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Combined Effects of Oligopeptides Isolated from Panax ginseng C.A. Meyer and Ostrea gigas Thunberg on Sexual Function in Male Mice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052349. [PMID: 33670840 PMCID: PMC7967744 DOI: 10.3390/ijerph18052349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/20/2021] [Accepted: 02/24/2021] [Indexed: 11/22/2022]
Abstract
Male sexual debility affects patients’ confidence and damages the relationship between the couples and thus affects the stability of the family. This study aimed to investigate the effects of oligopeptides isolated from ginseng and oyster (GOPs and OOPs), separately and in combination, on sexual function in male mice. In the first experiment, male mice were randomly divided into five groups: vehicle control group; whey protein (125.0 mg kg−1) group; and GOPs 62.5, 125.0, and 250.0 mg kg−1 groups. In the second experiment, male mice were randomly divided into five groups: vehicle control group, whey protein (160.0 mg kg−1) group, and OOPs 80.0, 160.0, and 320.0 mg kg−1 groups. In the third experiment, male mice were randomly divided into six groups: vehicle control group, whey protein (222.5 mg kg−1) group, and GOPs + OOPs 62.5 + 160.0, 62.5 + 320.0, and 125.0 + 160.0, 125.0 + 320.0 mg kg−1 groups. Test substances were given by gavage once a day for 30 days. The sexual behavior parameters, serum nitric oxide (NO), testosterone, cyclic guanosine monophosphate (cGMP), and phosphodiesterase-5 (PDE5) concentrations were detected. We found that GOPs at 250.0 mg kg−1 improved male sexual behavior, NO, and testosterone content, whereas GOPs at 62.5 and 125.0 mg kg−1 and OOPs at 80.0, 160, and 320 mg kg−1 did not have significant effects. The combination of 62.5 mg kg−1 GOPs + 160.0 mg kg−1 OOPs and the combination of 125.0 mg kg−1 GOPs + 320.0 mg kg−1 OOPs improved male sexual behavior, serum NO, testosterone, and cGMP contents and decreased PDE5 content. The combination of 62.5 mg kg−1 GOPs and 160.0 mg kg−1 OOPs had the best effects among four combined groups. These results suggested that GOPs in combination with OOPs had the synergistic effects of enhancing male sexual function, probably via elevating serum testosterone, NO, and corpus cavernosum cGMP level and decreasing the corpus cavernosum PDE5 level. GOPs and OOPs could be novel natural agents for improving male sexual function.
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Kubo S, Yasui T, Matsuura Y, Tomotake M. Differences in male climacteric symptoms with aging among rotating night shift workers. Aging Male 2020; 23:995-1003. [PMID: 31397630 DOI: 10.1080/13685538.2019.1650264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to clarify the actual status of male climacteric symptoms in rotating night shift workers and how to cope with the symptoms. METHODS We planned a self-administered questionnaire survey in male rotating night shift workers. Male climacteric symptoms were evaluated by using the Aging Males' Symptoms (AMS) scale. RESULTS Of 1891 questionnaires that were sent, 1561 were collected. There were significant differences in total AMS scores among the age groups. In all age groups, there were high proportions of men with increased need for sleep and often feeling tired (64.9%) and decrease in muscular strength (60.7%). There were significant differences in AMS scores for somatic symptoms between men in their 20 s and those in their 40 s or 50 s and between men in their 30 s and those in their 50 s and in AMS scores for sexual symptoms between men in their 20 s and those in their 30 s, 40 s, 50 s or 60 s, between men in their 30 s and those in their 40 s, 50 s or 60 s and between men in their 40 s and those in their 50 s or 60 s. CONCLUSION Significant age-dependent differences are found in somatic symptoms and sexual symptoms in rotating night shift workers.
