1
|
Indirli R, Lanzi V, Arosio M, Mantovani G, Ferrante E. The association of hypogonadism with depression and its treatments. Front Endocrinol (Lausanne) 2023; 14:1198437. [PMID: 37635965 PMCID: PMC10449581 DOI: 10.3389/fendo.2023.1198437] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
According to World Health Organization estimates, 5% of the adult population worldwide suffers from depression. In addition to the affective, psychomotor and cognitive symptoms which characterize this mood disorder, sexual dysfunction has been frequently reported among men suffering from depression. The most common sexual manifestations are decreased libido, erectile dysfunction and orgasmic disorder. In addition, epidemiological studies have documented a reduction of testosterone concentrations in men with depression and, for these reasons, depressive disorders appear as one possible cause of male functional hypogonadism. Moreover, some largely used antidepressant medications can cause or worsen sexual complaints, thus depression and its treatments rise several andrological-relevant issues. The other way round, men with hypogonadism can manifest depressed mood, anxiety, insomnia, memory impairment which, if mild, may respond to testosterone replacement therapy (TRT). However, the prevalence of functional hypogonadism in depression, and of depressive symptoms in hypogonadal men, is not known. Severe depressive symptoms do not respond to TRT, while the effect of treating major depression on functional hypogonadism, has not been investigated. Overall, the clinical relevance of each condition to the other, as well as the physiopathological underpinnings of their relationship, are still to be clarified. The present review summarizes current evidence on the influence of testosterone on mood and of depression on the hypothalamic-pituitary-testis axis; the clinical association between male hypogonadism and depression; and the reciprocal effects of respective treatments.
Collapse
Affiliation(s)
- Rita Indirli
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Valeria Lanzi
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Arosio
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Emanuele Ferrante
- Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
2
|
Lee MJ, Gamaldo A, Peters ME, Roy D, Gamaldo CE, Sierra-Arce M, Chow A, Vargas I, Dziedzic P, Buenaver L, Salas RME. Assessing Sleep Concerns in Individuals With Acquired Brain Injury: The Feasibility of a Smartpad Sleep Tool. J Neuropsychiatry Clin Neurosci 2022; 33:225-229. [PMID: 33706533 DOI: 10.1176/appi.neuropsych.20060172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The investigators examined the presence of disrupted sleep in acquired brain injury (ABI) and the utility of a mobile health program, MySleepScript, as an effective clinical tool to detect sleep disturbances. METHODS A cross-sectional pilot study of MySleepScript, a customizable electronic battery of validated sleep questionnaires, was conducted. Participants were recruited at the Acquired Brain Injury Clinic at Johns Hopkins Bayview Medical Center. RESULTS Sixty-eight adults with ABI (mean age, 46.3 years [SD=14.8]) participated in the study, with a mean completion time of 16.6 minutes (SD=5.4). Time to completion did not differ on individual completion or staff assistance. The mean score on the Pittsburgh Sleep Quality Index was 9.2 (SD=4.7); 83.9% of individuals had poor sleep quality (defined as a score >5). Insomnia Severity Index scores indicated moderate to severe insomnia in 45% of participants; 36.5% of participants screened positive for symptoms concerning sleep apnea, while 39.3% of individuals screened positive for restless legs syndrome. CONCLUSIONS Poor sleep quality was highly prevalent in this ABI cohort. MySleepScript may be an effective method of assessing for sleep disturbance in ABI. Further efforts to identify sleep disorders in this patient population should be pursued to optimize ABI management.
