Editorial: Male hypogonadism: need for reclassification? DOI Creative Commons
Rossella Cannarella, Richard Quinton, Aldo E. Calogero

и другие.

Frontiers in Endocrinology, Год журнала: 2024, Номер 15

Опубликована: Ноя. 11, 2024

First systematically described in modern times by Albright 1941 as a clinical syndrome caused gonadal dysfunction (Albright et al., 1941), the concept of male "eunuchoidism" dates back to biblical and beyond (Barkan, 1999). Although diagnosis has been usually expressed terms testosterone deficiency, it is now increasingly recognized that subfertility due impaired spermatogenesis represents another key feature (Jayasena 2022;Munari 2023). Numerous causes hypogonadism have described, albeit broadly classified into forms with hypothalamic-pituitary (hypogonadotropic, central, or secondary), (or primary) etiologies; turn divided congenital acquired forms.Over recent years, so-called functional recognized, including age-and obesity-related causes, some investigators prefer nongonadal illness (De Silva 2024). The Massachusetts Male Aging Study identified decline serum levels advancing age accentuated presence comorbidities (Araujo 2004). It estimated obesity diabetes mellitus are found approximately one-third men sexual symptoms, hypotestosteronaemia inappropriately normal gonadotropin values (Dhindsa 2018). However, although European this biochemical signature 11.8% older men, only 2.2% had associated triplet symptoms (reduced libido, loss spontaneous erections quality erections) conferred (Tajar 2012). Moreover, luteinizing hormone (LH)-mediated concentrations was overwhelmingly determined accumulating (especially obesity), no direct impact chronological aging per se.Added rapid advance identifying ever more genetic associations central using next-generation sequencing (NGS), many genes yet be tested animal models. complexity these results also intriguing, mutations being neither completely "white" (non-pathogenic) nor "black" (pathogenic), data suggests may include various shades "gray". NGS, for example, allows detection polymorphisms could confer predisposition developing specific environmental triggers, such excessive weight (Caronia 2011), critical illness, exposure stressors, obesity, mellitus, etc, i.e. blurring distinction between organic hypogonadism. Thus, not always condition simple definition identification, new classifications necessary fully understand its manifestations forms. In collection, we assembled articles describe less conventional both males females.A literature review Barbagallo colleagues (Barbagallo 2024) signposts role genetics determining individual susceptibility onset females, noting numerous patients who presented following drastic loss. These observations likewise indicate strong interplay factors environment.Fertile eunuch Pasqualini first 1950 characterized hypogonadotropic partial puberty (testicular volume >8 ml), follicle-stimulating (FSH), testicular histology consistent (Pasqualini 1950). article Dwyer (Dwyer 2024), largest study fertile published date.They examined frequency reversal (Quinton 1999;Raivio 1997) among (Sidhoum 2014), varies according original subtype at presentation, from 5% those lacking puberty, through 13% 44% syndrome. classic does preserved spermatogenesis, which instead compatible partially compromised (for example polymorphisms, compound heterozygosities, etc.). This highlights need reclassification hypogonadism.The Aung how difficult differentiate during adolescence non-reproductive phenotype (such anosmia, clefting, deafness, etc) self-limiting delayed puberty. authors suggest clinical-biochemical combination micropenis low inhibin B can helpful differential (Aung collection includes an fits ongoing debate regarding medical versus surgical treatment cryptorchidism. Through retrospective design, Sun observed same efficacy (in efficiency) ex-cryptorchid treated therapy combined therapy.They conclude safer, invasive, expensive option than (Sun underwent included human chorionic (hCG)-monotherapy pulsatile Gonadotropin-releasing (GnRH) (equivalent hCG+FSH therapy). remains seen whether one modality better outcomes other. What best therapeutic approach when comes cryptorchidism hot topic today (Rohayem 2024).We hope will useful readers understanding heterogeneous what define much progress still needs made fill existing gaps. We truly help us understand, least part, open questions inspire ad hoc studies further improve our knowledge on lead comprehensive "central hypogonadism".

Язык: Английский

Enhancing Sexual Health for Cancer Survivors DOI
Laila Agrawal,

Liz O’Riordan,

Caleb Natale

и другие.

American Society of Clinical Oncology Educational Book, Год журнала: 2025, Номер 45(3)

Опубликована: Апрель 3, 2025

Changes to sexual function after cancer treatment are extremely prevalent, affecting up 90% of female patients with and 40%-85% male cancer. Sexual health concerns include low libido, genitourinary syndrome menopause, dyspareunia, erectile dysfunction (ED), hypogonadism, body image concerns, impacts on intimate relationships. Given the significant impact quality life, oncology professionals should integrate discussions into routine patient care, regardless patient's age, sex, or type. Sexuality is best understood in a biopsychosocial framework treatments including chemotherapy, surgery, radiation, endocrine therapy can affect all these domains. Management menopause includes nonhormonal low-dose local hormonal options. Pelvic floor vaginal stenosis be treated pelvic physical use dilator therapy. ED phosphodiesterase type 5 inhibitors if needed, interventions such as intracavernosal injection vasoactive agents, urethral suppositories, vacuum erection devices, surgical implants available. Cancer androgen-deprivation lead hypogonadism men, which testosterone therapy, unless contraindicated. Psychosocial counseling, sex couples counseling options for response, image, relationship concerns. A comprehensive, patient-centered approach help improve outcomes overall well-being survivors.

