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C Pillay O, Manyonda I. The surgical menopause. Best Pract Res Clin Obstet Gynaecol 2022; 81:111-118. [PMID: 35568447 DOI: 10.1016/j.bpobgyn.2022.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
Surgical menopause (iatrogenic menopause) happens when both ovaries are removed before the natural "switching off" of ovarian function; it can cause premature ovarian insufficiency where the menopause occurs in women before the age of 40. Surgical menopause is associated with a sudden reduction of ovarian sex steroid production rather than a gradual one as is the case in natural menopause. In women who have undergone bilateral salpingo-oophorectomy (BSO) before the natural age of menopause, strong consideration should be given to giving hormone replacement therapy (HRT) till the natural age of menopause at least. Sexual function and sexual desire are altered post-BSO, especially in younger women hence part of HRT prescription must include consideration of androgen too.
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Affiliation(s)
- Ouma C Pillay
- Department of Obstetrics & Gynaecology, St George´s University Hospitals NHS Foundation Trust, London, United Kingdom.
| | - Isaac Manyonda
- Department of Obstetrics and Gynecology, St George's, University of London, London / St George´s University Hospitals NHS Foundation Trust, United Kingdom
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2
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Ray King K, Fuselier L, Sirvisetty H. LGBTQIA+ invisibility in nursing anatomy/physiology textbooks. J Prof Nurs 2021; 37:816-827. [PMID: 34742510 DOI: 10.1016/j.profnurs.2021.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Indexed: 12/12/2022]
Abstract
Members of the LGBTQIA+ experience health disparities that are compounded by providers that lack cultural competence, i.e., the skills, attitudes, and knowledge to offer culturally sensitive care. Educational efforts focus on increasing LGBTQIA+ representation across undergraduate nursing curricula and the recruitment and retention of members of this community into nursing programs. However, the ways that classroom materials represent LGBTQIA+ people can perpetuate social norms rather than accurate scientific understandings, thus limiting students' development of cultural competence while also driving LGBTQIA+ students from nursing. This study performs a content analysis for LGBTQIA+ inclusion in four widely adopted undergraduate nursing anatomy/physiology textbooks. We identify specific social beliefs that exclude LGBTQIA+ people and compare the different ways these manifested in each of the four textbooks. We argue that the way these books represent LGBTQIA+ people violate the fundamental ethical principles of nursing. Based on our findings, we challenge educators to consider the impact that language, images, and other classroom materials have on LGBTQIA+ students and all students' ability to develop cultural competence.
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Affiliation(s)
- Katherine Ray King
- Department of Biology, University of Louisville, Life Sciences Building #139, Louisville, KY 40208, USA.
| | - Linda Fuselier
- Department of Biology, University of Louisville, Life Sciences Building #139, Louisville, KY 40208, USA.
| | - Harshini Sirvisetty
- Department of Biology, University of Louisville, Life Sciences Building #139, Louisville, KY 40208, USA.
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Yoo JE, Kim D, Han K, Rhee SY, Shin DW, Lee H. Diabetes Status and Association With Risk of Tuberculosis Among Korean Adults. JAMA Netw Open 2021; 4:e2126099. [PMID: 34546370 PMCID: PMC8456384 DOI: 10.1001/jamanetworkopen.2021.26099] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE The risk of tuberculosis (TB) associated with diabetes status, considering impaired fasting glucose or duration of diabetes, has not been well established. OBJECTIVE To evaluate the association of diabetes status with the development of TB in the general population. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study used data from the Korean National Health Insurance System database. Adult participants without a history of TB who underwent a health screening in 2009 were included. Eligible participants were followed up for incident TB cases from 1 year after the day of health screening until December 31, 2018. Data analysis was performed from September 2019 to September 2020. EXPOSURES Five levels of diabetes status were evaluated: normal glucose, impaired fasting glucose (considered as without diabetes), new-onset diabetes, diabetes duration less than 5 years, and diabetes duration 5 years or longer (considered as having diabetes). MAIN OUTCOMES AND MEASURES Newly diagnosed TB. RESULTS Among 4 423 177 participants, the mean (SD) age was 46.5 (13.9) years, and there were 2 597 142 men (58.7%). A total of 26 458 participants (0.6%) received a diagnosis of TB within a median (interquartile range) of 8.3 (8.1-8.6) years of follow-up. An increased risk of TB was observed in participants with diabetes compared with those without diabetes (adjusted hazard ratio [aHR], 1.48; 95% CI, 1.42-1.53). Although participants with impaired fasting glucose did not show an increased risk of TB incidence (aHR, 0.97; 95% CI, 0.93-1.01), the risk of TB incidence increased with diabetes duration (new-onset diabetes, aHR, 1.32; 95% CI, 1.23-1.42; diabetes duration <5 years, aHR, 1.45; 95% CI, 1.36-1.54; diabetes duration ≥5 years, aHR, 1.57; 95% CI, 1.48-1.66). Among participants with new-onset diabetes, compared with those in the lowest decile (fasting plasma glucose [FPG] level ≥126 but <128 mg/dL), the risk of TB was significantly increased for those in the highest decile (FPG level ≥202 mg/dL, aHR, 1.79; 95% CI, 1.42-2.26). CONCLUSIONS AND RELEVANCE These findings suggest that longer diabetes duration is associated with development of TB, showing a dose-response association. Among participants with new-onset diabetes, incident TB was more common among those with FPG levels greater than or equal to 202 mg/dL.
