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Late Onset Hypogonadism

Ali Abbara, Shakunthala Narayanaswamy, Chioma Izzi-Engbeaya, Alexander N Comninos, Sophie Clarke, Zainab Malik, Deborah Papadopoulou, Ailish Clobentz, Zubair Sarang, Paul Bassett, Channa Jayasena, Waljit S Dhillo
<br>Background: Male testosterone levels decline by 1% per year from the age of 40yrs. Whilst a primary testicular deficit occurs, hypothalamic or pituitary dysregulation may also coexist. This study aimed to compare the hypothalamic response to kisspeptin and the pituitary response to GnRH of older men with those of young men. METHODS: Following 1 hour of baseline sampling, healthy older men (n=5, mean age 59.3±2.9yrs) received a 3 hour intravenous infusion (IVI) of either: vehicle, kisspeptin-54 0...
March 15, 2018: Neuroendocrinology
Giulia Rastrelli, Mario Maggi, Giovanni Corona
The frequency of late-onset hypogonadism (LOH) ranges between 2 and 15%. Up to 85% of LOH is due to a functional impairment of the hypothalamus-pituitary-testicular axis, mostly secondary to metabolic conditions. Areas covered: This paper provides a comprehensive review of all the available medications for treating LOH, including antiestrogens, gonadotropins and testosterone therapy (TTh). In addition, the evidence on clinical outcomes of these treatments is provided by meta-analyzing the results from the available randomized clinical trials...
March 5, 2018: Expert Review of Clinical Pharmacology
B Zhang, W Ma, Q Zhu, W Xu, L Gao, B Xu, S Xu, C Gao, L Gao, J Liu, Y Cui
Approximately 40% of middle-aged men exhibit symptoms of late-onset hypogonadism (LOH). However, the mechanism of androgen deficiency is still currently unclear. As shown in our previous studies, the SET protein is expressed in testicular Leydig cells and ovarian granule cells. This study was designed to investigate the effect of the SET protein on androgen production in Leydig cells. The AdCMV/SET and AdH1siRNA/SET adenoviruses were individually transduced into a cultured mouse Leydig cell line (mLTC-1) with or without human chorionic gonadotropin (HCG) stimulation in vitro...
February 26, 2018: Andrology
Masahiro Kurobe, Koji Kawai, Takahiro Suetomi, Teruaki Iwamoto, Natsui Waku, Takashi Kawahara, Takahiro Kojima, Akira Joraku, Jun Miyazaki, Hiroyuki Nishiyama
OBJECTIVE: Hypogonadism is a major complication in testicular cancer survivors, but its prevalence varies among studies. In Japan, free testosterone has been used for diagnosis of late-onset hypogonadism syndrome. In the present study, we evaluated the hormone level of testicular cancer survivors and its impact on their quality of life. METHODS: Overall, 50 testicular cancer survivors treated from 1990 to 2013 were enrolled. The median age was 44 years. The serum levels of free testosterone, total testosterone and luteinizing hormone were measured...
February 25, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Aneta Monika Gawlik, Magdalena Hankus, Kamila Szeliga, Aleksandra Antosz, Tomasz Gawlik, Kamil Soltysik, Agnieszka Drosdzol-Cop, Krzysztof Wilk, Grzegorz Kudela, Tomasz Koszutski, Ewa Malecka-Tendera
Objective: Estrogen replacement therapy (ERT) for Turner syndrome (TS) is a widely discussed topic; however, the optimal model of ERT for patients with delayed diagnosis and/or initiation of therapy is still unclear, mainly due to insufficient data. We present the results of a prospective observational single-center study in which the efficacy of late-onset puberty induction by one-regimen transdermal ERT in TS girls was evaluated. Methods: The analysis encompassed 49 TS girls (63...
2018: Frontiers in Endocrinology
Kamran Ahmed, Kostas Hatzimouratidis, Asif Muneer
Cognitive and somatiform changes occur with ageing and are often attributed to late-onset hypogonadism. Testosterone replacement in older men remains controversial despite increasing evidence of symptomatic and clinical benefit in relation to improvements in sexual dysfunction, muscle mass, and diabetic control. The controversial areas related to cardiovascular safety and risk of prostate cancer need to be considered.
