Testosterone Treatment May Reduce Depression in Men

MedicalResearch.com Interview with:

Dr. Andreas Walther

Dr. Walther

Dr. Andreas Walther PhD
Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany
Department of Clinical Psychology and Psychotherapy, University of Zurich,
Zurich, Switzerland
Task Force on Men’s Mental Health of the World Federation of the Societies of Biological Psychiatry


MedicalResearch.com: What is the background for this study?

Response: The study situation with regard to endogenous testosterone level and depressive symptoms in men is currently very mixed. There are studies that show no association, but other studies show that low testosterone levels are associated with increased depressive symptoms. That is why several studies have tried to administer testosterone in men to treat depressive symptomatology among other conditions (e.g. erectile dysfunction, cognitive decline).

However, no clear conclusions could be drawn from the studies to date, as some studies reported positive results, while others did not show any effects. Likewise, some studies showed better results in certain subgroups of men such as dysthymic men, treatment resistant, men with low testosterone, which raised the question of relevant moderators.

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Testosterone May Be Link Between PCOS and Autism

MedicalResearch.com Interview with:

Adriana Cherskov Autism Research Centre Department of Psychiatry University of Cambridge Cambridge

Ms. Cherskov

Adriana Cherskov
Autism Research Centre
Department of Psychiatry
University of Cambridge
Cambridge

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Autism is a condition that affects social interaction, communication, and may be accompanied by unusually narrow interests or difficulties adjusting to unexpected change. Signs of autism are usually present in childhood and the condition affects about 1-2% of the population. At the Autism Research Centre at the University of Cambridge, our research team is interested in understanding some of the environmental triggers of autism. Previously, our research group has shown that autistic children have elevated levels of “sex steroid” hormones (including testosterone) before they are born.

Polycystic ovary syndrome (PCOS) is a relatively common condition, affecting about one in ten women, which is primarily characterized by increased levels of the sex-steroid hormone testosterone and its precursors. These mothers may also have higher testosterone levels than usual during pregnancy, which may exposure their unborn baby to more of this hormone. Additionally, they may have genetic factors increasing sex steroid hormones that can be passed down to their children. Our research team sought to examine whether women with PCOS therefore may have an increased chance of having a child with autism.

We used anonymized health records from a large database of GP records in the UK and included 8,588 women with PCOS and their first-born children in the study as well as 41,127 women without PCOS as controls. We found that after adjusting for factors such as maternal mental health conditions or metabolic conditions, women with PCOS had a 2.3% change of having an autistic child, compared with 1.7% change for mothers without PCOS. We would like to stress, however, that the increased risk for women with PCOS is still very small, and the likelihood of having an autistic child is still very low.

As part of this research, we have also conducted two other studies, where we found that women with PCOS themselves were twice as likely to have autism and that women with autism were also twice as likely to have PCOS. These findings suggest a common pathway between autism and PCOS which will be important to explore in future research.

MedicalResearch.com: What should readers take away from your report?

Response: As mentioned earlier, our findings indicate women with PCOS have an increased chance of having a child with autism, but this increase is still very small, and the chance of having a child with autism is still very low even in this population (2.3% compared with 1.7%). As a result, the main take-away from our research is that we have found further evidence for the role of prenatal testosterone as one of many players in the development of autism and a potentially common pathway between autism and PCOS.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: This link will help us in the future to understand the cause of both conditions. In this study we were not able to measure testosterone or sex steroid levels in women or their children, and this will be an important step in determining whether it is the sex-steroid hormones themselves, another downstream factor (such as insulin levels which are affected in PCOS), or genetics at the root of this association. Ultimately, both autism and PCOS are very complex conditions with many causative factors. The association we find here is likely just one of these players for both conditions, but it paves the path for future research.

In the future, this research may also help doctors and patients make decisions about treatment, as women with autism at high risk of developing PCOS may be able to start treatment or lifestyle changes early, which can improve PCOS management and quality of life. Alternatively, we underline again that the small increased likelihood of women with PCOS having a child with autism should not cause additional stress or worry in this population, since there are many factors involved in developing autism which will require further research to understand fully. 

Citation: Adriana Cherskov, Alexa Pohl, Carrie Allison, Heping Zhang, Rupert A. Payne, Simon Baron-Cohen. Polycystic ovary syndrome and autism: A test of the prenatal sex steroid theory. Translational Psychiatry, 2018; 8 (1) DOI: 10.1038/s41398-018-0186-7

Aug 5, 2018 @ 10:24 pm 

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Testosterone Improved Body Mass and QoL in Male and Female Cancer Patients

MedicalResearch.com Interview with:

Traver Wright, Ph.D. Research Assistant Professor Department of Health and Kinesiology Texas A&M University College Station, TX

Dr. Wright

Traver Wright, Ph.D.
Research Assistant Professor
Department of Health and Kinesiology
Texas A&M University
College Station, TX

MedicalResearch.com: What is the background for this study?  

Response: Many cancer patients suffer from a loss of body mass known as cachexia which results in not only a loss of fat, but a debilitating loss of muscle mass and function. This cachexia negatively impacts patient mobility and quality of life, and can also reduce their eligibility to undergo treatments such as radiation and chemotherapy.  Despite the profound negative consequences of cachexia, there are no established therapies to directly address this debilitating loss of body mass during treatment.