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Affiliation(s)
- Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Supportive Care Center, Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Salekeen R, Diaconeasa AG, Billah MM, Islam KMD. Energy Metabolism Focused Analysis of Sexual Dimorphism in Biological Aging and Hypothesized Sex-specificity in Sirtuin Dependency. Mitochondrion 2021; 60:85-100. [PMID: 34332101 DOI: 10.1016/j.mito.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/09/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
Abstract
The process of biological aging or senescence refers to the gradual loss of homeostasis and subsequent loss of function - leading to higher chances of mortality. Many mechanisms and driving forces have been suggested to facilitate the evolution of a molecular circuit acting as a trade-off between survival and proliferation, resulting in senescence. A major observation on biological aging and longevity in humans and model organisms is the prevalence of significant sexual divergence in the onset, mechanisms and effects of aging associated processes. In the current account, we describe possible mechanisms by which aging, sex and reproduction are evolutionarily intertwined in order to maintain systemic energy homeostasis. We also interrogate existing literature on the sexual dimorphism of genetic, cellular, metabolic, endocrine and epigenetic processes driving cellular and systemic aging. Subsequently, based on available evidence, we propose a hypothetic model of sex-limited decoupling of female longevity from sirtuins, a major family of regulator proteins of the survival-proliferation trade-off. We also provide necessary considerations to be made in order to test the hypothesis and explore the physiological and therapeutic implications of this decoupling event in male and female longevity after reaching reproductive maturity. HYPOTHESIS STATEMENT: Sirtuins provide survival benefits in a sex-nonspecific manner but the dependency on sirtuins in driving metabolic networks after reaching reproductive maturity is evolutionarily decoupled from female longevity.
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Affiliation(s)
- Rahagir Salekeen
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Amalia Gabriela Diaconeasa
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Bucharest, Romania.
| | - Md Morsaline Billah
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Kazi Mohammed Didarul Islam
- Biotechnology and Genetic Engineering Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
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5
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Sakhteman A, Pasdaran A, Afifi M, Hamedi A. An Assay on the Possible Effect of Essential Oil Constituents on Receptors Involved in Women's Hormonal Health and Reproductive System Diseases. J Evid Based Integr Med 2021; 25:2515690X20932527. [PMID: 32567329 PMCID: PMC7309338 DOI: 10.1177/2515690x20932527] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aromatic herbal remedies, hydrosols, and essential oils are widely used for women's hormonal health. Scientific investigation of their major constituents may prevent unwanted infertility cases, fetal abnormalities, and drug-herb interactions. It also may lead to development of new medications. A list of 265 volatile molecules (mainly monoterpenes and sesquiterpenes) were prepared from a literature survey in Scopus and PubMed (2000-2019) on hydrosols and essential oils that are used for women's hormonal and reproductive health conditions. The PDB (protein data bank) files of the receptors (136 native PDB files) that involve with oxytocin, progesterone, estrogen, prolactin, acetyl choline, androgen, dopamine, human chorionic gonadotropin, luteinizing hormone, follicle-stimulating hormone, aromatase, and HER2 receptors were downloaded from Protein Data Bank. An in silico study using AutoDock 4.2 and Vina in parallel mode was performed to investigate possible interactions of the ligands with the receptors. Drug likeliness was investigated for the most active molecules using DruLiTo software. Aristola-1(10),8-diene, bergapten (5-methoxypsoralen), α-bergamotene, bicyclogermacrene, α-bisabolol oxide A, α-bisabolone oxide, p-cymen-8-ol, 10-epi elemol, α-elemol, β-eudesmol, 7-epi-β-eudesmol, ficusin, β-humulene, methyl jasmonate, nerolidol, pinocarvone, (+)-spathulenol, and thujone had better interactions with some androgen, aromatase, estrogen, progesterone, HER2, AChR, and/or dopamine receptors. Most of these molecules had an acceptable drug likeliness except for α-bergamotene, bicyclogermacrene, β-humulene, and aristola-1(10),8-diene. Some volatile natural molecules can be considered as lead compound for drug development to treat hormonal conditions.
