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Oyedokun PA, Ashonibare VJ, Fabrael FB, Akhigbe TM, Akangbe MD, Akhigbe RE. Understanding the intricate impacts and mechanism of actions of adaptogens on reproductive function. Cell Biochem Biophys 2024:10.1007/s12013-024-01565-6. [PMID: 39369159 DOI: 10.1007/s12013-024-01565-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2024] [Indexed: 10/07/2024]
Abstract
Adaptogens, comprising plants and mushrooms, modulate the immune system, energy balance, and various physiological processes, including reproduction. Despite their potential benefits, the impact of adaptogens on reproductive function remains understudied. This review examines the effects of common adaptogens on male and female reproductive functions, highlighting their regulation of neuro-endocrine-immune interactions crucial for reproduction. While existing literature reveals varying impacts on reproductive function, most adaptogens exhibit beneficial effects, modulating neuroimmunology and promoting gonadal steroidogenesis, spermatogenesis, and folliculogenesis through direct mechanisms or suppression of oxidative stress and inflammation. Further experimental research is necessary to elucidate the mechanisms of action of adaptogens, which would significantly advance the management of reproductive disorders and other diseases. Validating these findings in clinical trials is also essential.
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Affiliation(s)
- Precious Adeoye Oyedokun
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - Victory Jesutoyosi Ashonibare
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Department of Infection Biology, Leibniz Institute for Natural Product Research and Infection Biology, Jena, Adolf-Reichwein-Straße 23, 07745, Jena, Germany
- Institute of Microbiology, Friedrich Schiller University, Jena, Neugasse 25, Jena, Germany
| | - Fidelis Batale Fabrael
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Department of Biochemistry, Faculty of Life Science, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
| | - Tunmise Maryanne Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Breeding and Genetic Unit, Department of Agronomy, Osun State University, Ogbomoso, Osun State, Nigeria
| | - Marvelous Dasola Akangbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Department of Nursing, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - Roland Eghoghosoa Akhigbe
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria.
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Wang Q, Guo Y, Zhang H, Qin X, Zhang C, Zhou W. The value of shear wave elastography combined with red blood cell distribution width in evaluating arterial erectile dysfunction. BMC Urol 2024; 24:205. [PMID: 39300493 DOI: 10.1186/s12894-024-01579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/21/2024] [Indexed: 09/22/2024] Open
Abstract
PURPOSE A retrospective study was conducted to determine the value of shear wave elastography (SWE) and red blood cell distribution width (RDW) in the diagnosis of various forms of erectile dysfunction (ED). METHODS With the method of Nocturnal Penile Tumescence and Rigidity (NPTR) and the screening method of Color Duplex Doppler Ultrasound (CDDU), hematological data were collected from 131 individuals, among whom 24 are with psychogenic ED, 48 are with non-arterial ED(NAED) and 59 are with arterial ED(AED) with erectile dysfunction. SWE value of penile corpus cavernosum(CCP) and cavernous arterial flow velocity were measured before (flaccid state) and after (erect state) intracavernous injection (ICI) in all patients. RESULTS Among the AED patients and other types of ED patients, there were statistically significant differences in the abridged five-item International Index of Erectile Function (IIEF-5), red blood cell distribution width-coefficient of variation (RDW-CV), red blood cell distribution width-standard deviation (RDW-SD), and SWE values (all P < 0.01). In the AED patients, the IIEF-5 scores had a significant negative relationship with RDW-CV, RDW-SD, and SWE values, with SWE values having the strongest correlation. (p < 0.001, r=-0.638). CONCLUSION The combination of RDW level and SWE value demonstrated the greatest performance in diagnosing AED, according to the receiver-operator characteristic(ROC) curve analysis (AUC = 0.870, p < 0.0001, cut-off value of 0.75, sensitivity of 74.6%, specificity of 91.7%).RDW and SWE value may develop into an incredibly simple, practical tool for predicting and diagnosing AED. TRIAL REGISTRATION retrospectively registered.
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Affiliation(s)
- Qingyuan Wang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Yixuan Guo
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Hanqi Zhang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Xiachuan Qin
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China
| | - Chaoxue Zhang
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China.
| | - Wang Zhou
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui, China.
- School of Pharmacy, Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, Hefei, Anhui, China.
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Wu YC, Sung WW. Clomiphene Citrate Treatment as an Alternative Therapeutic Approach for Male Hypogonadism: Mechanisms and Clinical Implications. Pharmaceuticals (Basel) 2024; 17:1233. [PMID: 39338395 PMCID: PMC11435126 DOI: 10.3390/ph17091233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 09/11/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024] Open
Abstract
Male hypogonadism, which is characterized by low testosterone levels, has a significant impact on male sexual function, overall health, and fertility. Testosterone replacement therapy (TRT) is the conventional treatment for this condition, but it has potential adverse effects and is not suitable for men seeking to conceive. Testosterone plays an essential role in male sexual function, metabolism, mood, and overall well-being. Clomiphene citrate, a drug originally developed for female infertility, has recently gained attention as an off-label treatment for male hypogonadism. By blocking the negative feedback of estrogen on the hypothalamus and pituitary glands, clomiphene stimulates gonadotropin secretion, leading to increased endogenous testosterone production, which, in turn, improves sperm parameters and fertility and alleviates the symptoms of hypogonadism. Regarding the safety profile of clomiphene compared with TRT, clomiphene appears to confer a lower risk than TRT, which is associated with adverse effects such as polycythemia. Furthermore, combination therapy with clomiphene and anastrozole or human chorionic gonadotropin has been investigated as a potential approach to enhancing the effectiveness of treatments for improving hypogonadism symptoms. In conclusion, clomiphene citrate may offer a promising alternative to TRT for men with hypogonadism, particularly those desiring fertility preservations. However, its long-term efficacy and safety remain inadequately understood. Future research should focus on exploring the benefits of combination therapies and personalized treatment strategies based on individual patient characteristics.
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Affiliation(s)
- Yao-Cheng Wu
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Wen-Wei Sung
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Urology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
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Gonzalez-Daza SJ, Díaz-Hung AM, García-Perdomo HA. Association between varicocele and hypogonadism, or erectile dysfunction: A systematic review and meta-analysis. Actas Urol Esp 2024:S2173-5786(24)00084-2. [PMID: 38960064 DOI: 10.1016/j.acuroe.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 05/09/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE To assess the association between varicocele and hypogonadism, or erectile dysfunction. METHODS We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager 5.3 and reported information about the Odds Ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome. RESULTS We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR 3.27 95% CI 1.23 to 8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele. CONCLUSION There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.
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Affiliation(s)
- S J Gonzalez-Daza
- Grupo de Investigación UROGIV, Escuela de Medicina, Universidad del Valle, Cali, Colombia
| | - A M Díaz-Hung
- Grupo de Investigación UROGIV, Escuela de Medicina, Universidad del Valle, Cali, Colombia; Unidad de Urología, Departamento de Cirugía, Escuela de Medicina, Universidad del Valle, Cali, Colombia
| | - H A García-Perdomo
- Grupo de Investigación UROGIV, Escuela de Medicina, Universidad del Valle, Cali, Colombia; Unidad de Urología, Departamento de Cirugía, Escuela de Medicina, Universidad del Valle, Cali, Colombia.
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Fujita N, Okamoto T, Yamamoto H, Yoneyama T, Hashimoto Y, Mikami T, Itoh K, Ohyama C, Hatakeyama S. Association between sex hormones and erectile dysfunction in men without hypoandrogenism. Sci Rep 2024; 14:13433. [PMID: 38862562 PMCID: PMC11167061 DOI: 10.1038/s41598-024-64339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/07/2024] [Indexed: 06/13/2024] Open
Abstract
In addition to testosterone, various endocrine hormones, such as dehydroepiandrosterone sulfate (DHEA-S) and estradiol, may be involved in erectile function. However, the role of these sex hormones in the erectile function of men without hypoandrogenism remains unclear. This cross-sectional study included 398 community-dwelling men without hypoandrogenism. The participants were categorized into the non-ED and ED groups. Multivariable logistic regression analyses were performed to investigate the relationship between ED and serum sex hormone levels, including total testosterone, DHEA-S, estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin. Among the 398 men, 66 (17%) and 332 (83%) were categorized into the non-ED and ED groups, respectively. In the multivariable analyses, serum DHEA-S and estradiol levels were significantly associated with ED (odds ratio [OR]: 0.996, P = 0.030; OR: 1.082, P = 0.002; respectively), whereas serum total testosterone, LH, FSH, and prolactin levels did not demonstrate significant association. After adjusting for age, none of neutrophil-to-lymphocyte ratio, serum plasminogen activator inhibitor-1 levels, and skin advanced glycation end-products levels demonstrated significant correlation with serum DHEA-S and estradiol levels. In conclusion, lower testosterone levels did not affect ED in men with normal testosterone levels, whereas serum DHEA-S and estradiol levels were significantly associated with ED.
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Affiliation(s)
- Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan.
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan
| | - Takahiro Yoneyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan
| | - Tatsuya Mikami
- Innovation Center for Health Promotion, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan
| | - Ken Itoh
- Department of Stress Response Science, Center for Advanced Medical Science, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5-Zaifucho, Hirosaki, 036-8562, Japan
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562, Japan
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Martin LJ, Touaibia M. Prevention of Male Late-Onset Hypogonadism by Natural Polyphenolic Antioxidants. Nutrients 2024; 16:1815. [PMID: 38931170 PMCID: PMC11206339 DOI: 10.3390/nu16121815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Androgen production primarily occurs in Leydig cells located in the interstitial compartment of the testis. In aging males, testosterone is crucial for maintaining muscle mass and strength, bone density, sexual function, metabolic health, energy levels, cognitive function, as well as overall well-being. As men age, testosterone production by Leydig cells of the testes begins to decline at a rate of approximately 1% per year starting from their 30s. This review highlights recent findings concerning the use of natural polyphenolics compounds, such as flavonoids, resveratrol, and phenolic acids, to enhance testosterone production, thereby preventing age-related degenerative conditions associated with testosterone insufficiency. Interestingly, most of the natural polyphenolic antioxidants having beneficial effects on testosterone production tend to enhance the expression of the steroidogenic acute regulatory protein (Star) gene in Leydig cells. The STAR protein facilitates the entry of the steroid precursor cholesterol inside mitochondria, a rate-limiting step for androgen biosynthesis. Natural polyphenolic compounds can also improve the activities of steroidogenic enzymes, hypothalamus-pituitary gland axis signaling, and testosterone bioavailability. Thus, many polyphenolic compounds such as luteolin, quercetin, resveratrol, ferulic acid phenethyl ester or gigantol may be promising in delaying the initiation of late-onset hypogonadism accompanying aging in males.