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Affiliation(s)
- Sachiko Kubo
- Graduate School of Health Sciences, Tokushima University, Tokushima, Japan
- Faculty of Nursing, Shikoku University, Tokushima, Japan
| | - Toshiyuki Yasui
- Department of Reproductive and Menopausal Medicine, Tokushima University Graduate School, Tokushima, Japan
| | - Yukie Matsuura
- Department of Reproductive and Menopausal Medicine, Tokushima University Graduate School, Tokushima, Japan
| | - Masahito Tomotake
- Department of Mental Health, Tokushima University Graduate School, Tokushima, Japan
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Chen YZ, Chiang PK, Lin WR, Chen M, Chow YC, Chiu AW, Tsai WK. The relationship between androgen deprivation therapy and depression symptoms in patients with prostate cancer. Aging Male 2020; 23:629-634. [PMID: 30651026 DOI: 10.1080/13685538.2018.1560404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
AIM In this study, we administered a questionnaire to consecutive prostate cancer patients who received androgen deprivation therapy (ADT) for understanding the prevalence of depression symptoms. MATERIALS AND METHODS We retrospectively identified patients with prostate adenocarcinoma who received ADT between January 2015 and February 2018 at Mackay Memorial Hospital. The patients were then asked to complete the Chinese version of the Patient Health Questionnaire-9 (PHQ-9) during an interview. The patients were divided into two groups according to PHQ-9 score: those with depression symptoms (PHQ-9 ≥ 6, depression group), and those without depression symptoms (PHQ-9 < 6, non-depression group). Two groups were compared using t-tests and correlation coefficients, as appropriate. Statistical significance was set at p < .05. RESULTS There were no significant correlations between PHQ-9 scores and any of the parameters in the patients overall. In subgroup analysis, a positive correlation was found between the duration of ADT and PHQ-9 score in the patients with depression symptoms (p = .03). In addition, univariate analysis showed a positive association between the duration of ADT and PHQ-9 score, and a longer duration of ADT was further independently associated with increased PHQ-9 score in multivariate analysis in the patients with depression symptoms. CONCLUSION This study demonstrated that in patients with prostate cancer and depression symptoms, the severity of the depression symptoms was positively correlated with the duration of ADT. In contrast, this association was not found in patients without depression symptoms.
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Affiliation(s)
- Yi-Zhong Chen
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Pai-Kai Chiang
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- School of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Wun-Rong Lin
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- School of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Marcelo Chen
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- School of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Cosmetic Applications and Management, MacKay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Yung-Chiong Chow
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Cosmetic Applications and Management, MacKay Junior College of Medicine Nursing and Management, Taipei, Taiwan
| | - Allen W Chiu
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Kung Tsai
- Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- School of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Bai J, Xie J, Xing Y, Wang LT, Xie J, Yang F, Liu T, Liu M, Tang J, Yi Z, Qiu WW. Synthesis and biological evaluation of methylpyrimidine-fused tricyclic diterpene analogs as novel oral anti-late-onset hypogonadism agents. Eur J Med Chem 2019; 176:21-40. [DOI: 10.1016/j.ejmech.2019.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
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Testosterone Therapy: a Panacea for Sexual Dysfunction in Men? CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Xu W, Zhu Q, Zhang B, Liu S, Dai X, Gao C, Gao L, Cui Y. Protective effect of calretinin on testicular Leydig cells via the inhibition of apoptosis. Aging (Albany NY) 2018; 9:1269-1279. [PMID: 28437248 PMCID: PMC5425126 DOI: 10.18632/aging.101226] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/17/2017] [Indexed: 12/11/2022]
Abstract
The core mechanism of Late-onset hypogonadism (LOH) is the deficiency of androgen due to the functional and quantitative decline of testicular Leydig cells. Here we explored the protective effect of calretinin, a Ca2+-binding protein, on Leydig cells. We found in MLTC-1 cells transfected with LV-calb2, the cell viability and optical density (OD) were higher (p<0.05), cells in the S phase of the cell cycle were increased (p<0.01) and p-ERK1/2 and p-AKT levels were significantly higher (p<0.01 and p<0.05), while in R2C cells transfected with LV-siRNA-calb2, all of the results mentioned above were adverse (p<0.05). The cell apoptotic index after calretinin over-expressed was significantly lower (p<0.001), while the expression levels of mitochondria-related apoptotic factors such as cleaved caspase-9 and cytochrome C (cyto C) were lower and ratio of Bcl2/Bax was higher (p<0.05). After calretinin down-regulated, the apoptotic index was higher (p<0.05), while the expression levels of mitochondria-related apoptotic factors were higher and the ratio of Bcl2/Bax was lower (p<0.05). Therefore, calretinin increases Leydig cell viability and proliferation, possibly via ERK1/2 and AKT pathways, and suppresses apoptosis possibly via the mitochondria-related apoptotic pathway, which could be beneficial in understanding the pathophysiology of LOH and could lead to the study of new treatments.
