kinase, myoglobin, testosterone, and cortisol were obtained at baseline and after 6 weeks of intense training. Athlete burnout was also measured at 6 weeks. The full mediation model was non-significant, F(9,30) = 1.23, p = .32. However, the direct effects only model was significant, F(10, 29) = 5.22, p = .001, and accounted for 64% of the variance in burnout symptoms. Controlling coaching behaviors, athletic identity, academic identity, and testosterone/cortisol ratio change were all significant predictors. Our findings provide support for the value of an athletic identity, the deleterious effects of controlling coaches, and the detrimental effects of an academic identity (when narrowly considered in terms of burnout symptoms). The ability of biomarkers of muscle damage as indicators of perceptions of burnout symptoms is questionable. Lay summary: Burnout in swimming is characterized by mental and physical exhaustion, a devaluation of swimming, and successes often becomes less meaningful. Swimmers who train hard, resulting in soreness and fatigue, may not experience such a state as stressful or indicative of burnout. However, controlling coaches and athletes who strongly value academic success may be prone to experiencing burnout symptoms. Strong athletic identities may protect swimmers from burnout symptoms. IMPLICATIONS FOR PRACTICE Coaches should allow their swimmers input into their training. Coaches should be aware that academic demands may contribute to burnout. Coaches should be aware that swimmers with weak athletic identities may be susceptible to burnout.

Relationship between erectile dysfunction and moderate to severe prostatitis-like symptoms in middle-aged men: a propensity score-matched analysis.

We assessed the relationship between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED) using propensity score matching. Data from 8727 middle-aged men who had undergone health checkups were analyzed. The National Institutes of Health Chronic Prostatitis Symptoms Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF), the Premature Ejaculation Diagnostic Tool (PEDT), testosterone measurement, basic blood chemistry, and metabolic syndrome (MetS) assessment were performed in this study. Of the 8727 men considered, 7181 formed the cohort for propensity score matching, including 597 men with moderate to severe prostatitis-like symptoms (case) and 6584 men with no prostatitis-like symptoms (control); ultimately, however, members of the case and control groups were matched at a 1:1 ratio by propensity score. After matching, the variables of age, testosterone, PEDT and MetS were evenly distributed between the groups. After matching, the mean IIEF score of the case group was significantly lower than that of the control group (17.2 ± 5.5 vs. 14.7 ± 5.3; P < 0.001). Additionally, the severity of ED was significantly greater in the case group (no, mild, mild to moderate, moderate, and severe, respectively: 27.5%, 30.2%, 24.6%, 13.1%, and 4.7% in the control group; 10.7%, 27.0%, 33.0%, 18.9%, and 10.4% in the case group; P < 0.001). Finally, the rate of moderate to severe ED was significantly higher in the case group than in the control group (17.8% vs. 29.3%; P < 0.001). Moderate to severe prostatitis-like symptoms were significantly and independently correlated with ED in middle-aged men.

Pre-analytical factors affect the accurate measurement of testosterone concentrations in plasma and serum of goats.

Several pre-analytical factors may influence the accurate measurements of testosterone (T) and therefore, these factors must be a significant concern. This study aimed to examine the effects of 1) time of sample collection, 2) delay to centrifugation, 3) sample matrix types, and 4) device and duration of sample storage on the T concentrations. Blood samples were collected from 34 bucks of Kacang goats. For testing the effect of collection time, 12 pairs of morning and afternoon samples were collected. For testing the effect of delayed centrifugation, 24 samples were subjected to treatments: (i) centrifuged ⟨1 hour after collection (control group), (ii) centrifuged 6, 12, and 24 hours after collection (test groups). For testing the different sample matrix types, 10 samples were processed as serum and plasma. For testing the effect of sample storage device and duration, 60 samples were subjected to treatments: i) frozen at -20OC (control group), ii) stored in a cooler box, a styrofoam box, and a thermos-flask for two, four, and six days (test groups). T concentrations were measured using a validated testosterone ELISA kit. Concentrations of plasma testosterone (pT) from morning samples were significantly higher compared to afternoon samples (p⟨0.05). Delayed centrifugation for up to 24 h decreased significantly on pT concentrations (p⟨0.05). The concentrations of T from serum and plasma did not differ and showed a strong correlation (r=0.981). Storage device and duration affected the T concentrations compared to frozen samples (p⟨0.05) which T concentrations were stable for up to 4 days in a styrofoam box and a thermos-flask and up to 6 days in a cooler box. In conclusion, the measurement accuracy and stability of T concentrations in goats are affected by collection time, delay to centrifugation, and device and duration of storage.

Functional ovarian reserve in transgender men receiving testosterone therapy: evidence for preserved anti-Müllerian hormone and antral follicle count under prolonged treatment.