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Affiliation(s)
- Luc J. Martin
- Biology Department, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Mohamed Touaibia
- Chemistry and Biochemistry Department, Université de Moncton, Moncton, NB E1A 3E9, Canada;
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Giagulli VA, Lisco G, De Tullio A, Guastamacchia E, Triggiani V, Jirillo E. The pathogenic role of the immune system in erectile dysfunction and Peyronie's disease: focusing on immunopathophysiology and potential therapeutic strategies. Sex Med Rev 2024; 12:210-220. [PMID: 38196188 DOI: 10.1093/sxmrev/qead055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Erectile dysfunction (ED) represents the major cause of male sexual dysfunction, which is often associated with obesity, diabetes mellitus, atherosclerotic cardiovascular disease, and cigarette smoking. Peyronie's disease is a chronic disorder associated with irreversible fibrotic damage of the tunica albuginea leading to ED, painful erection, coital disturbance, and physical and social complaints. Both conditions are characterized by chronic inflammation, oxidative stress, and significant changes in intracavernous hydrodynamics. In this scenario, oxidized lipoproteins, M1-polarized macrophages, proinflammatory cytokines (such as the tumor necrosis factor α), endothelial nitric oxide synthase, penile smooth muscle cells, and toll-like receptors represent the main triggers of the inflammatory process in ED. Phosphodiesterase-5 inhibitors are the most common treatment for ED. This treatment is used intermittently, as it is conceived as a symptomatic and not curative therapy. Moreover, not all patients respond to phosphodiesterase-5 inhibitors (35%-85%), particularly those with dysmetabolic phenotypes. Additional or alternative treatments are therefore desirable, mostly in refractory cases. OBJECTIVES In this review, we describe the immune-mediated pathogenesis of ED and Peyronie's disease (PD). In our literature search we placed particular emphasis on potentially practical therapeutic approaches, including natural products (such as polyphenols), due to their anti-inflammatory and antioxidant activities, stem cell therapy, and platelet-derived preparations. METHODS We searched PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, Google Scholar, and institutional websites. Original studies, narrative reviews, systematic reviews, and meta-analyses written in English were searched, screened, and selected. RESULTS In animal models of ED and PD, therapeutic approaches, including anti-inflammatory and antioxidant agents, stem cell therapy, and platelet-derived preparations, have provided positive results, including improved penile function, reduced inflammation and oxidative stress, and promotion of tissue repair. However, clinical evidence of improvement in human patients is still insufficient. CONCLUSION Promising results for treating ED and PD have been shown in preclinical and pilot clinical studies, but specific clinical trials are needed to validate the efficacy of these therapeutic approaches in men with ED.
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Affiliation(s)
- Vito Angelo Giagulli
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giuseppe Lisco
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Anna De Tullio
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Edoardo Guastamacchia
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Emilio Jirillo
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, School of Medicine, University of Bari "Aldo Moro", Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Bozkurt YE, Gümüş BH, Düzgün F, Neşe N. Comparison of preoperative penile elastographic ultrasound findings and pathological tissue results of patients implemented with penile prosthesis. J Ultrasound 2023; 26:99-105. [PMID: 35951284 PMCID: PMC10063753 DOI: 10.1007/s40477-022-00705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/24/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVE Histopathological analysis of the relationship between penile elastography and erectile dysfunction. MATERIAL AND METHOD 12 patients who applied to our clinic for erectile dysfunction in the last 1 year and accepted this study were included. Preoperative two-dimensional shear wave elastography imaging was performed in 12 patients and recorded in the Pascal (kPa) unit. Approximately 0.5 × 0.5 × 0.5 cm tissue samples were taken from the right and left cavernous tissue during penile prosthesis implantation operation. Tissue samples were sent to the pathology department. The percentage of the area covered by muscle fibers and elastic fibers in the corpus cavernosum was noted semi-quantitatively (ratio of muscle fibers and cavernous body elastic fiber score). All data obtained were compared with each other. RESULTS Cavernous body elastic fiber score data(Grouped Score 1, 2 and 3) and percentage of cavernous body muscle fibers data (Grouped %10, %20, %30… %100) were compared with Shear wave elastography data (kPa). The results were not statistically significant according to the Kruskal Wallis Test. Cavernous body elastic fiber score and the percentage of cavernous body muscle fibers were also compared, it was not statistically significant according to the Kruskal Wallis test and Spearman's correlation test. CONCLUSIONS Penile shear wave elastography can be used clinically to quantitatively assess the amount of smooth muscle cells and elastic fibers in the penis, but it deserves to be studied with a larger number of patients and a more specific interpretation of the pathology preparation.
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Affiliation(s)
- Yunus Erol Bozkurt
- Department of Urology, Celal Bayar University Faculty of Medicine, Manisa, Turkey.
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey.
| | - Bilal H Gümüş
- Department of Urology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatih Düzgün
- Department of Radiology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Nalan Neşe
- Department of Pathology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Saikia Q, Hazarika A, Kalita JC. Isoliquiritigenin ameliorates paroxetine-induced sexual dysfunction in male albino mice. Reprod Toxicol 2023; 117:108341. [PMID: 36740106 DOI: 10.1016/j.reprotox.2023.108341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Paroxetine (PRX), a widely prescribed antidepressant, often leads to sexual dysfunction. The available management options such as sildenafil (SDF), are associated with side effects. The present study investigates the fertility-boosting properties of isoliquiritigenin (ISL) on PRX-induced sexual dysfunction in male mice. We allocated fertile mice into six different groups (n = 5): group I- DMSO; group II- PRX; group III- co-administered PRX and SDF; group IV- ISL alone; group V- co-administered PRX and ISL (low dose); and, group VI- co-administered PRX and ISL (high dose). 14 days post treatment, animals were sacrificed, and the weights of the testis and epididymis were evaluated. Furthermore, sperm parameters, testicular and epididymal antioxidant levels, serum testosterone and nitric oxide (NO) levels, histoarchitecture of testis and epididymis, and markers of cellular toxicity were assessed. Results revealed that the PRX administration reduced organ weights, sperm count, intact acrosome, catalase (CAT), superoxide dismutase (SOD), glutathione (GSH), serum testosterone, and NO levels, and increased sperm abnormalities and MDA levels (a biomarker for lipid peroxidation). Additionally, we observed damage in the testis and epididymis. The toxicity biomarker study revealed a higher concentration of SGOT, SGPT, and ALP enzymes in the PRX-treated group. However, the co-administration of PRX with ISL ameliorated the adverse effect of PRX on the parameters mentioned above. The PRX+ISL (high) results were almost at par with the PRX+SDF group. The group that received ISL alone showed overall improvements. In conclusion, our comprehensive panel of tests indicates that ISL could be helpful in managing sexual dysfunction.
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Affiliation(s)
- Queen Saikia
- Department of Zoology, Gauhati University, Guwahati, Assam, India.
| | - Ajit Hazarika
- Tyagbir Hem Baruah College, Jamugurihat, Sonitpur, Assam, India
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Abstract
Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The specific contribution of low T to sexual function impairment in aging men has still not been completely clarified. Similarly, the role of T replacement therapy (TRT), as well as the combination of TRT with phosphodiesterase type 5 inhibitors (PDE5i) for patients with erectile dysfunction (ED), is still conflicting. Here we aim to summarize and critically discuss all available data supporting the contribution of low T to sexual impairment observed with aging as well as the possible role of TRT. Available data on men with sexual dysfunction show that reduced sexual desire is the most important correlate of male hypogonadism. Conversely, aging and associated morbidities substantially attenuate the relationship between ED and T. TRT is effective in improving sexual function in middle-aged and older subjects but its role is small and extremely variable. Lifestyle interventions can result in similar outcomes to those of TRT. In conclusion, it is our opinion that PDE5i along with lifestyle measures should be considered the first approach for treating ED even in subjects with milder T deficiency. When these interventions fail or are difficult to apply, TRT should be considered.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Mario Serio, Italy.
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Oyeleye SI, Olasehinde TA, Odumosu IP, Oboh G. Plantain peels restore sexual performance, hormonal imbalance, and modulate nitric oxide production and key enzymes of penile function in paroxetine-sexually impaired male rats. J Food Biochem 2022; 46:e14261. [PMID: 35609010 DOI: 10.1111/jfbc.14261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/16/2022] [Accepted: 04/18/2022] [Indexed: 12/29/2022]
Abstract
This study focused on the effect of unripe (UPP) and ripe (RPP) plantain peels' extracts (200 and 400 mg/kg) on sexual behavior, hormonal profiles [testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH)], and enzymes [acetylcholinesterase (AChE), phosphodiesterase-5' (PDE-5), arginase, angiotensin-I converting enzyme (ACE), ecto-5'neucleotidase, and adenosine deaminase (ADA)] in paroxetine (PAR)-induced penile dysfunction rats. From the result, arginase, PDE-5', ACE, ecto-5'-nucleotidase ADA, and AChE activities, sexual activities, hormonal profile, and NO level were reduced, while thiobarbituric acid reactive species (TBARS) level increased (p < .05) relative to normal control rats. However, treatment with UPP and URP reduced the activities of these enzymes, decreased TBARS levels, and increased hormones, and penile NO levels in PAR-induced rats. Thus, the use of UPP and RPP could be channeled towards the improvement of sexual performance in erectile dysfunction (ED) disorder. PRACTICAL APPLICATIONS: Plantain fruits are a tropical staple food crop commonly consumed at various stages of ripeness and cooking methods. However, its peels are regarded as a waste product with reported cases of environmental menace. Interestingly, plantain peel is being used as a major raw material for industrial applications in the agro-based industries and in folklore for the treatment of many human ailments due to its rich phytochemicals such as polyphenols, carotenoids, alkaloids, etc., which have been reported. A prelude study has also indicated its usefulness in ED management, but further pharmacological investigations are needed to proffer information on its effect in ED management and its anti-androgenic activity in male Wistar rats. The information from this study could be of pharmaceutical importance in designing natural remedies capable of improving penile rigidity, hormone profiles, and alteration of enzymes linked with ED.