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Affiliation(s)
- Amirhossein Sakhteman
- Department of Medicinal Chemistry, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ardalan Pasdaran
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Afifi
- Student Research Committee, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Hamedi
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Tedjawirja VN, Nieuwdorp M, Yeung KK, Balm R, de Waard V. A Novel Hypothesis: A Role for Follicle Stimulating Hormone in Abdominal Aortic Aneurysm Development in Postmenopausal Women. Front Endocrinol (Lausanne) 2021; 12:726107. [PMID: 34721292 PMCID: PMC8548664 DOI: 10.3389/fendo.2021.726107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/02/2021] [Indexed: 12/24/2022] Open
Abstract
An abdominal aortic aneurysm (AAA) is a dilatation of the abdominal aorta, which can potentially be fatal due to exsanguination following rupture. Although AAA is less prevalent in women, women with AAA have a more severe AAA progression compared to men as reflected by enhanced aneurysm growth rates and a higher rupture risk. Women are diagnosed with AAA at an older age than men, and in line with increased osteoporosis and cardiovascular events, the delayed AAA onset has been attributed to the reduction of the protective effect of oestrogens during the menopausal transition. However, new insights have shown that a high follicle stimulating hormone (FSH) level during menopause may also play a key role in those diseases. In this report we hypothesize that FSH may aggravate AAA development and progression in postmenopausal women via a direct and/or indirect role, promoting aorta pathology. Since FSH receptors (FSHR) are reported on many other cell types than granulosa cells in the ovaries, it is feasible that FSH stimulation of FSHR-bearing cells such as aortic endothelial cells or inflammatory cells, could promote AAA formation directly. Indirectly, AAA progression may be influenced by an FSH-mediated increase in osteoporosis, which is associated with aortic calcification. Also, an FSH-mediated decrease in cholesterol uptake by the liver and an increase in cholesterol biosynthesis will increase the cholesterol level in the circulation, and subsequently promote aortic atherosclerosis and inflammation. Lastly, FSH-induced adipogenesis may lead to obesity-mediated dysfunction of the microvasculature of the aorta and/or modulation of the periaortic adipose tissue. Thus the long term increased plasma FSH levels during the menopausal transition may contribute to enhanced AAA disease in menopausal women and could be a potential novel target for treatment to lower AAA-related events in women.
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Affiliation(s)
- Victoria N. Tedjawirja
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
- *Correspondence: Victoria N. Tedjawirja,
| | - Max Nieuwdorp
- Departments of Internal and Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Kak Khee Yeung
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Ron Balm
- Department of Surgery, Amsterdam University Medical Center (UMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Vivian de Waard
- Department of Medical Biochemistry, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
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7
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Expression of androgen receptors in the structures of vulvovaginal tissue. ACTA ACUST UNITED AC 2020; 27:1336-1342. [DOI: 10.1097/gme.0000000000001587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Voice Change Following Testosterone Supplementation in Women: A Multi-Institutional Case Series. J Voice 2020; 35:936.e1-936.e7. [PMID: 32386906 DOI: 10.1016/j.jvoice.2020.03.008] [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: 02/03/2020] [Revised: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To describe voice changes as a result of the off-label use of androgen supplementation in women. METHODS A multi-institutional retrospective consecutive case series identified women taking androgen supplementation who presented to voice clinics at two institutions with a chief complaint of voice change between 2014 and 2019. Age, occupation, hormone therapy, indication, Voice Handicap Index-10, fundamental frequency, semitone pitch range, testosterone blood level, treatment undertaken, and long-term outcome were collected. RESULTS Nine women presented with voice change after initiation of androgen hormone supplementation. The mean age was 55 and three patients were performers. All patients underwent hormone therapy with testosterone supplementation, most commonly subcutaneous testosterone pellets. Six patients (67%) were being treated for menopause symptoms, one patient for decreased libido, one patient for breast cancer, and one patient who desired additional muscle gain. Time of symptom onset after hormone therapy initiation was highly variable, ranging from 0 to 48 months with a mean of 15 months. Mean Voice Handicap Index-10 was 21, mean fundamental frequency at comfortable speaking level was 155 Hz and mean semitone pitch range was 22 semitones. Two patients had markedly elevated serum total testosterone levels. Hormone therapy discontinuation and voice therapy were recommended in six (67%) patients each. Five patients returned for follow-up after treatment and noted some subjective benefit. CONCLUSIONS Female patients treated with androgen supplementation may experience unintended voice changes, most prominently reduction in fundamental frequency. Although some benefit may be obtained from voice therapy and cessation of hormone therapy, voice changes may be permanent. Caution should be exercised when prescribing these medications to women.