October 2017: European Urology Focus
M G F Maatje, M Dinkelman-Smit, W P A Boellaard, G R Dohle
- Late onset hypogonadism (LOH) is a shortage of testosterone in adult men whose male development was normal. This form of hypogonadism results in decreased testosterone levels and variable gonadotrophin levels. - The symptoms of LOH are often aspecific and may be consistent with ageing in men: lowered libido, loss of strength, reduced cognitive functioning and disorders of sleeping and mood. - There is discussion about testosterone parameters, but if clinical symptoms are consistent with LOH and the testosterone level is < 8 nmol/l, hypogonadism is evidently indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
Hsin-Jung Ho, Hitoshi Shirakawa, Puspo E Giriwono, Asagi Ito, Michio Komai
Isoprenoids play widely differing roles in various physiological processes in animals and plants. Geranylgeraniol (GGOH) is an isoprenoid found in plants, and is an important metabolic derivative in the isoprenoid/cholesterol synthesis pathway. Earlier studies focused on GGOH's ability to improve the side effects of bisphosphonate therapy by regulating the mevalonate pathway. More recently, the mevalonate pathway-independent effects of GGOH have been described, including anti-inflammatory, anti-tumorigenic, and neuroprotective activities...
January 5, 2018: Bioscience, Biotechnology, and Biochemistry
Giovanni Corona, Mauro Dicuio, Giulia Rastrelli, Alessandra Sforza, Mario Maggi
Late onset hypogonadism (LOH) is the most commonly used term to indicate the age-dependent reduction of testosterone. Sexual dysfunction represents the most important determinant for medical consultation and the most specific symptoms associated with LOH. In particular, data from the European Male Ageing Study (EMAS), a population-based survey on more than 3400 subjects, recognized that a triad of sexual symptoms (low libido and reduced spontaneous and sex-related erections) is the only syndromic association with decreased testosterone levels...
November 2017: Giornale Italiano di Cardiologia
Woong Jin Bae, Guan Qun Zhu, Sae Woong Choi, Hyun Cheol Jeong, Fahad Bashraheel, Kang Sup Kim, Su Jin Kim, Hyuk Jin Cho, U Syn Ha, Sung Hoo Hong, Ji Youl Lee, Hyun-A Oh, Hye Cheong Koo, Do Ram Kim, Sung Yeoun Hwang, Sae Woong Kim
The Korean herbal formulation Ojayeonjonghwan is used for improving late-onset hypogonadism (LOH) symptoms such as erectile dysfunction (ED). A previous research suggested that a modified Ojayeonjonghwan (KH-204) could be used as an alternative to the treatment for ED. The pharmacological effects were examined in different conditions, including in vitro and in vivo. We measured the survival rate of TM3 Leydig cells under the oxidative stress condition. The s.c. injection of leuprorelin was used to induce androgen deprivation...
2017: Oxidative Medicine and Cellular Longevity
Mark Livingston, Anura Kalansooriya, Andrew J Hartland, Sudarshan Ramachandran, Adrian Heald
AIM: Although "late onset hypogonadism", a condition that includes low testosterone and symptoms, is common in men over the age of 40 years, diagnosis is not clear cut amongst non-specialists. It is the aim of this review to provide an up to date picture of how this state should be diagnosed and managed. METHODS: We aim to describe how primary and secondary hypogonadism should be excluded before the diagnosis of late onset hypogonadism is reached. As laboratory testosterone measurements are essential the current pitfalls such as inappropriate sample collection and the use of population derived reference ranges are expanded...
November 2017: International Journal of Clinical Practice
Judith Gerards, Michael M Ritter, Elke Kaminsky, Andreas Gal, Wolfgang Hoeppner, Marcus Quinkler
DAX1 (NR0B1) is an orphan nuclear receptor, which plays an important role in development and function of the adrenal glands and gonads. Mutations in DAX1 cause X-linked adrenal hypoplasia congenita (X-linked AHC), which is characterized by adrenal insufficiency (AI) and hypogonadotropic hypogonadism (HHG). Affected boys present with adrenal failure usually in childhood and, later in life, with delayed puberty. However, patients with a late-onset form of X-linked AHC have also been described in the past years...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Nikolaos Kyriakakis, Tolulope Shonibare, Julie Kyaw-Tun, Julie Lynch, Carlos F Lagos, John C Achermann, Robert D Murray
PURPOSE: DAX-1 (NR0B1) is an orphan nuclear receptor, which plays a critical role in development and regulation of the adrenal gland and hypothalamo-pituitary-gonadal axis. Mutations in NR0B1 lead to adrenal hypoplasia congenita (AHC), hypogonadotropic hypogonadism (HH) and azoospermia in men. Presentation is typically with adrenal insufficiency (AI) during infancy or childhood. To date only eight cases/kindreds are reported to have presented in adulthood. METHODS: We describe two new cases of men with DAX-1 mutations who presented in adulthood and who were diagnosed at a large University Hospital...
