Male hormone metabolism

2018 ◽  
pp. 238-262
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Gonadal Dysgenesis ◽  
Endocrine System ◽  
Well Being ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Xyy Syndrome ◽  
And Function ◽  
Secondary Hypogonadism ◽  
Male Specific ◽  
Male Hormones

This chapter discusses the male-specific endocrine system anatomy and function. It details the physiology of the hypothalamo-pituitary–testicular axis, testosterone, luteinizing hormone, and gonadotropin-releasing hormone. Considering male metabolic, sexual, bone, muscle, and neurological health, this chapter frames male hormones in their relation to well-being. It describes disorders evidenced by genetic analysis, such as Klinefelter’s syndrome, XYY syndrome, Noonan’s syndrome, mixed gonadal dysgenesis, and androgen-receptor defects. It discusses total testosterone and sex hormone-binding globulin in diagnosing or predicting male endocrine-related disorders, such as primary hypogonadism, secondary hypogonadism, erectile dysfunction, and gynaecomastia. It also lists the epidemiology, symptoms, and management of these disorders.

scholarly journals Hypogonadism and liver fibrosis in HIV-infected patients

2021 ◽  
Author(s):  
E. Quiros-Roldan ◽  
T. Porcelli ◽  
L. C. Pezzaioli ◽  
M. Degli Antoni ◽  
S. Paghera ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Univariate Analysis ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Pituitary Dysfunction ◽  
Consequent Reduction ◽  
Secondary Hypogonadism ◽  
The Relationship

Abstract Purpose Hypogonadism is frequent in HIV-infected men and might impact on metabolic and sexual health. Low testosterone results from either primary testicular damage, secondary hypothalamic-pituitary dysfunction, or from liver-derived sex-hormone-binding-globulin (SHBG) elevation, with consequent reduction of free testosterone. The relationship between liver fibrosis and hypogonadism in HIV-infected men is unknown. Aim of our study was to determine the prevalence and type of hypogonadism in a cohort of HIV-infected men and its relationship with liver fibrosis. Methods We performed a cross-sectional retrospective study including 107 HIV-infected men (median age 54 years) with hypogonadal symptoms. Based on total testosterone (TT), calculated free testosterone, and luteinizing hormone, five categories were identified: eugonadism, primary, secondary, normogonadotropic and compensated hypogonadism. Estimates of liver fibrosis were performed by aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores. Results Hypogonadism was found in 32/107 patients (30.8%), with normogonadotropic (10/107, 9.3%) and compensated (17/107, 15.8%) being the most frequent forms. Patients with secondary/normogonadotropic hypogonadism had higher body mass index (BMI) (p < 0001). Patients with compensated hypogonadism had longer HIV infection duration (p = 0.031), higher APRI (p = 0.035) and FIB-4 scores (p = 0.008), and higher HCV co-infection. Univariate analysis showed a direct significant correlation between APRI and TT (p = 0.006) and SHBG (p = 0.002), and between FIB-4 and SHBG (p = 0.045). Multivariate analysis showed that SHBG was independently associated with both liver fibrosis scores. Conclusion Overt and compensated hypogonadism are frequently observed among HIV-infected men. Whereas obesity is related to secondary hypogonadism, high SHBG levels, related to liver fibrosis degree and HCV co-infection, are responsible for compensated forms.

Improvement in Mood and Fatigue after Dehydroepiandrosterone Replacement in Addison’s Disease in a Randomized, Double Blind Trial

2000 ◽  
Vol 85 (12) ◽  
pp. 4650-4656 ◽  
Author(s):  
Penelope J. Hunt ◽  
Eleanor M. Gurnell ◽  
Felicia A. Huppert ◽  
Christine Richards ◽  
A. Toby Prevost ◽  
...  
Keyword(s):  
Hormone Replacement ◽  
Addison’S Disease ◽  
Well Being ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Addison's Disease ◽  
Double Blind Study ◽  
Mineral Density ◽  
Double Blind ◽  
Positive Effects

Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are adrenal precursors of steroid biosynthesis and centrally acting neurosteroids. Glucocorticoid and mineralocorticoid deficiencies in Addison’s disease require life-long hormone replacement, but the associated failure of DHEA synthesis is not corrected. We conducted a randomized, double blind study in which 39 patients with Addison’s disease received either 50 mg oral DHEA daily for 12 weeks, followed by a 4-week washout period, then 12 weeks of placebo, or vice versa. After DHEA treatment, levels of DHEAS andΔ 4-androstenedione rose from subnormal to within the adult physiological range. Total testosterone increased from subnormal to low normal with a fall in serum sex hormone-binding globulin in females, but with no change in either parameter in males. In both sexes, psychological assessment showed significant enhancement of self-esteem with a tendency for improved overall well-being. Mood and fatigue also improved significantly, with benefit being evident in the evenings. No effects on cognitive or sexual function, body composition, lipids, or bone mineral density were observed. Our results indicate that DHEA replacement corrects this steroid deficiency effectively and improves some aspects of psychological function. Beneficial effects in males, independent of circulating testosterone levels, suggest that it may act directly on the central nervous system rather than by augmenting peripheral androgen biosynthesis. These positive effects, in the absence of significant adverse events, suggest a role for DHEA replacement therapy in the treatment of Addison’s disease.

Screening for Hypogonadism in Primary Healthcare: How to do this Effectively

2018 ◽  
Vol 126 (03) ◽  
pp. 176-181
Author(s):  
Mark Livingston ◽  
Richard Jones ◽  
Geoff Hackett ◽  
Gemma Donnahey ◽  
Gabriela Moreno ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Free Testosterone ◽  
Sex Hormone Binding Globulin ◽  
Serum Prolactin ◽  
Total Testosterone ◽  
Male Hypogonadism ◽  
The Uk ◽  
Secondary Hypogonadism

Abstract Background Testosterone, the most important androgen produced by the testes, plays an integral role in male health. Testosterone levels are increasingly being checked in primary healthcare as awareness of the risks of male hypogonadism grows. Aim To investigate what tests are performed to screen for hypogonadism and to exclude secondary hypogonadism. Design and Setting All participants attended general practices in the UK. Methods Data search was performed using the EMIS® clinical database (provider of the majority of GP operating systems in Cheshire). The anonymised records of male patients aged 18–98 years who had undergone a check of serum testosterone during a 10-year period were analysed. Results Overall screening rate was 4.3%. Of 8 788 men with a testosterone result, 1 924 men (21.9%) had a total testosterone level <10 nmol/L. Just 689 of 8 788 men (7.8%) had a sex hormone-binding globulin (SHBG) result, corresponding to 30.5% of those potentially hypogonadal. Estimated free testosterone was negatively associated with BMI (Spearman’s rho -0.2, p<0.001) as was total testosterone in the over 50 s. Of 1 924 potentially hypogonadal men with a serum testosterone <10 nmol/L, 588 of 1 924 (30.6%) had a check of serum prolactin. 46.3% and 41.7% had LH and FSH measured, respectively. Only 19.1% of 1 924 men with a hypogonadal total testosterone level were subsequently put on testosterone replacement. The percentage of men in the relatively socially disadvantaged category was similar for both eugonadal and hypogonadal men with a much higher rate of screening for hypogonadism in more socially advantaged men. Conclusions Screening in primary healthcare identified a significant minority of men who had potential hypogonadism. Interpretation of a low serum testosterone requires measurement of serum prolactin, LH and FSH in order to rule out secondary hypogonadism. We suggest that this becomes part of routine screening with a balanced screening approach across the socioeconomic spectrum.

scholarly journals High Baseline SHBG, as an Independent Predictor, Was Associated With High Ovulation: a Secondary Analysis of PCOSAct

2021 ◽  
Author(s):  
Hui Chang ◽  
Qi Wu ◽  
Hang Ge ◽  
Jian Li ◽  
Meng-Yi Zhu ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Secondary Analysis ◽  
Endocrine System ◽  
Predictive Marker ◽  
Ovulation Rate ◽  
Sex Hormone Binding Globulin ◽  
Multivariate Logistic Regression Model ◽  
Total Testosterone ◽  
Reproductive Process ◽  
Baseline Serum