Collapse
Affiliation(s)
- Moon J Lee
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Alyssa Gamaldo
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Matthew E Peters
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Durga Roy
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Charlene E Gamaldo
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Marcela Sierra-Arce
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Amanda Chow
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Irene Vargas
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Peter Dziedzic
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Luis Buenaver
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| | - Rachel Marie E Salas
- Departments of Neurology (Lee, C.E. Gamaldo, Dziedzic, Salas), Psychiatry and Behavioral Sciences (Peters, Roy, Buenaver), and Biology (Sierra-Arce, Vargas), Johns Hopkins Medicine, Baltimore; Human Development and Family Studies, Pennsylvania State University, State College, Pa. (A. Gamaldo); and Johns Hopkins University, Undergraduate Program in Public Health Studies, Baltimore (Chow)
| |
Collapse
|
3
|
Zhang F, Xiong Y, Qin F, Yuan J. Short Sleep Duration and Erectile Dysfunction: A Review of the Literature. Nat Sci Sleep 2022; 14:1945-1961. [PMID: 36325277 PMCID: PMC9621223 DOI: 10.2147/nss.s375571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
The meaning of sleep has puzzled people for millennia. In modern society, short sleep duration is becoming a global problem. It has been established that short sleep duration can increase the risk of several diseases, such as cardiovascular and metabolic diseases. Currently, a growing body of research has revealed a possible link between sleep disorders and erectile dysfunction (ED). However, the mechanisms linking short sleep duration and ED are largely unknown. Thus, we provide a review of clinical trials and animal studies. In this review, we propose putative pathways connecting short sleep duration and ED, including neuroendocrine pathways and molecular mechanisms, aiming to pave the way for future research. Meanwhile, the assessment and improvement of sleep quality should be recommended in the diagnosis and treatment of ED patients.
Collapse
Affiliation(s)
- Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| |
Collapse
|
4
|
Wang Y, Salas RME. Approach to Common Sleep Disorders. Semin Neurol 2021; 41:781-794. [PMID: 34826879 DOI: 10.1055/s-0041-1726364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Sleep disorders are highly relevant in clinical practice given their prevalence as well as their impact on health outcomes and quality of life. The most common concerns are excessive daytime sleepiness, insomnia, disordered breathing, and abnormal movements or behaviors during sleep. A detailed but targeted history is vital, particularly from the sleep partner/witness. In-laboratory sleep testing (polysomnography and multiple sleep latency test) remains vital in the diagnosis of certain sleep disorders (such as sleep-disordered breathing and central hypersomnia) and in specific populations (such as in children and individuals with comorbid medical disorders). Advances in technology have allowed for a variety of methods in assessing a patient's sleep, from compact devices to evaluate for sleep apnea, wrist actigraphy, and mobile device-based applications. As the pathophysiology of various sleep disorders becomes better elucidated, disease-specific medications have been developed for these conditions. Nonetheless, a multidisciplinary approach to management is necessary, including improving sleep hygiene and cognitive behavioral therapy.
Collapse
Affiliation(s)
- Yujie Wang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachel Marie E Salas
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
5
|
Abstract
Sleep has increasingly been found to play a role in the overall health of an individual, but sleep quality has also been decreasing with the invasion of technology into the bedroom, “always-on” lifestyles, and increasing demands on one’s time when awake. We have herein reviewed the literature to assess the impact of sleep on erectile dysfunction, lower urinary tract symptoms, hypogonadal symptoms, low testosterone, and male infertility. We find that erectile dysfunction, lower urinary tract symptoms, and hypogonadal symptoms all have a linear relationship with sleep, as worse symptoms occur with poorer sleep. Male infertility, interestingly, has an inverse U-shaped relation to sleep in which men with too little and too much sleep seem to be more at risk for infertility than those with 7–8 hours of sleep. Finally, the literature has not demonstrated a significant clinical relationship between hypogonadal symptoms or testosterone levels and sleep. Overall, a large number of men experience poor quality sleep. Given the impact that poor sleep can have on general health and men’s health, in particular, screening for poor sleep quality and recommending interventions to improve sleep are becoming imperative during clinical evaluation and treatment.
Collapse
Affiliation(s)
- Taylor P Kohn
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jaden R Kohn
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nora M Haney
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|