Язык: Английский

Процитировано

0
Testosterone Depriviation Impairs Cardiac Systolic Function in Orchiectomized Wistar Rats DOI

Gabriela Almeida Motta,

Graziele Halmenschlager,

R. S. Dutra

и другие.

Hormone and Metabolic Research, Год журнала: 2025, Номер unknown

Опубликована: Апрель 22, 2025

Abstract Several studies have linked low levels of testosterone with increased symptoms cardiac disease and cardiovascular mortality; however, the effects deficiency on systolic function morphology are still not completely elucidated. The present study aims to evaluate influence deprivation morphology. Male Wistar rats were divided into two groups: Sham operation group (Sham): animals underwent sham Orchiectomized (Orchiec): bilateral orchiectomy. experimental protocol lasted 60 days after surgery. All weighted blood samples collected serum analysis, determined by chemiluminescence, first (before orchiectomy) 60th days. One day before euthanasia (on 59th day) echocardiographic parameters assessed left ventricle (LV) Statistical significant difference was set at≤0.05. Orchiec presented reduced LV fractional shortening (p=0.032), myocardial performance index (MPI) (p=0.043), prolonged mitral valve closure time (p=0.013) decreased heart rate (p=0.049) when compared Sham. No statistically found in ejection fraction (p=0.666) between groups. Besides that, weight lower (p=0.035) group. Testosterone function, changing contraction relaxation parameters. also changed weight. demonstrated for that castrated could alter such as closing MPI.

Язык: Английский

Процитировано

0
Testosterone Therapy in Older Men: Present and Future Considerations DOI Creative Commons
Bu B. Yeap, Cammie Tran,

Catherine M. Douglass

и другие.

Drugs & Aging, Год журнала: 2025, Номер unknown

Опубликована: Апрель 27, 2025

Testosterone is the classical male anabolic hormone, involved in sexual development, virilisation and regulation of body composition adult men. Organic disease involving hypothalamus, pituitary or testes may interfere with endogenous testosterone production. In such men, treatment effectively ameliorates symptoms signs androgen deficiency. However, non-gonadal factors including age, mass index medical comorbidities influence circulating testosterone, older men have on average lower concentrations compared younger these would be a pharmacological intervention requiring stringent justification via high-quality evidence from randomised controlled trials (RCTs). Recent RCTs show benefits to improve function, anaemia bone mineral density prevent revert type 2 diabetes mellitus at high risk. Results large cardiovascular safety trial risk provide important reassurance as prostate treatment. Key questions remain whether testosterone's other effects can used safely counter reductions lean associated incretin-based weight loss medications obesity, it might disabilities frailty, osteoporotic fractures dementia generally. This last question could answered by new RCT, targeting 65-80 years age bracket, which necessarily extended duration. A composite endpoint integrates potential risks, disability-free survival.

Язык: Английский

Процитировано

0
Androgen Deficiency, Associations and Survival of Men With Stage 4 and 5 Chronic Kidney Disease: A Cohort Study DOI
Neomal De Silva, Richard Quinton, Nipun Lakshitha de Silva

и другие.

Clinical Endocrinology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 6, 2024

ABSTRACT Objectives Anaemia is a key cause of morbidity in chronic kidney disease (CKD). Androgen deficiency (AD) males can contribute to anaemia all causes, including CKD. We sought examine the prevalence AD men with CKD, extent which it contributed and whether was independently associated long‐term survival. Methods This cross‐sectional observational study conducted among aged 18 years over CKD stages 4 5. The analysed morning blood samples regard their full count, urea electrolytes, albumin, lipids, testosterone (T) sex hormone binding globulin, calculation free by mass action equation. Mortality data were obtained 15 later for survival analysis. Results Among 322 patients mean age 63 years, overall 68.9%. There statistically significant negative correlation between erythropoiesis stimulating agent (ESA) dose concentrations (Pearson −0.193, p = 0.05). positive haemoglobin (Hb) level not on ESA therapy 0.331, < 0.001). Kaplan‐Meier plots showed 0.001 log‐rank analysis, indicating that significantly worse However, Cox regression (95% CI 0.997–1.000). Conclusions highly prevalent this population, increases further older more severe warranting haemodialysis. Association lower Hb higher T concentration might be causative, has important pharmaco‐economic as well clinical implications. Lower low T, likely reflects poor health rather than causation. A properly constituted randomised controlled evaluating effect native replacement warranted AD.