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Affiliation(s)
- Sunday Idowu Oyeleye
- Department of Biomedical Technology, Federal University of Technology, Akure, Nigeria.,Department of Biochemistry, Federal University of Technology, Akure, Nigeria
| | - Tosin Abiola Olasehinde
- Department of Biochemistry, Federal University of Technology, Akure, Nigeria.,Nutrition and Toxicology Division, Food Technology Department, Federal Institute of Industrial Research Oshodi, Lagos, Nigeria
| | | | - Ganiyu Oboh
- Department of Biomedical Technology, Federal University of Technology, Akure, Nigeria
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12
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Marinaro J, Goldstein M. Microsurgical Management of Male Infertility: Compelling Evidence That Collaboration with Qualified Male Reproductive Urologists Enhances Assisted Reproductive Technology (ART) Outcomes. J Clin Med 2022; 11:jcm11154593. [PMID: 35956208 PMCID: PMC9369943 DOI: 10.3390/jcm11154593] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
A male factor plays a significant role in a couple's reproductive success. Today, advances in reproductive technology, such as intracytoplasmic sperm injection (ICSI), have allowed it to be possible for just a single sperm to fertilize an egg, thus, overcoming many of the traditional barriers to male fertility, such as a low sperm count, impaired motility, and abnormal morphology. Given these advances in reproductive technology, it has been questioned whether a reproductive urologist is needed for the evaluation and treatment of infertile and subfertile men. In this review, we aim to provide compelling evidence that collaboration between reproductive endocrinologists and reproductive urologists is essential for optimizing a couple's fertility outcomes, as well as for improving the health of infertile men and providing cost-effective care.
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Affiliation(s)
- Jessica Marinaro
- Department of Urology, Weill Cornell Medicine, New York, NY 10065, USA
| | - Marc Goldstein
- Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, 525 East 68th St., Starr Pavilion, 9th Floor (Starr 900), New York, NY 10065, USA
- Correspondence:
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13
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Kashiwagi E, Shiota M, Naganuma H, Monji K, Imada K, Lee K, Matsumoto T, Takeuchi A, Inokuchi J, Eto M. Testosterone level in seminal vesicle fluid is a better indicator of erectile function than serum testosterone in patients with prostate cancer. Int J Urol 2022; 29:1155-1162. [PMID: 35717139 DOI: 10.1111/iju.14953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Semen comprises prostatic fluid and seminal vesicle fluid, and seminal vesicle fluid contains various factors such as prostaglandin E2 (PGE2), zinc, and testosterone, which play important roles in sperm motility. It is not known whether these factors affect erectile function. In this study, we investigated factors in seminal vesicle fluid that may affect erectile function. METHODS After receiving institutional review board approval, we collected seminal vesicle fluid samples from 134 Japanese patients with localized prostate cancer who underwent robot-assisted radical prostatectomy. We examined the relationship between the results of the Sexual Health Inventory for Men (SHIM), erection hardness score, an original questionnaire on the presence or absence of sexual desire, and concentrations of several factors in seminal vesicle fluid (testosterone, PGE2, transforming growth factor β1, and 8-hydroxy-2-deoxyguanosine), as well as the serum testosterone level. RESULTS Median participant age was 67 (range 51-77) years. Median concentrations were as follows: seminal vesicle testosterone 1.85 (range 0.17-4.32) ng/ml and serum testosterone 4.60 (range 1.75-10.82) ng/ml. When the SHIM score was divided into two groups, seminal vesicle testosterone concentration was significantly increased (p = 0.002) in participants with a SHIM score ≥17, and no significant difference was observed in serum testosterone levels (p = 0.661). Multivariate analysis revealed that seminal vesicle testosterone was significantly correlated with the SHIM score (≥17 vs. <17; odds ratio 2.137, 95% confidence interval 1.148-3.978, p = 0.016). CONCLUSIONS Testosterone levels in seminal vesicle fluid can reflect erectile function in patients with prostate cancer, suggesting that seminal vesicle testosterone is very important for male erectile function.
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Affiliation(s)
- Eiji Kashiwagi
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Hidekazu Naganuma
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Keisuke Monji
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Kenjiro Imada
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Ken Lee
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Takashi Matsumoto
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Ario Takeuchi
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Junichi Inokuchi
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
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14
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Morgado A, Silva AC, Diniz P, Silva CM. Can we rely on total testosterone measurement to exclude hypogonadism in erectile dysfunction? Int J Impot Res 2022:10.1038/s41443-022-00565-5. [DOI: 10.1038/s41443-022-00565-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 03/01/2022] [Accepted: 03/15/2022] [Indexed: 11/09/2022]
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15
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Canpolat S, Ulker N, Yardimci A, Tancan E, Sahin E, Yaman SO, Bulmuş O, Alver A, Ozcan M. Irisin ameliorates male sexual dysfunction in paroxetine-treated male rats. Psychoneuroendocrinology 2022; 136:105597. [PMID: 34861466 DOI: 10.1016/j.psyneuen.2021.105597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 01/23/2023]
Abstract
Sexual dysfunction is a common clinical condition due to different causes including the use of selective serotonin reuptake inhibitors (SSRI). Especially, SSRI paroxetine is known to cause numerous types of sexual dysfunction in men. There is growing interest in exercise as a non-pharmacological approach for the treatment of SSRI-induced sexual dysfunction. With these in mind, we investigated the effects of irisin, which is a recently detected exercise-linked hormone, on paroxetine-induced sexual dysfunction in male rats. Our findings showed that circulating irisin levels were lower in paroxetine-induced sexual dysfunction in male rats (20 mg/kg/day for 8 weeks by oral gavage than in vehicle-treated rats). In addition, results from sexual behavioral tests revealed that subcutaneous irisin perfusion (100 ng/kg/day via mini-osmotic pumps for 28 days) ameliorated sexual motivation and copulatory performance in sexually impaired male rats treated with paroxetine. The significantly reduced serum testosterone levels and α1-adrenoceptors (ADRA1A) and tyrosine hydroxylase gene (TH) expression levels in the nucleus accumbens (NAc) in paroxetine-induced sexually dysfunctioning male rats were markedly increased following irisin exposure. Similarly, the expression levels of ADRA1A and TH in the medial preoptic area (mPOA) significantly increased in male rats co-administered with paroxetine and irisin compared to the vehicle-treated male rats. These results demonstrate that irisin may be a therapeutic modality that mimics/supports the beneficial effects of exercise for improving SSRI-associated sexual dysfunction in men through increase in serum testosterone levels and increased expression of α1-adrenoceptors and TH in the NAc and mPOA associated with sexual motivation and copulatory behaviors.
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Affiliation(s)
- Sinan Canpolat
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Nazife Ulker
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Ahmet Yardimci
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Emre Tancan
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Elif Sahin
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Serap Ozer Yaman
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ozgur Bulmuş
- Department of Physiology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Ahmet Alver
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mete Ozcan
- Department of Biophysics, Faculty of Medicine, Firat University, Elazig, Turkey
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16
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Estradiol-Testosterone Imbalance Is Associated with Erectile Dysfunction in Patients with Klinefelter Syndrome. J Clin Med 2021; 10:jcm10112319. [PMID: 34073338 PMCID: PMC8197918 DOI: 10.3390/jcm10112319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
Erectile dysfunction (ED) is a frequent sexual disorder in adult men. Klinefelter syndrome (KS) is the most common sex chromosomal disorder and a frequent cause of male hypogonadism. Psychological and cognitive aspects are quite typical in KS and have been linked to ED, while the role of testosterone (T) levels in sexual function of KS subjects has not been fully elucidated. The purpose of the present study is to investigate the role of hormonal disturbances in erectile function of subjects with KS. We conducted a retrospective study involving 52 Klinefelter patients newly diagnosed who never received androgen replacing therapy. All the subjects underwent medical history, accurate physical examination, and blood tests. The International Index of Erectile Function questionnaire (IIEF-EF) score correlated negatively with estradiol/testosterone ratio (E2/T); this correlation remained statistically significant after correction for age (ρ −0.320 p = 0.018). A multiple linear regression analysis identified age and E2/T as the main predictors of IIEF-EF score (R2 0.169 F = 3.848 p = 0.008). Our findings corroborate previous KS data obtained in the general population showing an association between higher E2/T ratio and impaired erectile function. Larger studies are required to better elucidate the pathophysiology of ED in patients with KS.
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17
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Farook F, Al Meshrafi A, Mohamed Nizam N, Al Shammari A. The Association Between Periodontitis and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Am J Mens Health 2021; 15:15579883211007277. [PMID: 34013796 PMCID: PMC8142012 DOI: 10.1177/15579883211007277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/21/2022] Open
Abstract
The objective of this study is to investigate the association between periodontitis (PD) and erectile dysfunction (ED).A systematic review and meta-analysis on data was extracted and conducted according to PRISMA. Relevant articles were selected from a literature search using MEDLINE, EMBASE, Scopus, Web of Science and CENTRAL from inception until August 2, 2020. Both randomized and nonrandomized controlled studies were included. Case reports, case series, nonsystematic reviews and trials published as abstract were excluded. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to estimate the association between PD and the risk of ED. The meta-analysis was conducted with RevMan 5.3. Methodological quality assessment was carried out using the Newcastle-Ottawa Quality Assessment Scale and the quality of evidence was assessed using the GRADE approach.Six articles (215008 subjects) were included for analysis. Of the participants, 38,675 cases were compared to 1,76,333 healthy controls. Based on the random effects model, periodontitis was associated with an increased risk of ED (OR = 2.56, 95% CI: 1.70-3.85) as compared with the non-periodontitis individuals. The findings were statistically significant with a p < .0001. The statistical heterogeneity was high across all studies (I2 = 98%, p < .00001). Estimates of total effects were generally consistent with the sensitivity and subgroup analyses.Within the limits of the available evidence, our review and meta-analysis showed that a significant association exists between the PD and ED. The results should be interpreted with caution due to high degree of inconsistency across all the studies.