Is the functional ovarian reserve in transgender men affected by testosterone therapy? Serum anti-Müllerian Hormone (AMH) levels slightly decrease during testosterone treatment but remain within the normal range, suggesting preserved follicular ovarian reserve. Few small studies have investigated the impact of gender-affirming treatment on reproduction in transgender men. Conflicting results were reached concerning ovarian morphology and AMH levels in this context. The study consisted of two arms. The first arm was a prospective pilot study, which enrolled 56 transgender men (median age 22.5 [interquartile range (IQR)-19-27.7] years), 27 of whom had polycystic ovary syndrome (PCOS), prior to the initiation of gender-affirming testosterone therapy. A structured assessment was conducted prior to, and at 3 and 12 months after treatment initiation. The second arm was a cross-sectional study that comprised 47 transgender men (median age 24 [IQR-20-31] years) who received testosterone for a median duration of 35 [IQR 13-62] months. The main outcome measures were serum AMH and antral follicle count (AFC) as indices of ovarian follicular reserve. The study was conducted at a tertiary center for transgender health. Gender-affirming therapy was administered according to standard practice. AFC was determined by pelvic (abdominal or transvaginal) ultrasound and blood collection for measurements of AMH, testosterone, estradiol, LH and FSH was performed at the designated time-points. Prospective arm for the entire group we observed a decrease of 0.71 ng/ml in AMH levels between baseline and 12 months (P = 0.01). When expressed in age-specific percentiles, AMH went from the 47.37th to the 40.25th percentile at 12 months (P < 0.001). In a sub-group analysis, a decline of 9.52 points in age-specific percentile was seen in subjects with PCOS (P < 0.001), while no changes were detected in the non-PCOS group. Testosterone treatment did not affect AFC over time in the entire cohort. In the sub-group analysis, a mean decrease of 5.0 follicles was detected between baseline and the 12 months assessment (P = 0.047) only in subjects with PCOS. In the cross-sectional study, AMH inversely correlated with age but not with treatment duration. Notably AMH did not deviate from the 50th age-specific percentile. Finally, four men fathered biological children after being under testosterone treatment for up to 12 years. The limited sample size of the pilot study should be kept in mind. An additional limitation is the lack of a control group in the prospective study, as each participant served as his own control. Also, roughly 40% of the ultrasound examinations were performed transabdominally, potentially affecting the accuracy of the AFC measurements.As study participants were quite young, our reassuring data may not apply to older transgender men, either because of an age-related decline in ovarian reserve or to possible long-term effects of testosterone therapy. Furthermore, the chances for fertility preservation may be more limited in subjects with PCOS. This is an additional contribution to the emerging evidence that prolonged testosterone treatment may not be a major obstacle to later fertility potential in transgender men desirous of having children. Larger confirmatory studies, and particularly more with reproductive outcome data, are needed for evidence-based fertility counseling prior to treatment initiation in these subjects. This study received no funding. The authors have no competing interests to declare. N/A.

Testosterone and depressive symptoms during the late menopause transition

BackgroundThe menopause transition is associated with an increased risk of depression. While the mechanisms behind this increased risk are not well understood, the changing perimenopausal hormonal environment has been hypothesized to play a role. The current study examined the potential influence of testosterone and the ratio of testosterone to estradiol as a potential contributor to depressed mood in the menopause transition.MethodsFifty non-depressed perimenopausal women ages 45–55 were recruited for this study. Once every 3 weeks, for a total of four times, the women completed the Centre for Epidemiological Studies-Depression (CES-D) scale for the measurement of depressive symptoms and provided a first-morning urine sample for the measurement of urinary testosterone as well as estrone-3-glucuronide (E1G), a urinary metabolite of estradiol. The week-to-week and mean effects of testosterone, E1G, and the testosterone/E1G ratio on CES-D score were examined. Self-reported sleep quality and vasomotor symptoms were also assessed at each of the four time points.ResultsTestosterone levels rose with increasing months since last menstrual period associated with testosterone levels (β(SE) = 175.3(63.2), p = .006), though this effect was moderated by body mass index (p for the interaction = .001) such that overweight women showed a less pronounced increase over time. Past and current smokers also had higher testosterone levels compared to never smokers. Week-to-week testosterone/E1G ratio was positively associated with CES-D score (β(SE) = 1.57(0.76), p = .041) but not sleep quality or vasomotor symptoms (ps > .05). Mean testosterone/E1G ratio was also positively associated with vasomotor symptom bother (β(SE) = 0.14(0.06), p = .018) and poorer sleep quality (β(SE) = − 0.34(0.09), p = .0001).ConclusionThese results suggest that, within the context of the menopause transition, times that are characterized by a higher testosterone-to-estradiol ratio may be associated with higher depressive symptoms. Perimenopausal women with a higher average ratio of testosterone relative to estradiol may also experience more sleep difficulties and vasomotor symptom bother.

Gynaecomastia in a male neutered cat with an adrenal tumour and associated hyperprogesteronism, hypercortisolism and hyperaldosteronism.

Case summaryA 7-year-old male neutered domestic longhair cat was presented with chronic progressive gynaecomastia, polydipsia, polyphagia, weight loss and poor fur regrowth. Sexualised behavioural changes were not reported and virilisation was not present on physical examination. Pertinent haematology, biochemistry and urinalysis findings at the time of referral included mild hypokalaemia. Left adrenomegaly and mild prostatomegaly were identified on a CT scan. Evaluation of adrenal hormones with a low-dose dexamethasone suppression test, serum progesterone, testosterone, oestradiol, plasma aldosterone, renin, plasma metanephrine and normetanephrine measurement supported a diagnosis of hyperprogesteronism, hyperaldosteronism and hypercortisolism. Adrenalectomy was performed and histopathology was consistent with an adrenocortical tumour. Clinical signs and hormone elevations resolved postoperatively.Relevance and novel informationTo our knowledge, this is the second report of gynaecomastia secondary to an adrenal tumour in a male neutered cat and the first associated with hyperprogesteronism.