Abstract Background: Sex hormone-binding globulin (SHBG) is related to several human systems such as reproductive system and endocrine system. SHBG binds to testosterone and estradiol, therefore we explored ethe role of SHBG on reproductive process. Methods: We carried out secondary analysis of Polycystic Ovary Syndrome and Acupuncture Clinical Trail (PCOSAct) at 21 sites in China, comprising a total of 1000 women with PCOS. A total of 954 women with baseline homocysteine (HCY) were included in the study. Results: Multivariate analysis of predictors of ovulation showed that age, body mass index (BMI), estradiol (E2), total testosterone (T) and SHBG are predictors of ovulation (P=0.0211, 0.0011, 0.0211, 0.0029, 0.0434) whereas luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio is negatively correlated with ovulation (P=0.0539). A multivariate logistic regression model (MLRM) of all baseline serum parameters showed the strongest predictive ability for ovulation, followed by MLRM without SHBG. In addition to treatment, baseline SHBG was the strongest single predictor for ovulation. Patients in higher SHBG quartile showed significantly higher ovulation rate (HR=1.138; 95%CI [1.054,1.229], P=0.0009). Notably, significance was observed after adjustment for testosterone (HR=1.139, 95%CI [1.055,1.229], P=0.0009). However, quartiles of T, free testosterone (FT) and E2 all showed no correlation with ovulation. Kaplan-Meier curves showed that high SHBG is positively correlated with high ovulation, conception and pregnancy rates. Conclusions: Higher baseline SHBG is associated with higher ovulation rate and is an independent predictive marker.Trial registration: ClinicalTrials.gov (No. NCT01573858). Registered 10 April 2012, https://clinicaltrials.gov/ct2/show/NCT01573858?cond=NCT01573858&draw=2&rank=1.

A clinical update on female androgen insufficiency—testosterone testing and treatment in women presenting with low sexual desire

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 73 ◽  
Author(s):  
Henry G. Burger ◽  
Mary-Anne Papalia
Keyword(s):  
Sexual Desire ◽  
Well Being ◽  
Free Testosterone ◽  
Deficiency Syndrome ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Androgen Deficiency ◽  
Contributing Factors ◽  
Clear Cut ◽  
Age Related

The diagnosis of female androgen deficiency syndrome is suggested by complaints of a diminished sense of well being, persistent unexplained fatigue and decreased sexual desire, sexual receptivity and pleasure in a woman who is oestrogen-replete and in whom no other significant contributing factors can be identified. The diagnosis is supported by the finding of low circulating concentrations of free testosterone. Barriers to its recognition include the non-specificity of the symptoms and methodological problems due to insensitive testosterone assays. Barriers to its treatment include the unavailability of satisfactory forms of testosterone for administration to women and lack of data regarding long-term safety. Although several conditions lead to clear-cut androgen deficiency, such as hypopituitarism, adrenal and ovarian insufficiency, glucocorticoid therapy and use of oral contraceptives and oral oestrogens, it is important for clinicians to recognise that in normal women, androgen levels decline by 50% from the early 20s to the mid 40s, and hence age-related androgen insufficiency may occur in women in their late 30s and 40s, as well as postmenopausally. Satisfactory measurements of free testosterone requires a sensitive and reliable assay for total testosterone, and quantitation of sex hormone binding globulin, from which free testosterone is readily calculated. Adverse effects of testosterone treatment are few if replacement is monitored to achieve physiological circulating testosterone concentrations. Currently, available methods include testosterone implants and testosterone creams, and transdermal patches and sprays are in development.

The Effect of Child Sexual Abuse on Men

2016 ◽  
Vol 32 (3) ◽  
pp. 423-445 ◽  
Author(s):  
Patrick O’Leary ◽  
Scott D. Easton ◽  
Nick Gould
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Qualitative Interviews ◽  
General Health Questionnaire ◽  
Well Being ◽  
Masculine Identity ◽  
Self Blame ◽  
Confirmatory Factor ◽  
Male Specific ◽  
Gender Specific

Child sexual abuse (CSA) is a trauma that affects males in substantial numbers, sometimes in ways that are gender-specific (e.g., compromised masculine identity, confusion regarding sexuality). Much of the identification of the male-specific outcomes has been derived from practitioner experience and small qualitative studies. The current study explores gender-specific outcomes and describes the development of a scale to measure the effects of CSA on men. First, qualitative interviews with 20 men who were sexually abused in childhood were thematically analyzed. The emergent themes of sexuality, self-concept, psychological and emotional well-being, and social functioning were used to construct a 30-item instrument which was later completed by 147 men with histories of CSA. The dimensionality of the 30 items was then assessed for suitability as scales using confirmatory factor analysis (CFA). The final instrument, the Male Sexual Abuse Effects Scale (MSAES), combines three subscales: Negative Identity, Guilt and Self-Blame, and Psychological and Emotional Well-Being. Items concerning masculine identity were shown to be valid in the scale. MSAES scores were compared with the General Health Questionnaire–28 (GHQ-28) and found to be significantly correlated. GHQ-28 clinical thresholds were applied to differentiate clinical from nonclinical cases; an independent-samples t test showed that the clinical cases from the GHQ-28 had high scores on the MSAES. The new scale has the potential to help clinicians and researchers identify men who have been severely affected by CSA and who should be of clinical concern.