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Affiliation(s)
- Wendan Xu
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Qian Zhu
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Bei Zhang
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Shan Liu
- Center of Reproductive Medicine, Bethune International Peace Hospital, Hebei Shijiazhuang, China
| | - Xiaonan Dai
- Nanjing Maternal and Child Care Service Center, Nanjing Medical University, Nanjing, 210005, China
| | - Chao Gao
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Li Gao
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Yugui Cui
- State Key Laboratory of Reproductive Medicine, Clinical Center of Reproductive Medicine, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China
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Ohlander SJ, Varghese B, Pastuszak AW. Erythrocytosis Following Testosterone Therapy. Sex Med Rev 2018; 6:77-85. [PMID: 28526632 PMCID: PMC5690890 DOI: 10.1016/j.sxmr.2017.04.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/09/2017] [Accepted: 04/14/2017] [Indexed: 12/18/2022]
Abstract
INTRODUCTION A rapid increase in awareness of androgen deficiency has led to substantial increases in prescribing of testosterone therapy (TTh), with benefits of improvements in mood, libido, bone density, muscle mass, body composition, energy, and cognition. However, TTh can be limited by its side effects, particularly erythrocytosis. This review examines the literature on testosterone-induced erythrocytosis and polycythemia. AIM To review the available literature on testosterone-induced erythrocytosis, discuss possible mechanisms for pathophysiology, determine the significance of formulation, and elucidate potential thromboembolic risk. METHODS A literature review was performed using PubMed for articles addressing TTh, erythrocytosis, and polycythemia. MAIN OUTCOME MEASURES Mechanism, pharmacologic contribution, and risk of testosterone-induced erythrocytosis. RESULTS For men undergoing TTh, the risk of developing erythrocytosis compared with controls is well established, with short-acting injectable formulations having the highest associated incidence. Potential mechanisms explaining the relation between TTh and erythrocytosis include the role of hepcidin, iron sequestration and turnover, erythropoietin production, bone marrow stimulation, and genetic factors. High blood viscosity increases the risk for potential vascular complications involving the coronary, cerebrovascular, and peripheral vascular circulations, although there is limited evidence supporting a relation between TTh and vascular complications. CONCLUSION Short-acting injectable testosterone is associated with greater risk of erythrocytosis compared with other formulations. The mechanism of the pathophysiology and its role on thromboembolic events remain unclear, although some data support an increased risk of cardiovascular events resulting from testosterone-induced erythrocytosis. Ohlander SJ, Varghese B, Pastuszak AW. Erythrocytosis Following Testosterone Therapy. Sex Med Rev 2018;6:77-85.