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9
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Gonzalo-Encabo P, Valadés D, García-Honduvilla N, de Cos Blanco A, Friedenreich CM, Pérez-López A. Exercise type and fat mass loss regulate breast cancer-related sex hormones in obese and overweight postmenopausal women. Eur J Appl Physiol 2020; 120:1277-1287. [DOI: 10.1007/s00421-020-04361-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
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10
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Affiliation(s)
- Suneela Vegunta
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona
| | - Juliana M. Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona
| | - Ekta Kapoor
- Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
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11
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Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol 2019; 7:754-766. [PMID: 31353194 DOI: 10.1016/s2213-8587(19)30189-5] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The benefits and risks of testosterone treatment for women with diminished sexual wellbeing remain controversial. We did a systematic review and meta-analysis to assess potential benefits and risks of testosterone for women. METHODS We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for blinded, randomised controlled trials of testosterone treatment of at least 12 weeks' duration completed between Jan 1, 1990, and Dec 10, 2018. We also searched drug registration applications to the European Medicine Agency and the US Food and Drug Administration to identify any unpublished data. Primary outcomes were the effects of testosterone on sexual function, cardiometabolic variables, cognitive measures, and musculoskeletal health. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO), number CRD42018104073. FINDINGS Our search strategy retrieved 46 reports of 36 randomised controlled trials comprising 8480 participants. Our meta-analysis showed that, compared with placebo or a comparator (eg, oestrogen, with or without progestogen), testosterone significantly increased sexual function, including satisfactory sexual event frequency (mean difference 0·85, 95% CI 0·52 to 1·18), sexual desire (standardised mean difference 0·36, 95% CI 0·22 to 0·50), pleasure (mean difference 6·86, 95% CI 5·19 to 8·52), arousal (standardised mean difference 0·28, 95% CI 0·21 to 0·35), orgasm (standardised mean difference 0·25, 95% CI 0·18 to 0·32), responsiveness (standardised mean difference 0·28, 95% CI 0·21 to 0·35), and self-image (mean difference 5·64, 95% CI 4·03 to 7·26), and reduced sexual concerns (mean difference 8·99, 95% CI 6·90 to 11·08) and distress (standardised mean difference -0·27, 95% CI -0·36 to -0·17) in postmenopausal women. A significant rise in the amount of LDL-cholesterol, and reductions in the amounts of total cholesterol, HDL-cholesterol, and triglycerides, were seen with testosterone administered orally, but not when administered non-orally (eg, by transdermal patch or cream). An overall increase in weight was recorded with testosterone treatment. No effects of testosterone were reported for body composition, musculoskeletal variables, or cognitive measures, although the number of women who contributed data for these outcomes was small. Testosterone was associated with a significantly greater likelihood of reporting acne and hair growth, but no serious adverse events were recorded. INTERPRETATION Testosterone is effective for postmenopausal women with low sexual desire causing distress, with administration via non-oral routes (eg, transdermal application) preferred because of a neutral lipid profile. The effects of testosterone on individual wellbeing and musculoskeletal and cognitive health, as well as long-term safety, warrant further investigation. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Rakibul M Islam
- Women's Health Research Program, Monash University, Melbourne, VIC, Australia
| | - Robin J Bell
- Women's Health Research Program, Monash University, Melbourne, VIC, Australia
| | - Sally Green
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susan R Davis
- Women's Health Research Program, Monash University, Melbourne, VIC, Australia.
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12
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Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual Health in Menopause. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E559. [PMID: 31480774 PMCID: PMC6780739 DOI: 10.3390/medicina55090559] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.
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Affiliation(s)
- Irene Scavello
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Vincenza Di Stasi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy.