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Affiliation(s)
- Fathima Farook
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Azzam Al Meshrafi
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | | | - Abdulsalam Al Shammari
- College of Dentistry, King Saud Bin Abdulaziz University For Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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18
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Lee TH, Wani WA, Lee CH, Cheng KK, Shreaz S, Wong S, Hamdan N, Azmi NA. Edible Bird's Nest: The Functional Values of the Prized Animal-Based Bioproduct From Southeast Asia-A Review. Front Pharmacol 2021; 12:626233. [PMID: 33953670 PMCID: PMC8089372 DOI: 10.3389/fphar.2021.626233] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
Edible Bird's Nest (EBN) is the most prized health delicacy among the Chinese population in the world. Although some scientific characterization and its bioactivities have been studied and researched, no lights have been shed on its actual composition or mechanism. The aim of this review paper is to address the advances of EBN as a therapeutic animal bioproduct, challenges and future perspectives of research involving EBN. The methodology of this review primarily involved a thorough search from the literature undertaken on Web of Science (WoS) using the keyword "edible bird nest". Other information were obtained from the field/market in Malaysia, one of the largest EBN-producing countries. This article collects and describes the publications related to EBN and its therapeutic with diverse functional values. EBN extracts display anti-aging effects, inhibition of influenza virus infection, alternative traditional medicine in athletes and cancer patients, corneal wound healing effects, stimulation of proliferation of human adipose-derived stem cells, potentiate of mitogenic response, epidermal growth factor-like activities, enhancement of bone strength and dermal thickness, eye care, neuroprotective and antioxidant effects. In-depth literature study based on scientific findings were carried out on EBN and its properties. More importantly, the future direction of EBN in research and development as health-promoting ingredients in food and the potential treatment of certain diseases have been outlined.
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Affiliation(s)
- Ting Hun Lee
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia.,Innovation Centre in Agritechnology for Advanced Bioprocessing, Universiti Teknologi Malaysia, Pagoh Research Center, Johor Darul Takzim, Malaysia
| | - Waseem A Wani
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Chia Hau Lee
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Kian Kai Cheng
- Innovation Centre in Agritechnology for Advanced Bioprocessing, Universiti Teknologi Malaysia, Pagoh Research Center, Johor Darul Takzim, Malaysia
| | - Sheikh Shreaz
- Oral Microbiology General Facility Laboratory, Faculty of Dentistry, Health Sciences Center, Kuwait University, Safat, Kuwait
| | - Syieluing Wong
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Norfadilah Hamdan
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Nurul Alia Azmi
- School of Chemical and Energy Engineering, Faculty of Engineering, Universiti Teknologi Malaysia, Johor, Malaysia
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19
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de Oliveira AA, Nunes KP. Hypertension and Erectile Dysfunction: Breaking Down the Challenges. Am J Hypertens 2021; 34:134-142. [PMID: 32866225 DOI: 10.1093/ajh/hpaa143] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/15/2020] [Accepted: 08/29/2020] [Indexed: 02/07/2023] Open
Abstract
A diagnostic of hypertension increases the risk of erectile dysfunction (ED); likewise, ED can be an early sign of hypertension. In both cases, there is evidence that endothelial dysfunction is a common link between the 2 conditions. During hypertension, the sustained and widespread release of procontractile factors (e.g., angiotensin II, endothelin 1, and aldosterone) impairs the balance between vasoconstrictors and vasodilators and, in turn, detrimentally impacts vascular and erectile structures. This prohypertensive state associates with an enhancement in the generation of reactive oxygen species, which is not compensated by internal antioxidant mechanisms. Recently, the innate immune system, mainly via Toll-like receptor 4, has also been shown to actively contribute to the pathophysiology of hypertension and ED not only by inducing oxidative stress but also by sustaining a low-grade inflammatory state. Furthermore, some drugs used to treat hypertension can cause ED and, consequently, reduce compliance with the prescribed pharmacotherapy. To break down these challenges, in this review, we focus on discussing the well-established as well as the emerging mechanisms linking hypertension and ED with an emphasis on the signaling network of the vasculature and corpora cavernosa, the vascular-like structure of the penis.
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Affiliation(s)
- Amanda Almeida de Oliveira
- Laboratory of Vascular Physiology, Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, Melbourne, Florida, USA
| | - Kenia Pedrosa Nunes
- Laboratory of Vascular Physiology, Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, Melbourne, Florida, USA
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20
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Yang R, Liu C, Li Q, Wang W, Wu B, Chen A, Wang B, Li W, Chen J. Artificial intelligence based identification of the functional role of hirudin in diabetic erectile dysfunction treatment. Pharmacol Res 2021; 163:105244. [PMID: 33053440 DOI: 10.1016/j.phrs.2020.105244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
Diabetic erectile dysfunction (DED) hugely affected the patients' sexual life quality. However, there are no satisfactory therapeutic methods and intervention targets for this subtype of erectile dysfunction (ED). Inspired by the clinical practice of traditional Chinese medicine (TCM), we found that hirudin, the main active ingredient in the leech, could ameliorate the ED symptoms of the DED mouse model. To further reveal the underlying mechanism of hirudin, we designed a novel strategy to discover potential targets based on the diagnostic system of TCM, and found that myeloperoxidase (MPO) was a promising target of hirudin. Hirudin directly interacts with MPO and inhibits its activity, thus further decreases the content of oxidized low-density lipoprotein (ox-LDL) in serum. Our results demonstrated that the hirudin could ameliorate the symptoms of DED, and revealed the underlying mechanism of hirudin in regulating the activity of MPO.
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Affiliation(s)
- Ruocong Yang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Chao Liu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Qianqian Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Weilu Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bingbing Wu
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Aiping Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China
| | - Bin Wang
- Department of Andrology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Wei Li
- State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jianxin Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, 100029, China.
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21
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Zhang L, Dun X, Hou G, Zheng Y, Ju D, Meng P, Liu F, Yuan J, Jin L, Jiang T, Gao M, Yuan J. Construction and internal validation of a prediction nomogram for acquired premature ejaculation (APE) in PE patients. Andrology 2020; 9:886-893. [PMID: 33289965 PMCID: PMC8247358 DOI: 10.1111/andr.12956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 01/23/2023]
Abstract
Background A predictive model for acquired premature ejaculation (APE) in PE patients has not yet been established. Objectives This study was aimed at determining which factors were independently associated with the possibility of predicting APE in PE patients, and whether an effective pre‐treatment nomogram for predicting their individual chances of being APE in PE patients can be developed. Materials and methods We analyzed the medical histories of 915 PE patients diagnosed at Xijing Hospital (Xi'an, China) and Northwest Women's and Children's Hospital (Xi'an, China) between May 2019 and May 2020. The diagnostic nomogram was developed using a multivariate logistic regression model by integrating selected significant variables determined through univariate analysis. Receiver operating characteristic curves were used to measure the predictive accuracy of the nomogram and its constituted variables, and calibrations were performed by making a comparison of nomogram‐predicted probability with actual rate of APE. Results The independent predictors for APE that were identified include Age, Intra‐vaginal Ejaculation Latency Time (IELT), Frequency of sexual desire (FSD), and Eysenck Personality Questionnaire‐Revised Short Scale for Chinese (psychoticism) [EPQ‐RSC(P)] scores. The predictive accuracy of the nomogram was 0.782 (95% CI: 0.723–0.841). Also, excellent agreement was demonstrated between the nomogram‐predicted probability and the actual rate of APE. Discussion and conclusion We identified 4 independent predictors for APE and demonstrated the potential significant differences in psychoticism between LPE and APE patients. This was the first internally validated predictive APE nomogram where good discrimination and calibration were applied, and it offers a promising role in clinical practice. More studies are necessary for verification of its universal applicability.