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Affiliation(s)
- Samuel J Ohlander
- University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | | | - Alexander W Pastuszak
- Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
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Zang ZJ, Tang HF, Tuo Y, Xing WJ, Ji SY, Gao Y, Deng CH. Effects of velvet antler polypeptide on sexual behavior and testosterone synthesis in aging male mice. Asian J Androl 2017; 18:613-9. [PMID: 26608944 PMCID: PMC4955189 DOI: 10.4103/1008-682x.166435] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Twenty-four-month-old male C57BL/6 mice with low serum testosterone levels were used as a late-onset hypogonadism (LOH) animal model for examining the effects of velvet antler polypeptide (VAP) on sexual function and testosterone synthesis. These mice received VAP for 5 consecutive weeks by daily gavage at doses of 100, 200, or 300 mg kg−1 body weight per day (n = 10 mice per dose). Control animals (n = 10) received the same weight-based volume of vehicle. Sexual behavior and testosterone levels in serum and interstitial tissue of testis were measured after the last administration of VAP. Furthermore, to investigate the mechanisms of how VAP affects sexual behavior and testosterone synthesis in vivo, the expression of steroidogenic acute regulatory protein (StAR), cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD) in Leydig cells was also measured by immunofluorescence staining and quantitative real-time PCR. As a result, VAP produced a significant improvement in the sexual function of these aging male mice. Serum testosterone level and intratesticular testosterone (ITT) concentration also increased in the VAP-treated groups. The expression of StAR, P450scc, and 3β-HSD was also found to be enhanced in the VAP-treated groups compared with the control group. Our results suggested that VAP was effective in improving sexual function in aging male mice. The effect of velvet antler on sexual function was due to the increased expression of several rate-limiting enzymes of testosterone synthesis (StAR, P450scc, and 3β-HSD) and the following promotion of testosterone synthesis in vivo.
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Affiliation(s)
- Zhi-Jun Zang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hong-Feng Tang
- Department of Dermatology, Shunde First People's Hospital Affiliated to Southern Medical University, Foshan, China
| | - Ying Tuo
- Department of Histopathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei-Jie Xing
- Center for Reproductive Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Su-Yun Ji
- Department of Dermatology, Guangdong Provincial Dermatology Hospital, Guangzhou, China
| | - Yong Gao
- Reproductive Medicine Centre and Guangdong Provincial Key Laboratory of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chun-Hua Deng
- Department of Urology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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DeLay KJ, Haney N, Hellstrom WJ. Modifying Risk Factors in the Management of Erectile Dysfunction: A Review. World J Mens Health 2016; 34:89-100. [PMID: 27574592 PMCID: PMC4999494 DOI: 10.5534/wjmh.2016.34.2.89] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process.
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Affiliation(s)
- Kenneth J DeLay
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nora Haney
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne Jg Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Okada K, Miyake H, Ishida T, Sumii K, Enatsu N, Chiba K, Matsushita K, Fujisawa M. Improved Lower Urinary Tract Symptoms Associated With Testosterone Replacement Therapy in Japanese Men With Late-Onset Hypogonadism. Am J Mens Health 2016; 12:1403-1408. [PMID: 27256990 DOI: 10.1177/1557988316652843] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This study aimed to investigate the effects of testosterone replacement therapy (TRT) on lower urinary tract symptoms (LUTS) in men with late-onset hypogonadism (LOH) and to identify parameters predicting the efficacy of TRT in improving LUTS. This study included 60 consecutive Japanese men who were diagnosed with LOH and subsequently received TRT between January 2009 and December 2014. In this series, 250 mg of testosterone was injected intramuscularly every 3 or 4 weeks in all patients. The following parameters were retrospectively reviewed: body mass index (BMI), Aging Male Symptom (AMS) score, International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5) score, residual urine volume, prostate volume, serum levels of the prostate-specific antigen (PSA), and total- and free-testosterone levels before and 6 months after TRT. No significant differences were observed in BMI, residual urine volume, or prostate volume between surveys before and after TRT. The AMS score, IPSS, and IIEF-5 score were significantly improved and significant increases were noted in the serum levels of PSA and total- and free-testosterone levels after TRT. An analysis of IPSS subscores documented the significant improvement in storage symptom scores, but not in voiding symptom scores after TRT. Multivariate analyses of parameters assessed in this study identified the pretreatment AMS score, posttreatment IIEF-5 score, and prostate volume as independent predictors of improvements in IPSS following TRT. This study revealed that TRT appeared to have considerable therapeutic effects on LUTS, particularly on storage symptoms, in men with LOH.