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13
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Steffens JP, Valenga HM, Santana LCL, Albaricci MCDC, Kantarci A, Spolidorio LC. Role of testosterone and androgen receptor in periodontal disease progression in female rats. J Periodontol 2019; 91:545-553. [DOI: 10.1002/jper.19-0099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/10/2019] [Accepted: 05/06/2019] [Indexed: 12/26/2022]
Affiliation(s)
- João Paulo Steffens
- Department of StomatologyUniversidade Federal do Paraná – UFPR Curitiba PR Brazil
| | | | - Luis Carlos Leal Santana
- Department of Physiology and PathologySchool of Dentistry at AraraquaraUniversidade Estadual Paulista – UNESP Araraquara SP Brazil
| | | | | | - Luis Carlos Spolidorio
- Department of Physiology and PathologySchool of Dentistry at AraraquaraUniversidade Estadual Paulista – UNESP Araraquara SP Brazil
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Karakas M, Schäfer S, Appelbaum S, Ojeda F, Kuulasmaa K, Brückmann B, Berisha F, Schulte-Steinberg B, Jousilahti P, Blankenberg S, Palosaari T, Salomaa V, Zeller T. Testosterone Levels and Type 2 Diabetes-No Correlation with Age, Differential Predictive Value in Men and Women. Biomolecules 2018; 8:biom8030076. [PMID: 30127326 PMCID: PMC6165105 DOI: 10.3390/biom8030076] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/03/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023] Open
Abstract
Most studies reporting on the association of circulating testosterone levels with type 2 diabetes in men are of cross-sectional design. Reports on the relevance of altered testosterone levels in women are scarce. Here, we evaluate the role of low serum testosterone levels for incident diabetes in men and women in a population setting of 7706 subjects (3896 females). During a mean follow up time of 13.8 years, 7.8% developed type 2 diabetes. Significant correlations of testosterone with high density lipoprotein (HDL)-cholesterol (R = 0.21, p < 0.001), body-mass-index (R = −0.23, p < 0.001), and waist-to-hip-ratio (R = −0.21, p < 0.001) were found in men. No correlation was found with age in men; in women, the correlation was negligible (R = 0.04, p = 0.012). In men, low testosterone levels predicted high risk of type 2 diabetes, while in women this relationship was opposite. Men with low testosterone levels showed increased risk of future diabetes (hazard ratio (HR) 2.66, 95% confidence interval (CI) 1.91–3.72, p < 0.001 in basic model; HR 1.56 95%, CI 1.10–2.21, p = 0.003). In women, low testosterone levels indicated lower risk with (HR 0.53, 95% CI 0.37–0.77, p = 0.003), while the association lost significance in the fully adjusted model (HR 0.72, 95% CI 0.49–1.05, p = 0.09). Low levels of testosterone predicted future diabetes in men. A borderline opposite association was found in women.
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Affiliation(s)
- Mahir Karakas
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, 20246 Hamburg, Germany.
| | - Sarina Schäfer
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, 20246 Hamburg, Germany.
| | - Sebastian Appelbaum
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
| | - Francisco Ojeda
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
| | - Kari Kuulasmaa
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Burkhard Brückmann
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
| | - Filip Berisha
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
| | | | - Pekka Jousilahti
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, 20246 Hamburg, Germany.
| | - Tarja Palosaari
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Veikko Salomaa
- National Institute for Health and Welfare, 00271 Helsinki, Finland.
| | - Tanja Zeller
- Department of General and Interventional Cardiology, University Heart Center, 20246 Hamburg, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg, 20246 Hamburg, Germany.