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Affiliation(s)
- Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xinlong Dun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Zheng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Dongen Ju
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ping Meng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fei Liu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jiarui Yuan
- St. George's University School of Medicine, West Indies, Grenada
| | - Long Jin
- Department of Nuclear Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Tao Jiang
- Department of Preventive Medicine, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.,Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Yu S, Han B, Bai X, Liu S, Xing X, Zhao D, Liu M, Wang S. The cold-soaking extract of Chinese yam (Dioscorea opposita Thunb.) protects against erectile dysfunction by ameliorating testicular function in hydrocortisone-induced KDS-Yang rats and in oxidatively damaged TM3 cells. JOURNAL OF ETHNOPHARMACOLOGY 2020; 263:113223. [PMID: 32791294 DOI: 10.1016/j.jep.2020.113223] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/13/2020] [Accepted: 07/26/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Clinical applications and pharmacological research suggest that Dioscorea opposita Thunb. (Chinese yam), a well-known traditional Chinese medicine which has been used for more than 2000 years to nourish kidney-yang and protect the male reproductive system, might be efficacious for the treatment of erectile dysfunction (ED). AIM OF THE STUDY This study aimed to investigate the active component extract of Chinese yam, determine its effectiveness in hydrocortisone-induced "kidney-yang deficiency syndrome" (KDS-Yang) rats and in oxidatively damaged TM3 cells and explore the underlying mechanism on restoring erectile function. MATERIALS AND METHODS We clarified the Chinese yam cold-soaking extract (CYCSE) as the main active extract of Chinese yam by a CCK8 assay and further identified its composition. The KDS-Yang rats were induced by intragastric administration of hydrocortisone. After 10 d of CYCSE intervention, cavernous and testis morphology were stained with hematoxylin and eosin. Inducible nitric oxide synthase (iNOS), cyclic guanosine monophosphate (cGMP), testosterone, 8-hydroxy-2-deoxyguanosine (8-OHdG) and superoxide dismutase (SOD) levels were detected by enzyme-linked immunosorbent assay kits. Leydig cells were performed using immunohistochemistry. Reactive oxygen species were measured using a DCFH-DA fluorescent probe, and testicular collagenous fibers were stained with a Masson kit. Detection of testicular apoptosis was performed by a TUNEL assay. Nrf2 and NQO1 mRNA expression levels were measured by qRT-PCR. The protein expression levels of Nrf2, HO-1, TGF-β1 and SMAD2/3 were analyzed by Western blot. RESULTS We demonstrated in KDS-Yang rats and oxidatively damaged TM3 cells that CYCSE successfully restored erectile function through ameliorating testicular function. Our data suggested that CYCSE can stimulate the NO/cGMP pathway and restore the cavernous morphology to protect against KDS-Yang-induced ED. It also protected testis morphology, increased Leydig cell proliferation and stimulated testosterone secretion. In the damaged testes, excessive increases in 8-OHdG and inhibition of SOD activity were ameliorated, and the Nrf2/HO-1 signaling pathway was enhanced after treatment with CYCSE, indicating that the antioxidant defense system was activated. These findings were also validated in vitro. Additionally, fibrosis of the testes and TM3 cells was reversed by CYCSE through the TGF-β1/SMAD2/3 pathway. CONCLUSION CYCSE has a therapeutic effect on KDS-Yang-induced ED, and the mechanism includes stimulation of testosterone secretion, resistance to oxidative stress and prevention of fibrosis. These findings provide a new scientific verification for the application of Chinese yam in the treatment of KDS-Yang-induced ED.
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Affiliation(s)
- Shiting Yu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Bing Han
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Xueyuan Bai
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Shichao Liu
- Academic Affairs Office, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Xin Xing
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Daqing Zhao
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Meichen Liu
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
| | - Siming Wang
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, 1035 Boshuo Road, Changchun, Jilin Province, 130117, China.
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De Rocco Ponce M, Garolla A, Caretta N, De Toni L, Avogaro A, Foresta C. Estradiol correlates with erectile dysfunction and its severity in type 2 diabetic patients. J Diabetes Complications 2020; 34:107728. [PMID: 33028498 DOI: 10.1016/j.jdiacomp.2020.107728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/31/2020] [Indexed: 01/17/2023]
Abstract
AIMS Erectile dysfunction (ED) is a frequent microvascular complication of type 2 diabetes mellitus (T2DM). Hormonal derangements such as hypogonadism and hyperestrogenism are common in T2DM. Our aim was to investigate the relationship between estrogens and ED in diabetic patients. METHODS We performed a retrospective study on 57 patients with T2DM suffering from ED. ED was assessed with the International Index of Erectile Function questionnaire (IIEF-5) and penile color-doppler ultrasound (PCDU). Blood tests included glycated hemoglobin, lipid profile, total testosterone (T), and estradiol (E2). RESULTS E2 was negatively correlated with IIEF-5 score after correction for age, diabetes duration, BMI, HbA1c, LDL- and HDL-cholesterol, T and PSA (r = -0.457, p < 0.01). Patients in the higher E2 quartile, had statistically higher probability of severe ED (61.5%). In the same patients, the PCDU demonstrated a statistically longer Acceleration Time (120.0 ± 24.5, p = 0.048) indicating an impaired arterial flow. CONCLUSIONS In diabetic patients, higher E2 is associated with worse erectile function and impaired cavernous arterial flow. Diabetic patients with high E2 are more prone to severe ED. It could be suggested to include estradiol measurement in the hormonal assessment of ED in patients with T2DM.
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Affiliation(s)
- Maurizio De Rocco Ponce
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Andrea Garolla
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Nicola Caretta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Luca De Toni
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Angelo Avogaro
- Department of Medicine, Section of Diabetes and Metabolic Diseases, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Carlo Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
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Zhuravleva ZD, Johansson A, Jern P. Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms. J Sex Med 2020; 18:265-274. [PMID: 33243692 DOI: 10.1016/j.jsxm.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The association between erectile dysfunction (ED), free testosterone (T), and androgenic genetic polymorphisms is still unclear. As most studies in the field have focused on older (>40 y.o.) men, data from young men is scarce. In addition, the clinically observed comorbidity between ED and premature ejaculation (PE) has not been explained. AIM The aim of the present study was 3-fold: to assess in a sample of young men (1) the association between ED and T; (2) the role of androgenic genetic polymorphisms in the aforementioned association; and (3) comorbidity between ED and PE symptoms. METHODS Statistical analyses were performed on a population-based sample of 2,302 Finnish men, (Mage = 26.8 years). Hormone samples were available from 317 men, and genotype information was available from a minimum of 1,144 men depending on genetic locus. For twin analyses, the sample contained 533 male individuals from opposite-sex fraternal twin pairs, 491 identical male individuals (110 complete pairs), 493 male individuals from male fraternal twin pairs (92 complete pairs), and 658 siblings of twins. OUTCOMES The main outcome measure includes association between levels of salivary T and ED, main effects of the androgen-related genetic polymorphisms on ED scores. Bivariate twin models of PE and ED were fitted to elucidate possible shared etiology. RESULTS We found no significant association between T levels and ED and no significant main effects of the androgenic genetic polymorphisms on ED. We found no evidence suggesting that any of the genetic polymorphisms would moderate the association between T and ED symptoms. We found shared unique environmental influences between PE and ED (rE = .28). CLINICAL TRANSLATION Obtained data suggest that ED has T-independent causes and that any comorbidity between PE and ED is not explained by a set of genes affecting both phenotypes. STRENGTHS & LIMITATIONS First, the sample size for both parts of the study was relatively small, which may make some statistical analyses underpowered. Furthermore, as the sample was a population-based sample of relatively young men, the number of clinically relevant ED cases was low. Second, some concerns about T derived from saliva exist because saliva sampling comes with increased risks of error particularly because saliva samples are more vulnerable to contamination. CONCLUSION We found no significant association between free T levels, androgenic genetic polymorphisms, and ED in the younger age cohort. Twin analysis suggested a common nonshared environmental component in PE and ED. Zhuravleva1 ZD, Johansson A, Jern P. Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms. J Sex Med 2021;18:265-274.
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Affiliation(s)
- Zoia D Zhuravleva
- Department of Fundamental and Applied Research, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia.
| | - Ada Johansson
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Patrick Jern
- Department of Psychology, Åbo Akademi University, Turku, Finland
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25
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Sun W, Bi LK, Xie DD, Yu DX. Serum nesfatin-1 is associated with testosterone and the severity of erectile dysfunction. Andrologia 2020; 52:e13634. [PMID: 32427366 DOI: 10.1111/and.13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 11/27/2022] Open
Abstract
This cross-sectional study aimed to evaluate serum nesfatin-1 concentrations in patients with erectile dysfunction (ED). Patients with ED were selected from the Department of Urology of the Second Affiliated Hospital of Anhui Medical University. The International Index of Erectile Function-5 (IIEF-5) was used to evaluate the severity of ED. Serum nesfatin-1 and gonadal hormone levels, including luteinising hormone (LH), follicle-stimulating hormone (FSH) and testosterone were measured. The IIEF-5 scores (t = -21.034, p < .001) and nesfatin-1 levels (t = -7.043, p < .001) in patients with ED were significantly lower than in healthy controls. Moreover, patients with ED showed decreased testosterone levels (t = -3.478, p = .001), whereas there were no significant differences in serum levels of FSH (t = -0.088, p = .930) and LH (t = 1.114, p = .270) between the two groups. Furthermore, positive relationships were found between serum nesfatin-1 and testosterone concentrations (r = .742, p = .001) and IIEF-5 scores (r = .395, p = .009) in ED patients. Additionally, based on receiver operating characteristic curve analysis, the area under curve for nesfatin-1 was 0.884 with 83.3% sensitivity and 81.4% specificity in discriminating ED patients from healthy controls. The decrease in serum nesfatin-1 level may be related to testosterone and the severity of ED.
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Affiliation(s)
- Wei Sun
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Liang-Kuan Bi
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dong-Dong Xie
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - De-Xin Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Hernández-Cerda J, Bertomeu-González V, Zuazola P, Cordero A. Understanding Erectile Dysfunction in Hypertensive Patients: The Need for Good Patient Management. Vasc Health Risk Manag 2020; 16:231-239. [PMID: 32606719 PMCID: PMC7297457 DOI: 10.2147/vhrm.s223331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022] Open
Abstract
Erectile dysfunction (ED) is defined as a man’s consistent or recurrent inability to attain and/or maintain penile erection enough for successful vaginal intercourse. ED affects a large part of the population, increasing its incidence with age and comorbidities. It is estimated by the year 2025, 322 million men will suffer from ED. Incidence of ED has been related not only to chronic diseases such as diabetes mellitus, metabolic syndrome, hyperlipidemia, psychiatric diseases or urinary tract diseases, but also to hypertension and especially to antihypertensive treatments. This review summarizes current knowledge about the management of ED in hypertensive men and its role as cardiovascular disease predictor.
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Affiliation(s)
- Jorge Hernández-Cerda
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Spain
| | - Vicente Bertomeu-González
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Pilar Zuazola
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
| | - Alberto Cordero
- Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain.,Departamento de Medicina Clínica, Universidad Miguel Hernández, Elche, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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27
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Tatem AJ, Holland LC, Kovac J, Beilan JA, Lipshultz LI. Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature. Transl Androl Urol 2020; 9:S186-S194. [PMID: 32257859 PMCID: PMC7108994 DOI: 10.21037/tau.2019.11.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Testosterone is an archetypal androgenic-anabolic steroid (AAS), while its exogenous administration is considered to be the gold standard for the treatment of male hypogonadism. The benefits are not due to its intrinsic nature alone but are due to the result of its interactions with the androgen receptor (AR). As the management of hypogonadism continues to advance into the modern era, it would be preferable for modern andrologists to have multiple tools at their disposal to influence AR activity. Nandrolone, or 19-nortestosterone, is one such compound. In the following review of the literature, we examine the history, pharmacology, and clinical applications of this medication. We also present the results of our novel pilot study examining the favorable effects of nandrolone on joint pain for hypogonadal men.