THE UNIVERSALITY OF OTITIS MEDIA IN 50 INFANTS WITH CLEFT PALATE

PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 35-42
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone ◽  
Herman Felder
Keyword(s):  
Adverse Effects ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Emotional Development ◽  
Well Being ◽  
Suppurative Otitis Media ◽  
Middle Ear Disease ◽  
And Function ◽  
Irreparable Damage

Bilateral secretory (serous) or suppurative otitis media was found without exception in 50 infants with cleft palate who were 20 months of age or younger. Middle ear disease probably develops in all cleft palate infants during the first few months of life, and appears to be best managed by myringotomy with insertion of plastic tubes. Unless drainage and aeration of the middle ear are accomplished, irreparable damage to middle ear structures may develop in some patients; and, in all of them, hearing impairment will probably persist throughout infancy or longer, with adverse effects on well-being and function and with serious implications for intellectual, speech, and emotional development. Further studies are required to assess the long-range effectiveness of surgical management.

The Development of an Interpersonal Stressors Scale: Identifying Self-Imposed and Other-Imposed Interpersonal Stressors

2021 ◽  
pp. 003329412110434
Author(s):  
Danni Wang ◽  
Lu Tian ◽  
Zhi-jin Hou ◽  
Jiang-Ping Zhou ◽  
Adam Zhao ◽  
...  
Keyword(s):  
Interpersonal Relationships ◽  
Reliability And Validity ◽  
Well Being ◽  
Relationship Maintenance ◽  
Chinese College Students ◽  
General Anxiety ◽  
Initial Item ◽  
Interpersonal Stressors ◽  
And Function ◽  
Anxiety Depression

While there has been research focused on interpersonal relationships and their impact on stress and well-being, no instrument has been developed to comprehensively evaluate interpersonal stressors. This research sought to develop and validate an Interpersonal Stressors Scale (ISS) for Chinese college students through three studies. Focus groups were used to generate the initial item pool (Study 1). Then two large samples ( N1 = 511; N2 = 330) were collected to explore the factor structure of the ISS and subsequently examine its reliability and validity estimates (study 2 and 3). Initial results indicated a model with 27 items and five first-order factors (interaction difficulty, behaving as expected, social criticism, relationship maintenance, and indebtedness avoidance) as well as two second-order factors (self-imposed stressors and other-imposed stressors) with strong psychometric properties. Criterion-related validity estimates indicated these two kinds of stressors were both associated with stress while having different relationships with general anxiety, depression, social anxiety, interpersonal satisfaction, and self-efficacy in social interactions. The nature and function of the structure for the ISS were discussed as well as the practical and research implications.

The Endocrine System: Pituitary Gland

2017 ◽  
Author(s):  
Omer Doron ◽  
Jose E Cohen ◽  
Iddo Paldor
Keyword(s):  
Pituitary Gland ◽  
Human Body ◽  
Sella Turcica ◽  
Endocrine System ◽  
Portal System ◽  
Balance Growth ◽  
Sexual Drive ◽  
Pituitary Dysfunction ◽  
Physiologic Function ◽  
And Function

The pituitary gland is the main point where the neural and endocrine systems function in continuity, maintaining homeostasis of many functional elements of the human body. Located inside the sella turcica, it is separated from the rest of the central nervous system (CNS); however, it plays a crucial part in the regulation of the fundamental endocrine profile, inhibiting or promoting CNS signaling to the rest of the human body. Made up of two distinct tissue subtypes, this gland is fed by a complex vascular network, which enables communication beyond the blood-brain barrier. Lying in close proximity to both important neural and vascular structure, changes in gland size and function result in significant clinical impact. The pituitary gland controls many processes, among which are thermoregulation; metabolism and metabolic rate; glucose, solute, and water balance; growth and development; blood pressure; and sexual drive, pregnancy, childbearing, birth, and breast-feeding. The devastating effects of pituitary dysfunction underscore the importance of the pituitary gland in maintenance of the various functions that underlie normal everyday human activity. This review covers the basic aspects of pituitary gland development, anatomy, and physiologic function. This review contains 3 figures, and 38 references, Key words: adenohypophysis, neurohypophysis, pituitary-hypothalamic axis, pituitary portal system, sella turcica

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