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Affiliation(s)
- Keisuke Okada
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hideaki Miyake
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Takaki Ishida
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kenta Sumii
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Noritoshi Enatsu
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Koji Chiba
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kei Matsushita
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Masato Fujisawa
- 1 Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
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Shigehara K, Miyagi T, Nakashima T, Izumi K, Kitagawa Y, Mizokami A, Koh E, Shimamura M, Namiki M. Effects of dutasteride on lower urinary tract symptoms: a prospective analysis based on changes in testosterone/dihydrotestosterone levels and total prostatic volume reduction. Aging Male 2016; 19:128-33. [PMID: 26890877 DOI: 10.3109/13685538.2016.1145205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This study analyzed the effects of dutasteride on lower urinary tract symptoms based on the association between changes in the total testosterone (TT)/dihydrotestosterone (DHT) levels and total prostate volume (TPV) reduction. Sixty participants diagnosed with benign prostatic hyperplasia were given 0.5 mg of dutasteride daily for 52 weeks. Measures of TT and DHT levels, TPV and uroflowmetry were obtained before and after dutasteride treatment. Forty-three patients demonstrated a TPV reduction of ≥5% (Group 1), whereas the remaining 17 patients demonstrated a TPV reduction of <5% (Group 2). DHT suppression and DHT/TT ratio at baseline were significantly higher in Group 1 than Group 2. International Prostate Symptom Scores (IPSS) and uroflowmetry were significantly improved in both groups. In Group 2, nine patients demonstrated some improvement in IPSS (Group 2A), whereas eight did not (Group 2B). The rate of TT increase and improvement in voiding symptoms were significantly higher in Group 2A than Group 2B. Dutasteride-induced TPV reduction is dependent on individual 5-α reductase inhibitor activity. Some patients demonstrating smaller dutasteride-induced TPV reduction may experience an improvement in voiding symptoms owing to an increased level of testosterone.
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Affiliation(s)
- Kazuyoshi Shigehara
- a Department of Urology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
- b Department of Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Tohru Miyagi
- a Department of Urology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - Takao Nakashima
- a Department of Urology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - Koji Izumi
- b Department of Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Yasuhide Kitagawa
- b Department of Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Atsushi Mizokami
- b Department of Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
| | - Eitetsu Koh
- c Department of Urology , Showa Inan Medical Hospital , Komagane , Japan , and
| | | | - Mikio Namiki
- b Department of Urology , Kanazawa University Graduate School of Medical Science , Kanazawa , Japan
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Jones SD, Dukovac T, Sangkum P, Yafi FA, Hellstrom WJG. Erythrocytosis and Polycythemia Secondary to Testosterone Replacement Therapy in the Aging Male. Sex Med Rev 2015; 3:101-112. [PMID: 27784544 DOI: 10.1002/smrj.43] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Testosterone replacement therapy (TRT) is a common treatment for hypogonadism in aging males. Men with low to low-normal levels of testosterone have documented benefit from hormone replacement. Recent meta-analyses have revealed that increases in hemoglobin (Hb) and hematocrit (Hct) are the variants most commonly encountered. Clinically, this response is described as erythrocytosis or polycythemia secondary to TRT. However, the recent Food and Drug Administration warning regarding the risk for venothromboembolism (VTE) has made the increases in Hb and Hct of more pertinent concern. The risks associated with androgen replacement need further examination. AIM To review the available literature on erythrocytosis and polycythemia secondary to TRT. To discuss potential etiologies for this response, the role it plays in risk for VTE, and recommendations for considering treatment in at-risk populations. METHODS A literature review was performed through PubMed regarding TRT and erythrocytosis and polycythemia. MAIN OUTCOME MEASURES To assess the mechanisms of TRT-induced erythrocytosis and polycythemia with regard to basic science, pharmacologic preparation, and route of delivery. To review Hct and risk for thrombotic events. To offer clinical suggestions for therapy in patients at risk for veno-thrombotic events. RESULTS Men undergoing TRT have a 315% greater risk for developing erythrocytosis (defined as Hct > 0.52) when compared with control. Mechanisms involving iron bioavailability, erythropoietin production, and bone marrow stimulation have been postulated to explain the erythrogenic effect of TRT. The association between TRT-induced erythrocytosis and subsequent risk for VTE remains inconclusive. CONCLUSIONS All TRT formulations cause increases in Hb and Hct, but injectables tend to produce the greatest effect. The evidence regarding the risk for VTE with increased Hct is inconclusive. For patients with risk factors for veno-thrombotic events, formulations that provide the smallest effect on blood parameters hypothetically provide the safest option. Further trials are needed to fully evaluate the hematological side effects associated with TRT. Jones SD Jr, Dukovac T, Sangkum P, Yafi FA, and Hellstrom WJG. Erythrocytosis and polycythemia secondary to testosterone replacement therapy in the aging male. Sex Med Rev 2015;3:101-112.