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Affiliation(s)
| | - Levi C Holland
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Jason Kovac
- Men's Health Center, Urology of Indiana, Greenwood, IN, USA
| | | | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
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28
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Lim CAR, Nightingale TE, Elliott S, Krassioukov AV. Lifestyle modifications and pharmacological approaches to improve sexual function and satisfaction in men with spinal cord injury: a narrative review. Spinal Cord 2019; 58:391-401. [PMID: 31857687 DOI: 10.1038/s41393-019-0404-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022]
Abstract
STUDY DESIGN A narrative review describing various components of sexual dysfunction in men with spinal cord injury (SCI), as well as addressing potential therapeutic approaches. OBJECTIVES Restoration of sexual function is considered one of the most important health priorities for individuals with SCI. The purpose of this review is to provide information regarding the factors that are less appreciated when considering changes to sexual function in men with SCI. We also propose therapeutic approaches, with a focus on lifestyle modifications, which have been shown to improve sexual function. METHODS A literature search was performed and limited evidence for therapeutic approaches in individuals with SCI was supplemented by consistent findings from the able-bodied population. RESULTS We evaluated the less addressed factors known to contribute to sexual dysfunction in men with SCI, including hormonal influences (i.e., testosterone deficiency, thyroid hormone, and cortisol), psychological factors (i.e., pain, fatigue, depression, and body image), and secondary SCI complications (i.e., urinary tract infection, pressure sores, and autonomic dysreflexia). To address these factors beyond standard medical treatments for sexual dysfunction, options include physical activity/exercise, diet, and specific medications for symptom relief (i.e., testosterone replacement therapy and selective serotonin reuptake inhibitors for depression). CONCLUSIONS Physical activity's potential application, efficacy across multiple aspects of sexuality, and the lack of side effects, suggests that long-term exercise is a viable solution to directly or indirectly improve sexual function in males with SCI. Diet and supplemental medications may further promote body composition changes, which more broadly affect sexuality.
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Affiliation(s)
- Chloe A R Lim
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Tom E Nightingale
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
| | - Stacy Elliott
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.,BC Centre for Sexual Medicine, Vancouver Coastal Health, Vancouver, BC, Canada.,Departments of Psychiatry and Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. .,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada. .,GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada.
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29
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Tahtali İN. Is testosterone replacement an effective treatment of secondary premature ejaculation? Andrologia 2019; 52:e13452. [DOI: 10.1111/and.13452] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/14/2019] [Accepted: 03/28/2019] [Indexed: 12/20/2022] Open
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30
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Kaufman JM, Lapauw B, Mahmoud A, T'Sjoen G, Huhtaniemi IT. Aging and the Male Reproductive System. Endocr Rev 2019; 40:906-972. [PMID: 30888401 DOI: 10.1210/er.2018-00178] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/27/2018] [Indexed: 12/21/2022]
Abstract
This narrative review presents an overview of current knowledge on fertility and reproductive hormone changes in aging men, the factors driving and modulating these changes, their clinical consequences, and the benefits and risks of testosterone (T) therapy. Aging is accompanied by moderate decline of gamete quality and fertility. Population mean levels show a mild total T decline, an SHBG increase, a steeper free T decline, and a moderate LH increase with important contribution of comorbidities (e.g., obesity) to these changes. Sexual symptoms and lower hematocrit are associated with low T and are partly responsive to T therapy. The relationship of serum T with body composition and metabolic health is bidirectional; limited beneficial effects of T therapy on body composition have only marginal effects on metabolic health and physical function. Skeletal changes are associated primarily with estradiol and SHBG. Cognitive decline is not consistently linked to low T and is not improved by T therapy. Although limited evidence links moderate androgen decline with depressive symptoms, T therapy has small beneficial effects on mood, depressive symptoms, and vitality in elderly patients with low T. Suboptimal T (and/or DHT) has been associated with increased risk of stroke, but not of ischemic heart disease, whereas an association with mortality probably reflects that low T is a marker of poor health. Globally, neither severity of clinical consequences attributable to low T nor the nature and magnitude of beneficial treatment effects justify the concept of some broadly applied "T replacement therapy" in older men with low T. Moreover, long-term safety of T therapy is not established.
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Affiliation(s)
- Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Bruno Lapauw
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Ahmed Mahmoud
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Ilpo Tapani Huhtaniemi
- Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom.,Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
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31
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Morgado A, Moura ML, Dinis P, Silva CM. Current stepwise recommendations for hypogonadism screening in erectile dysfunction are not cost-effective. Int J Impot Res 2019; 32:297-301. [PMID: 31243352 DOI: 10.1038/s41443-019-0169-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/16/2019] [Accepted: 05/28/2019] [Indexed: 11/09/2022]
Abstract
Hypogonadism is a prevalent comorbidity with erectile disfunction (ED) and current guidelines recommend screening for hypogonadism with total testosterone (TT). If low TT is detected, further assessment with LH and SHBG plus albumin are needed to establish an etiology and treatment. Our primary objective was to determine the cost benefit of current stepwise approach versus ad initium full hormonal assessment. Two hundred consecutive male patients referred for ED were screened after consent and 81 were included and assessed for hypogonadism according to the current stepwise approach with TT, and only if TT was less than 345 ng/mL, a full hormonal assessment with TT, LH, and SHBG plus albumin to calculate free testosterone was performed. Direct costs were calculated using the national public healthcare system reimbursement tables and were compared with a hypothetical initial full hormonal assessment. Screening TT was less than 345 ng/mL in 34.6% patients leading to a full hormonal assessment on these. Using a stepwise approach there was a direct cost increase of 5.82 € per patient. Moreover, one out of every three patients had two extra venipunctures and an additional follow-up appointment. Current stepwise recommendations may prove costly in high prevalence scenarios such as the ED subpopulation as a direct cost increase was observed.
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Affiliation(s)
- Afonso Morgado
- Serviço de Urologia, Centro Hospitalar Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal. .,Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | | | - Paulo Dinis
- Serviço de Urologia, Centro Hospitalar Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal.,Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Carlos Martins Silva
- Serviço de Urologia, Centro Hospitalar Universitário São João, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal.,Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Bae YJ, Reinelt J, Netto J, Uhlig M, Willenberg A, Ceglarek U, Villringer A, Thiery J, Gaebler M, Kratzsch J. Salivary cortisone, as a biomarker for psychosocial stress, is associated with state anxiety and heart rate. Psychoneuroendocrinology 2019; 101:35-41. [PMID: 30408721 DOI: 10.1016/j.psyneuen.2018.10.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/25/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Stress activates the central nervous, the autonomic nervous, and the endocrine system. This study aimed to (1) test the usability of salivary cortisone in a standardized psychosocial stressor, (2) create a comprehensive profile of hormonal responses to determine laboratory parameters with high discriminatory power, and (3) analyze their association with psychometric and autonomic stress measures. METHODS Healthy young men (18-35 years) completed either the Trier Social Stress Test (TSST) (n = 33) or a Placebo-TSST (n = 34). Blood and saliva were collected at 14 time points along with state-anxiety (STAI) and heart rate. Serum steroids (cortisol*, cortisone*, dehydroepiandrosterone-sulfate, androstenedione*, progesterone*, 17-hydroxyprogesterone*, testosterone, estradiol*, aldosterone*), salivary cortisol* and cortisone*, copeptin*, adrenocorticoptropic hormone*, corticosteroid-binding globulin, and salivary alpha-amylase* were analyzed. We used mixed-design ANOVAs to test group differences, receiver operator characteristic (ROC) curve analyses to assess the discriminatory power of each measure, and Spearman correlation analyses to probe the association between measures. RESULTS The largest area under the ROC curve was observed in salivary cortisone at 20 min after the end of the TSST (AUC = 0.909 ± 0.044, p < 0.0001). Significant time-by-group interactions were found in the parameters marked with * above, indicating stress-induced increases. The peak response of salivary cortisone was significantly associated with those of STAI (rho = 0.477, p = 0.016) and heart rate (rho = 0.699, p < 0.0001) in the TSST group. CONCLUSION Our study found salivary cortisone to be a stress biomarker with high discriminatory power and significant correlations with subjective and autonomic stress measures. Our results can inform future stress studies of sampling time for different laboratory parameters.
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Affiliation(s)
- Yoon Ju Bae
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany
| | - Janis Reinelt
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany
| | - Jeffrey Netto
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany
| | - Marie Uhlig
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany
| | - Anja Willenberg
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany; Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany; Mind Brain Body Institute at the Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Luisenstraße 56, 10117, Berlin, Germany
| | - Joachim Thiery
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany
| | - Michael Gaebler
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Stephanstraße 1a, 04103, Leipzig, Germany; Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Philipp-Rosenthal-Straße 27, 04103, Leipzig, Germany; Mind Brain Body Institute at the Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Luisenstraße 56, 10117, Berlin, Germany
| | - Juergen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Paul-List Strasse 13-15, 04103, Leipzig, Germany.
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Abstract
OBJECTIVES To evaluate the association between handgrip strength and erectile dysfunction (ED) in community-dwelling older men. METHODS This cross-sectional study included 1771 participants of the Dong-gu Study. Handgrip strength was measured with a handheld dynamometer. ED was assessed with the Korean version of the International Index of Erectile Function (IIEF). ED was categorized as none to mild (IIEF-EF scores of 13-30) and moderate to severe (IIEF-EF scores of 0-12). Multivariable logistic regression was conducted with adjustment for potential confounders. RESULTS The proportion of men with moderate to severe ED was 48.8%. The age-adjusted ED score increased with increasing quartile of handgrip strength (11.0, 12.4, 13.4, and 14.0 in the lowest, second, third, and highest quartiles, respectively). After adjustment for potential confounders, greater handgrip strength was associated with a lower risk of ED (odds ratio (OR): 0.82 per 5 kg; 95% confidence interval (CI): 0.74-0.90). In addition, a high level of moderate to vigorous physical activity was associated with a lower risk of ED (OR: 0.75; 95% CI: 0.61-0.93). CONCLUSION In this study, aging men with greater handgrip strength had a lower risk of ED. This result suggests that reduced physical functioning may contribute to ED.