October 2017: Pituitary
B Cangiano, C Cacciatore, L Persani, M Bonomi
We describe a case of severe erythrocytosis caused by testosterone replacement therapy in a 66-year-old man affected with hypogonadotropic hypogonadism (HH) determining osteoporosis, resolved by switching to restoration therapy with clomiphene citrate. The patient complained fatigue, loss of libido and defective erections and a spontaneous vertebral fracture despite bisphosphonate therapy and vitamin D supplementation. The examinations proved isolated HH and he was therefore treated with testosterone gel with regression of specific manifestations but elevated hemoglobin and hematocrit values...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Piotr Dudek, Jarosław Kozakowski, Wojciech Zgliczyński
In Poland, the number of men over the age of 50 years exceeds 6 million. It is estimated that about 2-6% of this population develops symptoms of late-onset hypogonadism (LOH). In men, testosterone deficiency increases slightly with age. LOH is a clinically and biochemically defined disease of older men with serum testosterone level below the reference parameters of younger healthy men and with symptoms of testosterone deficiency, manifested by pronounced disturbances of quality of life and harmful effects on multiple organ systems...
June 2017: Przeglad Menopauzalny, Menopause Review
Keizo Ohnaka
The decline in sex hormones along with aging is suggested to be involved in age-associated diseases such as cardiovascular diseases, osteoporosis, and dementia. The decrease of estrogen level after menopause is related to osteoporosis in addition to climacteric disturbance in women, while that of testosterone to sarcopenia, osteoporosis and late-onset hypogonadism in men. New treatment strategy is expected for targeting age-associated diseases against the decreased level of sex hormones.
2017: Clinical Calcium
Akira Tsujimura, Ippei Hiramatsu, Yusuke Aoki, Hirofumi Shimoyama, Taiki Mizuno, Taiji Nozaki, Masato Shirai, Kazuhiro Kobayashi, Yoshiaki Kumamoto, Shigeo Horie
BACKGROUND: Atherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms. MATERIALS AND METHODS: The study comprised 303 outpatients who visited our clinic with symptoms of LOH...
June 2017: Prostate International
Giovanni Corona, Alessandra Sforza, Mario Maggi
Recent position statements and guidelines have raised the distinction between a true and false, age-related hypogonadism (HG) or late-onset hypogonadism (LOH). The former is the consequence of congenital or acquired "organic" damage of the brain centers or of the testis. The latter is mainly secondary to age-related comorbidities and does not require testosterone (T) therapy (TTh). In addition, concerns related to cardiovascular (CV) safety have further increased the scepticism related to TTh. In this paper, we reviewed the available evidence supporting the efficacy of TTh in non-organic HG and its long term safety...
August 2017: World Journal of Men's Health
G Corona, M Dicuio, G Rastrelli, E Maseroli, F Lotti, A Sforza, M Maggi
In men, testosterone (T) production declines as a function of ageing. Late-onset hypogonadism (LOH) is the most commonly used term to indicate this age-related condition. In LOH, the relative clinical significance and the potential benefit of testosterone treatment (TTh) are still the subject of strong criticisms in the scientific community. The debate is further complicated by the recent position statement of the US Food and Drug Administration (FDA) emphasizing that, in LOH, the benefits and safety of TTh have not been fully established...
August 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Rodrigo Blaya, Patricia Blaya, Luiza Rhoden, Ernani Luis Rhoden
Advances in medicine and progressive improvements in the health of the general population in developed countries have led to considerable increases in life expectancy over recent years. Metabolic syndrome (MetS) affects approximately 25% of the adult population and its prevalence is increasing all over the world. Central obesity plays an important role in emergence of MetS. Some studies have suggested that there may be link between low Total Testosterone levels and emergence of MetS. The objective of this review is to analyze the complex network of interactions between MetS and low testosterone levels in elderly men, considering etiologic, diagnostic, and therapeutic aspects...
November 28, 2017: Current Pharmaceutical Design
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