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Steffens JP, Santana LCL, Pitombo JCP, Ribeiro DO, Albaricci MCC, Warnavin SVSC, Kantarci A, Spolidorio LC. The role of androgens on periodontal repair in female rats. J Periodontol 2018; 89:486-495. [DOI: 10.1002/jper.17-0435] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/30/2017] [Accepted: 10/05/2017] [Indexed: 12/18/2022]
Affiliation(s)
- João Paulo Steffens
- Department of Stomatology; Universidade Federal do Paraná - UFPR; Curitiba PR Brazil
| | - Luis Carlos Leal Santana
- Department of Physiology and Pathology; Universidade Estadual Paulista - UNESP; School of Dentistry at Araraquara Araraquara SP Brazil
| | - Jonleno Coutinho Paiva Pitombo
- Department of Physiology and Pathology; Universidade Estadual Paulista - UNESP; School of Dentistry at Araraquara Araraquara SP Brazil
| | - Daniel Olivio Ribeiro
- Department of Physiology and Pathology; Universidade Estadual Paulista - UNESP; School of Dentistry at Araraquara Araraquara SP Brazil
| | - Maria Carolina Costa Albaricci
- Department of Physiology and Pathology; Universidade Estadual Paulista - UNESP; School of Dentistry at Araraquara Araraquara SP Brazil
| | | | - Alpdogan Kantarci
- Department of Applied Oral Sciences; Forsyth Institute; Cambridge MA
| | - Luis Carlos Spolidorio
- Department of Physiology and Pathology; Universidade Estadual Paulista - UNESP; School of Dentistry at Araraquara Araraquara SP Brazil
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16
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Whicker M, Black J, Altwerger G, Menderes G, Feinberg J, Ratner E. Management of sexuality, intimacy, and menopause symptoms in patients with ovarian cancer. Am J Obstet Gynecol 2017; 217:395-403. [PMID: 28411144 DOI: 10.1016/j.ajog.2017.04.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/19/2022]
Abstract
Issues of sexuality, intimacy, and early menopause significantly impact the quality of life of patients following the diagnosis and treatment of ovarian cancer. These are undertreated problems. Successful treatment requires the provider's awareness of the problem, ability to identify it, and willingness to treat it. Unfortunately many providers do not address these issues in the pretreatment or perioperative period. Furthermore, patients do not often alert their providers to their symptoms. While systemic hormone therapy may improve many of the issues, they are not appropriate for all patients given their action on estrogen receptors. However, other nonhormonal treatments exist including selective serotonin reuptake inhibitors, antiepileptics, natural remedies, and pelvic floor physical therapy. In addition psychological care and the involvement of the partner can be helpful in managing the sexual health concerns of these patients. At the time of diagnosis or at initial consultation, women should be informed of the potential physiologic, hormonal, and psychosocial effects of ovarian cancer on sexuality and that there is a multimodal approach to dealing with symptoms.
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Affiliation(s)
- Margaret Whicker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jonathan Black
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT.
| | - Gary Altwerger
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Gulden Menderes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Jacqueline Feinberg
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
| | - Elena Ratner
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, CT
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17
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Farris M, Bastianelli C, Rosato E, Brosens I, Benagiano G. Pharmacodynamics of combined estrogen-progestin oral contraceptives: 2. effects on hemostasis. Expert Rev Clin Pharmacol 2017; 10:1129-1144. [DOI: 10.1080/17512433.2017.1356718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Manuela Farris
- Department of Gynecology, Obstetrics and Urology, Sapienza, University of Rome, Rome, Italy
- AIED, Rome, Italy
| | - Carlo Bastianelli
- Department of Gynecology, Obstetrics and Urology, Sapienza, University of Rome, Rome, Italy
| | - Elena Rosato
- Department of Gynecology, Obstetrics and Urology, Sapienza, University of Rome, Rome, Italy
| | - Ivo Brosens
- LIFE, Leuven Institute for Fertility and Embryology, Leuven, Belgium
| | - Giuseppe Benagiano
- Department of Gynecology, Obstetrics and Urology, Sapienza, University of Rome, Rome, Italy
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18
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Badawi JK, Bosch R, Djurhuus JC, Hanna-Mitchell AT. Is testosterone important in LUT function in men and women? ICI-RS 2015. Neurourol Urodyn 2017; 36:859-862. [PMID: 28444714 DOI: 10.1002/nau.23041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/02/2016] [Indexed: 12/20/2022]
Abstract