Язык: Английский

Процитировано

2
An Update on Advances in Hypopituitarism: Etiology, Diagnosis, and Current Management DOI Open Access
Pedro Iglesias

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(20), С. 6161 - 6161

Опубликована: Окт. 16, 2024

This article provides an updated review of hypopituitarism (HP), endocrine disorder characterized by a deficiency one or more pituitary hormones. The various etiologies are reviewed, including neuroendocrine tumors (PitNETs), hypothalamic lesions, genetic mutations, and acquired factors such as head trauma, medications, neoplasms, infiltrative diseases. It is noted that PitNETs responsible for approximately half the cases in adults, whereas children causes predominantly congenital. Diagnosis based on clinical evaluation hormonal testing, with identification specific deficiencies essential effective treatment. Laboratory tests present challenges limitations must be understood addressed. Hormone replacement therapy mainstay treatment, significantly improving patients' quality life. important to know possible interactions between hormone therapies HP. Recent advances understanding pathophysiology HP importance multidisciplinary approach management associated complications discussed. emphasizes need comprehensive continuous follow-up optimize outcomes patients highlights ongoing research improve diagnostic treatment strategies.

Язык: Английский

Процитировано

2
Editorial: Male hypogonadism: need for reclassification? DOI Creative Commons
Rossella Cannarella, Richard Quinton, Aldo E. Calogero

и другие.

Frontiers in Endocrinology, Год журнала: 2024, Номер 15

Опубликована: Ноя. 11, 2024

First systematically described in modern times by Albright 1941 as a clinical syndrome caused gonadal dysfunction (Albright et al., 1941), the concept of male "eunuchoidism" dates back to biblical and beyond (Barkan, 1999). Although diagnosis has been usually expressed terms testosterone deficiency, it is now increasingly recognized that subfertility due impaired spermatogenesis represents another key feature (Jayasena 2022;Munari 2023). Numerous causes hypogonadism have described, albeit broadly classified into forms with hypothalamic-pituitary (hypogonadotropic, central, or secondary), (or primary) etiologies; turn divided congenital acquired forms.Over recent years, so-called functional recognized, including age-and obesity-related causes, some investigators prefer nongonadal illness (De Silva 2024). The Massachusetts Male Aging Study identified decline serum levels advancing age accentuated presence comorbidities (Araujo 2004). It estimated obesity diabetes mellitus are found approximately one-third men sexual symptoms, hypotestosteronaemia inappropriately normal gonadotropin values (Dhindsa 2018). However, although European this biochemical signature 11.8% older men, only 2.2% had associated triplet symptoms (reduced libido, loss spontaneous erections quality erections) conferred (Tajar 2012). Moreover, luteinizing hormone (LH)-mediated concentrations was overwhelmingly determined accumulating (especially obesity), no direct impact chronological aging per se.Added rapid advance identifying ever more genetic associations central using next-generation sequencing (NGS), many genes yet be tested animal models. complexity these results also intriguing, mutations being neither completely "white" (non-pathogenic) nor "black" (pathogenic), data suggests may include various shades "gray". NGS, for example, allows detection polymorphisms could confer predisposition developing specific environmental triggers, such excessive weight (Caronia 2011), critical illness, exposure stressors, obesity, mellitus, etc, i.e. blurring distinction between organic hypogonadism. Thus, not always condition simple definition identification, new classifications necessary fully understand its manifestations forms. In collection, we assembled articles describe less conventional both males females.A literature review Barbagallo colleagues (Barbagallo 2024) signposts role genetics determining individual susceptibility onset females, noting numerous patients who presented following drastic loss. These observations likewise indicate strong interplay factors environment.Fertile eunuch Pasqualini first 1950 characterized hypogonadotropic partial puberty (testicular volume >8 ml), follicle-stimulating (FSH), testicular histology consistent (Pasqualini 1950). article Dwyer (Dwyer 2024), largest study fertile published date.They examined frequency reversal (Quinton 1999;Raivio 1997) among (Sidhoum 2014), varies according original subtype at presentation, from 5% those lacking puberty, through 13% 44% syndrome. classic does preserved spermatogenesis, which instead compatible partially compromised (for example polymorphisms, compound heterozygosities, etc.). This highlights need reclassification hypogonadism.The Aung how difficult differentiate during adolescence non-reproductive phenotype (such anosmia, clefting, deafness, etc) self-limiting delayed puberty. authors suggest clinical-biochemical combination micropenis low inhibin B can helpful differential (Aung collection includes an fits ongoing debate regarding medical versus surgical treatment cryptorchidism. Through retrospective design, Sun observed same efficacy (in efficiency) ex-cryptorchid treated therapy combined therapy.They conclude safer, invasive, expensive option than (Sun underwent included human chorionic (hCG)-monotherapy pulsatile Gonadotropin-releasing (GnRH) (equivalent hCG+FSH therapy). remains seen whether one modality better outcomes other. What best therapeutic approach when comes cryptorchidism hot topic today (Rohayem 2024).We hope will useful readers understanding heterogeneous what define much progress still needs made fill existing gaps. We truly help us understand, least part, open questions inspire ad hoc studies further improve our knowledge on lead comprehensive "central hypogonadism".

Язык: Английский

Процитировано

0