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La Vignera S, Aversa A, Cannarella R, Condorelli RA, Duca Y, Russo GI, Calogero AE. Pharmacological treatment of lower urinary tract symptoms in benign prostatic hyperplasia: consequences on sexual function and possible endocrine effects. Expert Opin Pharmacother 2020; 22:179-189. [DOI: 10.1080/14656566.2020.1817382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ylenia Duca
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giorgio I. Russo
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, Catanzaro, Italy
| | - Aldo E. Calogero
- Department of Surgery, Urology Section, University of Catania, Catania, Italy
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Primary osteoporosis in men: an unmet medical need. Fertil Steril 2020; 112:791-798. [PMID: 31731933 DOI: 10.1016/j.fertnstert.2019.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/27/2022]
Abstract
Osteoporosis is a skeletal disease characterized by loss of bone strength and increased risk of fractures. Even though fracture prevalence is higher in women, fractures also constitute a significant public health issue in older men. Men are screened less and more frequently undertreated than female patients. It is the goal of this review, to summarize updated information about the current understanding of pathophysiology and clinical aspects of diagnosis and treatment of osteoporosis in men.
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Yarrow JF, Phillips EG, Conover CF, Bassett TE, Chen C, Teurlings T, Vasconez A, Alerte J, Prock H, Jiron JM, Flores M, Aguirre JI, Borst SE, Ye F. Testosterone Plus Finasteride Prevents Bone Loss without Prostate Growth in a Rodent Spinal Cord Injury Model. J Neurotrauma 2017; 34:2972-2981. [PMID: 28338402 DOI: 10.1089/neu.2016.4814] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
We have reported that testosterone-enanthate (TE) prevents the musculoskeletal decline occurring acutely after spinal cord injury (SCI), but results in a near doubling of prostate mass. Our purpose was to test the hypothesis that administration of TE plus finasteride (FIN; type II 5α-reductase inhibitor) would prevent the chronic musculoskeletal deficits in our rodent severe contusion SCI model, without inducing prostate enlargement. Forty-three 16-week-old male Sprague-Dawley rats received: 1) SHAM surgery (T9 laminectomy); 2) severe (250 kdyne) contusion SCI; 3) SCI+TE (7.0 mg/week, intramuscular); or 4) SCI+TE+FIN (5 mg/kg/day, subcutaneous). At 8 weeks post-surgery, SCI animals exhibited reduced serum testosterone and levator ani/bulbocavernosus (LABC) muscle mass, effects that were prevented by TE. Cancellous and cortical (periosteal) bone turnover (assessed by histomorphometry) were elevated post-SCI, resulting in reduced distal femur cancellous and cortical bone mass (assessed by microcomputed tomography). TE treatment normalized cancellous and cortical bone turnover and maintained cancellous bone mass at the level of SHAM animals, but produced prostate enlargement. FIN coadministration did not inhibit the TE-induced musculoskeletal effects, but prevented prostate growth. Neither drug regimen prevented SCI-induced cortical bone loss, although no differences in whole bone strength were present among groups. Our findings indicate that TE+FIN prevented the chronic cancellous bone deficits and LABC muscle loss in SCI animals without inducing prostate enlargement, which provides a rationale for the inclusion of TE+FIN in multimodal therapeutic interventions intended to alleviate the musculoskeletal decline post-SCI.
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Affiliation(s)
- Joshua F Yarrow
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida.,2 Department of Applied Physiology and Kinesiology, University of Florida , Gainesville, Florida
| | - Ean G Phillips
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Christine F Conover
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Taylor E Bassett
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Cong Chen
- 3 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Tyler Teurlings
- 3 Department of Orthopedics and Rehabilitation, University of Florida , Gainesville, Florida
| | - Andrea Vasconez
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Jonathan Alerte
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Hannah Prock
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - Jessica M Jiron
- 4 Physiological Sciences, University of Florida , Gainesville, Florida
| | - Micah Flores
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
| | - J Ignacio Aguirre
- 4 Physiological Sciences, University of Florida , Gainesville, Florida
| | - Stephen E Borst
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida.,2 Department of Applied Physiology and Kinesiology, University of Florida , Gainesville, Florida
| | - Fan Ye
- 1 Research Service, Malcom Randall Department of Veterans Affairs Medical Center , North Florida/South Georgia Veterans Health System, Gainesville, Florida
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Comhaire F, Mahmoud A. The andrologist's contribution to a better life for ageing men: part 2. Andrologia 2015; 48:99-110. [PMID: 26395368 DOI: 10.1111/and.12489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 02/06/2023] Open
Abstract
The long-term intake of a judiciously composed nutriceutical containing low-dose vitamins, antioxidants, minerals and particular herbal preparations seems justified for older persons who take medication, or who consume an unbalanced diet, or who are exposed to environmental toxins. Recent reports suggest these nutriceuticals may delay age-related diseases and the occurrence of cancer, and reduce mortality in apparently healthy ageing men. Food supplementation with a nutriceutical that was formulated particularly for ageing men should result in an increase of at least one quality-adjusted life year and may lower the financial and social burden of disease in elderly people.
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Affiliation(s)
- F Comhaire
- Department of Endocrinology, University Hospital Gent, Gent, Belgium
| | - A Mahmoud
- Department of Endocrinology, University Hospital Gent, Gent, Belgium
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Üçer O, Gümüş B. The treatment of late-onset hypogonadism. Turk J Urol 2014; 40:170-9. [PMID: 26328172 DOI: 10.5152/tud.2013.97752] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 08/27/2013] [Indexed: 11/22/2022]
Abstract
Late-onset hypogonadism (LOH) in aging men is a clinical and biochemical syndrome caused by an age-related decline in testosterone. Despite published in guidelines and recommendations, uncertainty surrounds the profile of clinical symptoms as well as the biochemical threshold of diagnosis. The only evidence-based treatment of late-onset hypogonadism is testosterone replacement therapy. The actual available evidence of the long-term risks and outcomes of testosterone-replacement therapy remains very limited, and carefully designed placebo-controlled trials of testosterone administration to assess the risks and benefits of such a therapy are required. Until such evidence is available, testosterone treatment should be restricted to elderly men with very low testosterone levels in the presence of clinical symptoms, and the advantages and disadvantages need to be accurately assessed. Careful monitoring of potential side effects is necessary. The purpose of this review is to discuss what is known and what remains unclear with respect to the benefits and risks of testosterone replacement treatment.
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Affiliation(s)
- Oktay Üçer
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Bilal Gümüş
- Department of Urology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
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