AIM This review article is a collaborative report based upon the Authors' presentations and Group discussion on the role of testosterone (T) in the male and female lower urinary tract (LUT) which took place at the 6th International Consultation on Incontinence Research Society's (ICI-RS) annual meeting, in Bristol, UK (September 8-10, 2015). METHODS It comprises overviews and opinions on both the current state of knowledge of the role of T in LUT function and dysfunction in both sexes. RESULTS Results from animal studies suggest that T treatment may be beneficial for disorders of the LUT in women including urinary incontinence and pelvic organ prolapse. The need for clinical studies to evaluate the effect of T treatment in peri- and post-menopausal women, taking into account the type of applied androgen, the application form, timing and dosage, is especially emphasized. In males, findings on the impact of T on the male external urethral sphincter underscores that there is still much to learn about its role in male LUT physiology. The important topic of the use of T therapy in the treatment of enuresis in the young, both sexes, is also discussed. The importance of understanding the steroidogenic pathways linking T with estradiol is discussed as being of paramount importance in researching the unique actions of T in the LUT. CONCLUSION The overall conclusion is that further research into the role of T in LUT function and dysfunction across genders and age groups (young to old) is extremely important. Neurourol. Urodynam. 36:859-862, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Jasmin Katrin Badawi
- Department of Urology, University Hospital Mannheim, Medical Faculty of the Ruprechts-Karls-University of Heidelberg, Mannheim, Germany
| | - Ruud Bosch
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
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19
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Effect of sex-hormone levels, sex, body mass index and other host factors on human craniofacial bone regeneration with bioactive tricalcium phosphate grafts. Biomaterials 2017; 123:48-62. [PMID: 28160669 DOI: 10.1016/j.biomaterials.2017.01.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/23/2016] [Accepted: 01/27/2017] [Indexed: 12/16/2022]
Abstract
Little is known regarding the associations between sex-hormone levels, sex, body mass index (BMI), age, other host factors and biomaterial stimulated bone regeneration in the human craniofacial skeleton. The aim of this study was to elucidate the associations between these factors and bone formation after sinus floor augmentation procedures (SFA) utilizing a bioactive tricalcium phosphate (TCP) bone grafting material. We conducted a prospective study in a human population in which 60 male and 60 female participants underwent SFA and dental implant placement using a staged approach. BMI as well as levels of serum estradiol (E2), total testosterone (TT), and the free androgen index (FAI) were measured by radioimmunoassay and electrochemoluminescent-immunoassay. At implant placement, 6 months after SFA, bone biopsy specimens were harvested for hard tissue histology, the amount of bone formation was evaluated by histomorphometry and immunohistochemical analysis of osteogenic marker expression. The Wilcoxon rank-sum U test, Spearman correlations and linear regression analysis were used to explore the association between bone formation and BMI, hormonal and other host factors. BMI and log E2 were significantly positively associated with bone formation in male individuals (p < 0.05). Histomorphometry revealed trends toward greater bone formation and osteogenic marker expression with non-smokers compared to smokers. In male patients, higher E2 levels and higher BMI enhanced TCP stimulated craniofacial i.e. intramembranous bone repair.
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20
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Asih PR, Tegg ML, Sohrabi H, Carruthers M, Gandy SE, Saad F, Verdile G, Ittner LM, Martins RN. Multiple Mechanisms Linking Type 2 Diabetes and Alzheimer's Disease: Testosterone as a Modifier. J Alzheimers Dis 2017; 59:445-466. [PMID: 28655134 PMCID: PMC6462402 DOI: 10.3233/jad-161259] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Evidence in support of links between type-2 diabetes mellitus (T2DM) and Alzheimer's disease (AD) has increased considerably in recent years. AD pathological hallmarks include the accumulation of extracellular amyloid-β (Aβ) and intracellular hyperphosphorylated tau in the brain, which are hypothesized to promote inflammation, oxidative stress, and neuronal loss. T2DM exhibits many AD pathological features, including reduced brain insulin uptake, lipid dysregulation, inflammation, oxidative stress, and depression; T2DM has also been shown to increase AD risk, and with increasing age, the prevalence of both conditions increases. In addition, amylin deposition in the pancreas is more common in AD than in normal aging, and although there is no significant increase in cerebral Aβ deposition in T2DM, the extent of Aβ accumulation in AD correlates with T2DM duration. Given these similarities and correlations, there may be common underlying mechanism(s) that predispose to both T2DM and AD. In other studies, an age-related gradual loss of testosterone and an increase in testosterone resistance has been shown in men; low testosterone levels can also occur in women. In this review, we focus on the evidence for low testosterone levels contributing to an increased risk of T2DM and AD, and the potential of testosterone treatment in reducing this risk in both men and women. However, such testosterone treatment may need to be long-term, and would need regular monitoring to maintain testosterone at physiological levels. It is possible that a combination of testosterone therapy together with a healthy lifestyle approach, including improved diet and exercise, may significantly reduce AD risk.