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Affiliation(s)
- Ho Seok Chung
- a Department of Urology , Chonnam National University Medical School , Gwangju , Republic of Korea
| | - Min-Ho Shin
- b Department of Preventive Medicine , Chonnam National University Medical School , Gwangju , Republic of Korea
| | - Kwangsung Park
- a Department of Urology , Chonnam National University Medical School , Gwangju , Republic of Korea
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The effect of diet on BPH, LUTS and ED. World J Urol 2018; 37:1001-1005. [PMID: 30470872 DOI: 10.1007/s00345-018-2568-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are common conditions that increase in the aging population. Several environmental factors have been linked to the development and progression of BPH and ED. Several studies have shown potential direct and indirect influences of several micronutrients and macronutrients on the risk of developing these conditions. We reviewed the available published literature of the effect of diet on BPH and ED. METHODS A comprehensive search was performed to identify studies that evaluated how diet affected males with BPH and ED. Searches were run on July 5th, 2018 in the following databases: Ovid MEDLINE®; Ovid EMBASE; and The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL). There were no language restrictions, publication date restrictions, or article type restrictions on the search strategy. RESULTS We retrieved a total of 1670 results across all databases. After removing any duplicated results, 2 independent reviewers screened a total of 1325 citations. A total of 35 articles were selected for inclusion in this review. Diet is an important factor affecting the risk of development of BPH and ED. Several studies have shown the effect of dietary interventions for BPH and ED. DISCUSSION A better understanding diet and its relative effects on the development, treatment and prevention of these diseases are an important area of further research for the given aging male population.
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Altmann T, Roth M. 2D:4D digit ratio and its relations to cross-sex and same-sex friendship choices. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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36
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Khan HL, Bhatti S, Abbas S, Khan YL, Gonzalez RMM, Aslamkhan M, Gonzalez GR, Aydin HH. Serotonin transporter (5-HTTLPR) genotypes and trinucleotide repeats of androgen receptor exert a combinatorial effect on hormonal milieu in patients with lifelong premature ejaculation. Andrology 2018; 6:916-926. [DOI: 10.1111/andr.12518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 04/26/2018] [Accepted: 06/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- H. L. Khan
- Lahore Institute of Fertility and Endocrinology; Hameed Latif Hospital; Lahore Pakistan
| | - S. Bhatti
- Lahore Institute of Fertility and Endocrinology; Hameed Latif Hospital; Lahore Pakistan
- Department of Human Genetics and Molecular biology; University of Health Sciences; Lahore Pakistan
- Department of Medical Education; Rashid Latif Medical College; Lahore Pakistan
| | - S. Abbas
- Lahore Institute of Fertility and Endocrinology; Hameed Latif Hospital; Lahore Pakistan
| | - Y. L. Khan
- Lahore Institute of Fertility and Endocrinology; Hameed Latif Hospital; Lahore Pakistan
| | - R. M. M. Gonzalez
- Centro de investigacion Biomedica de Occidente; IMSS; Uiversidad de Guadalajara; Guadalajara Jalisco Maxico
| | - M. Aslamkhan
- Department of Human Genetics and Molecular biology; University of Health Sciences; Lahore Pakistan
| | - G. R. Gonzalez
- Universidad De Guadalajara CIBO; IMSS; Guadalajara Jalisco Maxico
| | - H. H. Aydin
- Department of Medical Biochemistry; Ege University School of Medicine; Bornova Izmir Turkey
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Su DM, Feng Y, Wang L, Wu YL, Ge RS, Ma X. Influence of fetal Leydig cells on the development of adult Leydig cell population in rats. J Reprod Dev 2018. [PMID: 29515056 PMCID: PMC6021611 DOI: 10.1262/jrd.2017-102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Leydig cells are the main endogenous testosterone synthesis cells in the body. Testosterone is an essential hormone in males that affects metabolism, emotion, and pubertal development.
However, little is known about the development of Leydig cells and relationship between fetal Leydig cells (FLCs) and adult Leydig cells (ALCs). The aims of this study were to investigate
the effect of (FLCs) on ALC development. Our study showed that FLCs in neonatal rat testis can be eliminated by 100 mg/kg ethane dimethane sulfonate (EDS) treatment without affecting the
health of newborn rats. Immunohistological results showed that eliminating FLCs led to early re-generation of the ALC population (progenitor Leydig cells [PLCs] and ALCs) accompanied at
first by increased and then by decreased serum testosterone, indicating that ALCs which appeared after neonatal EDS treatment were degenerated or had attenuated functions. Our results showed
that FLCs were eliminated 4 days after EDS treatment, the ALC population regenerated by 21 days, and serum testosterone levels dramatically decreased at 56 days. Collectively, our results
indicate that the ablation of FLCs in neonatal rat results in abnormal development of ALCs. Our study further indicates that abnormal development of Leydig cells in the fetal stage leads to
steroid hormone disorders, such as testosterone deficiency, in the adult stage. Therefore, studies of Leydig cell development are important for understanding the pathogenesis of testosterone
deficiency or pubertas praecox.
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Affiliation(s)
- Dong-Mei Su
- West China Hospital, West China School of Clinical Medicine, Sichuan University, Chengdu 610041, China
| | - Ying Feng
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Lin Wang
- Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Yi-Lun Wu
- Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Ren-Shan Ge
- Center of Scientific Research, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang 325027, China
| | - Xue Ma
- Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu 610041, China
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Boeri L, Capogrosso P, Ventimiglia E, Cazzaniga W, Pederzoli F, Moretti D, Dehò F, Montanari E, Montorsi F, Salonia A. Does Calculated Free Testosterone Overcome Total Testosterone in Protecting From Sexual Symptom Impairment? Findings of a Cross-Sectional Study. J Sex Med 2018; 14:1549-1557. [PMID: 29198510 DOI: 10.1016/j.jsxm.2017.10.070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/17/2017] [Accepted: 10/27/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although erectile dysfunction (ED) has been associated with low circulating total testosterone (TT) levels, the utility of free testosterone (FT) over TT is debatable. AIM To assess the relative impact of low TT and low calculated FT (cFT) on androgen-related sexual symptoms in men with ED. METHODS Data from 485 men were analyzed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF) and the Beck Inventory for Depression (BDI). Descriptive statistics tested differences between patients with normal TT levels (>3 ng/mL) and normal cFT levels (>65 pg/mL; group 1) and men with normal TT and low cFT (group 2), low TT and normal cFT (group 3), and low TT and low cFT (group 4). Linear regression models tested the association between clinical predictors and sexual function impairment. OUTCOMES We assessed the impact of different hormonal categories on androgen-related symptoms and the clinical utility of measuring cFT in men with ED. RESULTS Groups 1, 2, 3, and 4 were composed of 338 (69.6%), 44 (9.1%), 34 (7.0%), and 69 (14.3%) patients, respectively. Compared with group 1, patients in group 2 were older (P < .001), had a higher body mass index (P < .01), and had a larger proportion with CCI scores of at least 1 (P = .006). Likewise, group 2 presented lower scores for the IIEF erectile function (P = .07), sexual desire (P = .04), and orgasmic function (P = .007) domains and lower BDI scores (P = .02) than group 1. Similar findings were found for group 4 vs 1. Conversely, patients in group 3 had similar scores on the questionnaires to those in group 1. Low cFT and normal or low TT achieved independent predictor status for pathologic IIEF domains and BDI scores after accounting for age, CCI, and body mass index. Conversely, low TT and normal cFT status was not associated with pathologic scores on the questionnaires. CLINICAL IMPLICATIONS The inclusion of cFT in the first-line assessment of hypogonadal symptoms in men with ED has major clinical utility. STRENGTHS AND LIMITATIONS This is the first study evaluating the concomitant impact of TT and cFT on men with ED using well-validated instruments to assess patients' sexuality and depressive symptoms. Limitations are the retrospective nature of the study and lack of physical function data and bone ultrasound measurements. CONCLUSIONS Although normal cFT was not associated with signs and symptoms suggestive of testosterone deficiency, even when concomitant with low TT or low cFT irrespective of TT values, it was indicative of poorer clinical profiles and impaired sexual and depressive parameters compared with normal TT and normal cFT in a cohort of patients with ED. Boeri L, Capogrosso P, Ventimiglia E, et al. Does Calculated Free Testosterone Overcome Total Testosterone in Protecting From Sexual Symptom Impairment? Findings of a Cross-Sectional Study. J Sex Med 2017;14:1549-1557.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Department of Urology, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Donatella Moretti
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Federico Dehò
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, IRCCS Fondazione Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy.
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Translational Perspective on the Role of Testosterone in Sexual Function and Dysfunction. J Sex Med 2017; 13:1183-98. [PMID: 27436075 DOI: 10.1016/j.jsxm.2016.06.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/13/2016] [Accepted: 06/09/2016] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The biological importance of testosterone is generally accepted by the medical community; however, controversy focuses on its relevance to sexual function and the sexual response, and our understanding of the extent of its role in this area is evolving. AIM To provide scientific evidence examining the role of testosterone at the cellular and molecular levels as it pertains to normal erectile physiology and the development of erectile dysfunction and to assist in guiding successful therapeutic interventions for androgen-dependent sexual dysfunction. METHODS In this White Paper, the Basic Science Committee of the Sexual Medicine Society of North America assessed the current basic science literature examining the role of testosterone in sexual function and dysfunction. RESULTS Testosterone plays an important role in sexual function through multiple processes: physiologic (stimulates activity of nitric oxide synthase), developmental (establishes and maintains the structural and functional integrity of the penis), neural (development, maintenance, function, and plasticity of the cavernous nerve and pelvic ganglia), therapeutically for dysfunctional regulation (beneficial effect on aging, diabetes, and prostatectomy), and phosphodiesterase type 5 inhibition (testosterone supplement to counteract phosphodiesterase type 5 inhibitor resistance). CONCLUSION Despite controversies concerning testosterone with regard to sexual function, basic science studies provide incontrovertible evidence for a significant role of testosterone in sexual function and suggest that properly administered testosterone therapy is potentially advantageous for treating male sexual dysfunction.