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Affiliation(s)
- Steven D Jones
- Department of UrologyTulane University School of MedicineNew OrleansLAUSA
| | - Thomas Dukovac
- Department of UrologyTulane University School of MedicineNew OrleansLAUSA
| | - Premsant Sangkum
- Department of UrologyTulane University School of MedicineNew OrleansLAUSA
| | - Faysal A Yafi
- Department of UrologyTulane University School of MedicineNew OrleansLAUSA
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Sumii K, Miyake H, Enatsu N, Matsushita K, Fujisawa M. Prospective assessment of health-related quality of life in men with late-onset hypogonadism who received testosterone replacement therapy. Andrologia 2015; 48:198-202. [PMID: 25988884 DOI: 10.1111/and.12433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2015] [Indexed: 01/03/2023] Open
Abstract
The objective of this study was to characterise the status of health-related quality of life (HRQOL) in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). HRQOL in 69 consecutive Japanese men with LOH undergoing TRT for at least 6 months was prospectively evaluated before and 6 months after the initiation of TRT using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). All eight-scale scores except for bodily pain (BP) in the 69 patients at 6 months after the introduction of TRT significantly improved compared with those before TRT; however, all scale scores except for BP in the 69 patients were significantly inferior to those in age-matched Japanese controls irrespective of the timing of SF-8. Multivariate analyses of several parameters revealed that both age and Aging Male Symptom (AMS) score had an independent impact on mental health (MH), despite the lack of an independent association between any score and the remaining factors examined. TRT appeared to significantly improve the status of HRQOL in men with LOH; however, even after the introduction of TRT, HRQOL associated with MH remained significantly impaired in elderly men and/or those with a high AMS score.
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Affiliation(s)
- K Sumii
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Miyake
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Enatsu
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Matsushita
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Fujisawa
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Kaplan AL, Lenis AT, Shah A, Rajfer J, Hu JC. Testosterone Replacement Therapy in Men with Prostate Cancer: A Time-Varying Analysis. J Sex Med 2015; 12:374-80. [DOI: 10.1111/jsm.12768] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Yeap BB. Hormonal changes and their impact on cognition and mental health of ageing men. Maturitas 2014; 79:227-35. [PMID: 24953176 DOI: 10.1016/j.maturitas.2014.05.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 01/25/2023]
Abstract
Demographic changes resulting in ageing of the world's population have major implications for health. As men grow older, circulating levels of the principal androgen or male sex hormone testosterone (T) decline, while the prevalence of ill-health increases. Observational studies in middle-aged and older men have shown associations between lower levels of T and poorer mental health in older men, including worse cognitive performance, dementia and presence of depressive symptoms. The role of T metabolites, the more potent androgen dihydrotestosterone (DHT) and the oestrogen receptor ligand estradiol (E2) in the pathophysiology of cognitive decline are unclear. Studies of men undergoing androgen deprivation therapy in the setting of prostate cancer have shown subtle detrimental effects of reduced T levels on cognitive performance. Randomised trials of T supplementation in older men have been limited in size and produced variable results, with some studies showing improvement in specific tests of cognitive function. Interventional data from trials of T therapy in men with dementia are limited. Lower levels of T have also been associated with depressive symptoms in older men. Some studies have reported an effect of T therapy to improve mood and depressive symptoms in men with low or low-normal T levels. T supplementation should be considered in men with a diagnosis of androgen deficiency. Beyond this clinical indication, further research is needed to establish the benefits of T supplementation in older men at risk of deteriorating cognition and mental health.
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia; Department of Endocrinology and Diabetes, Fremantle and Fiona Stanley Hospitals, Perth, Western Australia, Australia.
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