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Affiliation(s)
- Prita R. Asih
- Department of Anatomy, Dementia Research Unit, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- KaRa Institute of Neurological Diseases, Sydney, NSW, Australia
| | - Michelle L. Tegg
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Hamid Sohrabi
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Australian Alzheimer’s Research Foundation Perth, WA, Australia
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | | | - Samuel E. Gandy
- Departments of Neurology and Psychiatry and the Alzheimer’s Disease Research Center, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY, USA
| | - Farid Saad
- Bayer Pharma AG, Global Medical Affairs Andrology, Berlin, Germany
- Gulf Medical University School of Medicine, Ajman, UAE
| | - Giuseppe Verdile
- Australian Alzheimer’s Research Foundation Perth, WA, Australia
- School of Biomedical Sciences, Curtin University of Technology, Bentley, WA, Australia
| | - Lars M. Ittner
- Department of Anatomy, Dementia Research Unit, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - Ralph N. Martins
- KaRa Institute of Neurological Diseases, Sydney, NSW, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Australian Alzheimer’s Research Foundation Perth, WA, Australia
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
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Abstract
With aging and other muscle wasting diseases, men and women undergo similar pathological changes in skeletal muscle: increased inflammation, enhanced oxidative stress, mitochondrial dysfunction, satellite cell senescence, elevated apoptosis and proteasome activity, and suppressed protein synthesis and myocyte regeneration. Decreased food intake and physical activity also indirectly contribute to muscle wasting. Sex hormones also play important roles in maintaining skeletal muscle homeostasis. Testosterone is a potent anabolic factor promoting muscle protein synthesis and muscular regeneration. Estrogens have a protective effect on skeletal muscle by attenuating inflammation; however, the mechanisms of estrogen action in skeletal muscle are less well characterized than those of testosterone. Age- and/or disease-induced alterations in sex hormones are major contributors to muscle wasting. Hence, men and women may respond differently to catabolic conditions because of their hormonal profiles. Here we review the similarities and differences between men and women with common wasting conditions including sarcopenia and cachexia due to cancer, end-stage renal disease/chronic kidney disease, liver disease, chronic heart failure, and chronic obstructive pulmonary disease based on the literature in clinical studies. In addition, the responses in men and women to the commonly used therapeutic agents and their efficacy to improve muscle mass and function are also reviewed.
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22
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Simmons JG, Byrne ML, Schwartz OS, Whittle SL, Sheeber L, Kaess M, Youssef GJ, Allen NB. Dual-axis hormonal covariation in adolescence and the moderating influence of prior trauma and aversive maternal parenting. Dev Psychobiol 2015; 57:670-87. [PMID: 25754696 DOI: 10.1002/dev.21275] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 11/19/2014] [Indexed: 01/05/2023]
Abstract
Adversity early in life can disrupt the functioning of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes and increase risk for negative health outcomes. The interplay between these axes and the environment is complex, and understanding needs to be advanced by the investigation of the multiple hormonal relationships underlying these processes. The current study examined basal hormonal associations between morning levels of cortisol, testosterone, and dehydroepiandrosterone in a cohort of adolescents (mean age 15.56 years). The moderating influence of childhood adversity was also examined, as indexed by self-reported trauma (at mean age 14.91), and observed maternal aggressive parenting (at mean age 12.41). Between-person regressions revealed significant associations between hormones that were moderated by both measures of adversity. In females, all hormones positively covaried, but also interacted with adversity, such that positive covariation was typically only present when levels of trauma and/or aggressive parenting were low. In males, hormonal associations and interactions were less evident; however, interactions were detected for cortisol-testosterone - positively covarying at high levels of aggressive parenting but negatively covarying at low levels - and DHEA-cortisol - similarly positively covarying at high levels of parental aggression. These results demonstrate associations between adrenal and gonadal hormones and the moderating role of adversity, which is likely driven by feedback mechanisms, or cross-talk, between the axes. These findings suggest that hormonal changes may be the pathway through which early life adversity alters physiology and increases health risks, but does so differentially in the sexes; however further study is necessary to establish causation.
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Affiliation(s)
- Julian G Simmons
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia.,Orygen Youth Health Research Centre, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Michelle L Byrne
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Orli S Schwartz
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Sarah L Whittle
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Victoria, Australia
| | | | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - George J Youssef
- Monash Clinical and Imaging Neuroscience, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia. .,Murdoch Childrens Research Institute, Parkville, Victoria, Australia. .,Department of Psychology, University of Oregon, Eugene, OR, USA.
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23
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Goodrum BA. The Effects of Long-Term Testosterone Use on Lipid-Related Cardiovascular Risk Factors Among FtM Patients. Int J Transgend 2015. [DOI: 10.1080/15532739.2014.995261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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