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Wan X, Wang H, Ji Z. Microsurgical varicocelectomy for clinical varicocele: A review for potential new indications. Andrologia 2017; 49. [PMID: 28671268 DOI: 10.1111/and.12827] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
- X. Wan
- Department of Liver Surgery; Peking Union Medical College Hospital; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - H. Wang
- Department of Urology; Peking Union Medical College Hospital; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
| | - Z. Ji
- Department of Urology; Peking Union Medical College Hospital; Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing China
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Chen X, Yang D, Lin G, Bao J, Wang J, Tan W. Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis. Andrologia 2017; 49. [PMID: 28378913 DOI: 10.1111/and.12778] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 01/14/2023] Open
Affiliation(s)
- X. Chen
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - D. Yang
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - G. Lin
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - J. Bao
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - J. Wang
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
| | - W. Tan
- Department of Urology; Nanfang Hospital; Southern Medical University; Guangzhou China
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Turkay R, Inci E, Yenice MG, Tugcu V. Shear wave elastography: Can it be a new radiologic approach for the diagnosis of erectile dysfunction? ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2017; 25:150-155. [PMID: 29410690 DOI: 10.1177/1742271x17697512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/02/2017] [Indexed: 01/12/2023]
Abstract
Introduction Erectile dysfunction (ED) is a common health problem among males, and radiology has limited use in its diagnosis and treatment. Shear wave elastography (SWE) is a new sonographic technique. In this study, we examined the significance of SWE in the diagnosis of ED. Methods The study included a total number of 70 participants. The mean age of the participants was 54.14 ± 8.03 years (range: 39 and 71 years old). We composed two groups. Group 1 had 35 patients who presented to the urology clinic in our hospital complaining of ED, and had a score of 17 or lower from the International Index of Erectile Function (IIEF) questionnaire. Group 2 consisted of 35 healthy volunteers who did not have ED. SWE measurements were performed from corpus cavernosum penis in both groups, and the results were noted. Differences between the groups were evaluated statistically. Results The difference between the mean SWE measurements of two groups (Group 1: 20.94 ± 6.23 kPa and group 2: 24.63 ± 7.58 kPa) was found to be statistically significant (p = 0.027; p < 0.05). For a cut-off value of 17.1 kPa, the SWE method has specificity, sensitivity, positive predictive value, and negative predictive value regarding diagnosis of ED as 94.29%, 34.29%, 85.71%, and 58.93%, respectively. The mean age of the groups did not show a statistically significant difference (p = 0.287; p > 0.05). Conclusions Due to its high specificity and positive predictive value, SWE can offer useful data in the radiologic evaluation of ED cases.
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Corona G, Isidori AM, Aversa A, Burnett AL, Maggi M. Endocrinologic Control of Men's Sexual Desire and Arousal/Erection. J Sex Med 2016; 13:317-37. [PMID: 26944463 DOI: 10.1016/j.jsxm.2016.01.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Several hormones and neurotransmitters orchestrate men's sexual response, including the appetitive (sexual desire) and consummative (arousal and penile erection) phases. AIM To provide an overview and recommendations regarding endocrinologic control of sexual desire and arousal and erection and their disturbances. METHODS Medical literature was reviewed by the subcommittee of the International Consultation of Sexual Medicine, followed by extensive internal discussion, and then public presentation and discussion with other experts. The role of pituitary (prolactin, oxytocin, growth hormone, and α-melanocyte-stimulating hormone), thyroid, and testicular hormones was scrutinized and discussed. MAIN OUTCOME MEASURES Recommendations were based on grading of evidence-based medical literature, followed by interactive discussion. RESULTS Testosterone has a primary role in controlling and synchronizing male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire that can be successfully corrected by appropriate treatments. Oxytocin and α-melanocyte-stimulating hormone are important in eliciting sexual arousal; however, use of these peptides, or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases. CONCLUSION Endocrine abnormalities are common in patients with sexual dysfunction. Their identification and treatment is strongly encouraged in disturbances of sexual desire and arousal.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL Bologna, Maggiore-Bellaria Hospital, Bologna, Italy.
| | - Andrea M Isidori
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Aversa
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Deptartment of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy
| | - Arthur L Burnett
- Department of Urology, the James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Biomedical, Clinical and Experimental Sciences, University of Florence, Florence, Italy
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Ji B, Jin XB. Varicocele is associated with hypogonadism and impaired erectile function: a prospective comparative study. Andrologia 2016; 49. [PMID: 27595632 DOI: 10.1111/and.12683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 12/11/2022] Open
Affiliation(s)
- B. Ji
- Department of Urology; Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
- Department of Urology; Qingdao 3rd People's Hospital; Qingdao Shandong China
| | - X.-b. Jin
- Department of Urology; Provincial Hospital Affiliated to Shandong University; Jinan Shandong China
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Wu F, Chen T, Mao S, Jiang H, Ding Q, Xu G. Levels of estradiol and testosterone are altered in Chinese men with sexual dysfunction. Andrology 2016; 4:932-8. [PMID: 27152758 DOI: 10.1111/andr.12195] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 02/08/2016] [Accepted: 03/10/2016] [Indexed: 01/23/2023]
Affiliation(s)
- F. Wu
- Department of Urology; Huashan Hospital; Fudan University; Shanghai China
| | - T. Chen
- Department of Urology and Andrology; Center for Reproductive Medicine; Shandong University; Shandong Provincial Key Laboratory of Reproductive Medicine; National Research Center for Assisted Reproductive Technology and Reproductive Genetics; The Key Laboratory for Reproductive Endocrinology of Ministry of Education; Jinan China
| | - S. Mao
- Department of Urology; Huashan Hospital; Fudan University; Shanghai China
| | - H. Jiang
- Department of Urology; Huashan Hospital; Fudan University; Shanghai China
| | - Q. Ding
- Department of Urology; Huashan Hospital; Fudan University; Shanghai China
| | - G. Xu
- Department of Urology; Huashan Hospital; Fudan University; Shanghai China
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Jenkins LC, Mulhall JP. Impact of Prostate Cancer Treatments on Sexual Health. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zhao C, Kwan Park J. Phosphodiesterase Type 5 Inhibitor and Erectile Dysfunction in Lower Urinary Tract Symptoms. Low Urin Tract Symptoms 2015; 4 Suppl 1:75-80. [PMID: 26676704 DOI: 10.1111/j.1757-5672.2011.00121.x] [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] [Indexed: 01/10/2023]
Abstract
Benign prostatic hyperplasia (BPH) is one of the most common diseases in older men and mostly induces lower urinary tract symptoms (LUTS). Multiple studies have shown that BPH inducing LUTS are intensely correlated with erectile dysfunction (ED) and that severity of LUTS was proportional to ED severity. Although a direct causal relationship has not been clarified, a tentative pathophysiology has been suggested to interpret the relationship between two disorders. Androgen plays an important role in the maintenance of the functional and structural integrity of the lower urinary tract and penis. Low testosterone, especially free testosterone, worsened detrusor overactivity and replacement of testosterone improved LUTS in the hypogonadal BPH patients. Nitric oxide synthase and nitric oxide are decreased in the transition zone of the hyperplastic prostate but phosphodiesterase types 4, 5, 11 are prominent in transition zone of hyperplastic prostate. Phosphodiesterase type 5 (PDE5) inhibitor with a long half-life could obtain the desired effect; therefore, tadalafil and undenafil frequently have been used to evaluate the effects in the two disorders. In clinical trials, tadalafil showed improvement of BPH-induced LUTS, but few of the studies showed a significant improvement on uroflowmetry. PDE5 inhibitors increase the concentration of cyclic guanosine monophosphate (cGMP) in plasma and smooth muscle, promoting erection of the penis, as well as relaxation of the bladder neck and prostate, leading to natural voiding. Sexual function and LUTS should be assessed and discussed with the patient when choosing the appropriate strategy and the patient's response to treatment should also be evaluated at the same time.
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Affiliation(s)
- Chen Zhao
- Department of Urology, Medical School, and Institute for Medical Sciences, and Research Institute of Chonbuk National University, Chonbuk National University Hospital, Jeonbuk, Korea
| | - Jong Kwan Park
- Department of Urology, Medical School, and Institute for Medical Sciences, and Research Institute of Chonbuk National University, Chonbuk National University Hospital, Jeonbuk, Korea
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Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril 2015; 104:1051-60. [PMID: 26385403 DOI: 10.1016/j.fertnstert.2015.08.033] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/17/2015] [Accepted: 08/26/2015] [Indexed: 12/31/2022]
Abstract
Orgasm and ejaculation are two separate physiological processes that are sometimes difficult to distinguish. Orgasm is an intense transient peak sensation of intense pleasure creating an altered state of consciousness associated with reported physical changes. Antegrade ejaculation is a complex physiological process that is composed of two phases (emission and expulsion), and is influenced by intricate neurological and hormonal pathways. Despite the many published research projects dealing with the physiology of orgasm and ejaculation, much about this topic is still unknown. Ejaculatory dysfunction is a common disorder, and currently has no definitive cure. Understanding the complex physiology of orgasm and ejaculation allows the development of therapeutic targets for ejaculatory dysfunction. In this article, we summarize the current literature on the physiology of orgasm and ejaculation, starting with a brief description of the anatomy of sex organs and the physiology of erection. Then, we describe the physiology of orgasm and ejaculation detailing the neuronal, neurochemical, and hormonal control of the ejaculation process.
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