In this National Cancer Institute funded double-blind, placebo-controlled study we examined the effectiveness of 7 weeks of treatment with the muscle-building hormone testosterone to preserve the body condition of men and women with cervical or head and neck cancer.  Twenty-one patients received weekly injections of either placebo or testosterone.  Over the 7 weeks of treatment, patients were monitored for changes in body composition, activity level, physical ability, and questionnaires regarding quality of life and well-being.

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Decreased Sleep Associated With Lower Testosterone Levels

MedicalResearch.com Interview with:
Kristen L. Knutson, PhD Associate Professor Center for Circadian and Sleep Medicine Department of Neurology Northwestern University Feinberg School of Medicine Chicago, IL  60611​Premal Patel, MD, PGY-5
Urology
University of Manitoba

MedicalResearch.com: What is the background for this study? What are the main findings? What should readers take away from your report?

Response: Within the literature there has only been small experimental studies which looked at impaired sleep and testosterone. To our knowledge, there has been no study that has evaluated sleep and testosterone using a population dataset. We utilized the National Health and Nutrition Examination Survey to assess the association of sleep with serum testosterone. NHANES examines a nationally representative sample of about ~5000 persons each year.

After performing a multivariate linear regression of numerous variables within the NHANES database (age, marital status, prior co-morbidities, number of hours of sleep, etc…) we found that a reduction in the number of hours slept, increasing body mass index and increasing age were associated with lower testosterone levels.

Given that this is a cross-sectional analysis, we are unable to provide causality of this relationship but we do feel it is important to counsel patients with low testosterone about the importance of living a healthy lifestyle which includes a well-balanced diet, exercise and sufficient sleep.

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Prenatal Acetaminophen Linked To Decreased Masculinization and Testosterone in Male Offspring

MedicalResearch.com Interview with:
David M. Kristensen, PhD
Assistant Professor                                                                                                         Novo Nordisk Foundation Center for Protein Research
Faculty of Health and Medical Sciences, University of Copenhagen,
Blegdamsvej 3A, DK-2200 Copenhagen, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have demonstrated that a reduced level of testosterone during fetal life by paracetamol means that male characteristics do not develop as they should. This also affects sex drive. In the trial, mice exposed to paracetamol at the foetal stage were simply unable to copulate in the same way as our control animals. Male programming had not been properly established during their foetal development and this could be seen long afterwards in their adult life. Moreover, the area of the brain that controls sex drive – the sexual dimorphic nucleus – had half as many neurons in the mice that had received paracetamol as the control mice. The inhibition of testosterone seem to have led to less activity in an area of the brain that is significant for male characteristics.

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Normalizing Testosterone With Replacement Therapy Reduced Atrial Fibrillation Risk

MedicalResearch.com Interview with:

Rajat S. Barua, MD; PhD; FACC; FSCAI Associate Professor of Medicine (Cardiology), University of Kansas School of Medicine Director, Cardiovascular Research, Dept. of Cardiology, Kansas City VA Medical Center Director, Interventional Cardiology & Cardiac Catheterization Laboratory Kansas City VA Medical Center

Dr. Barua

Rajat S. Barua, MD; PhD; FACC; FSCAI
Associate Professor of Medicine (Cardiology), University of Kansas School of Medicine
Director, Cardiovascular Research, Dept. of Cardiology, Kansas City VA Medical Center
Director, Interventional Cardiology & Cardiac Catheterization Laboratory
Kansas City VA Medical Center

MedicalResearch.com: What is the background for this study?

Response: Atrial fibrillation is the most common cardiac arrhythmia worldwide, with significant morbidity, mortality and financial burden. Atrial fibrillation is known to increase with age and is higher in men than in women. Although the underlying mechanisms of this sex difference are still unclear, one preclinical and several small clinical studies have suggested that testosterone deficiency may play a role in the development of atrial fibrillation. To date, no studies have investigated the effect of testosterone-level normalization on incidence of new atrial fibrillation in men after testosterone replacement therapy.

In this study, we investigated the incidence of atrial fibrillation in hypogonadal men with documented low testosterone levels. We compared the incidence of atrial fibrillation among patients who did not receive any testosterone replacement therapy, those who received testosterone replacement therapy that resulted in normalization of total testosterone, and those who received testosterone replacement therapy but that did not result in normal total testosterone levels.

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Taking Testosterone Doesn’t Increase Prostate Cancer Risk

MedicalResearch.com Interview with:

Dr. Stacy Loeb, MD, MScDepartment of Urology, Population Health, and Laura and Isaac Perlmutter Cancer CenterNew York University, New York

Dr. Stacy Loeb

Dr. Stacy Loeb MD Msc
Assistant Professor of Urology and Population Health
New York University Langone Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The association between exposure to testosterone replacement therapy and prostate cancer risk is controversial.  The purpose of our study was to examine this issue using national registries from Sweden, with complete records on prescription medications and prostate cancer diagnoses.  Overall, we found no association between testosterone use and overall prostate cancer risk. There was an early increase in favorable cancers which is likely due to a detection bias, but long-term users actually had a significantly reduced risk of aggressive disease.

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Testosterone Therapy Improves Bone Mineral Density In Men With Low T

MedicalResearch.com Interview with:

Tony M. Keaveny, Ph.D. Professor, Departments of Mechanical Engineering and Bioengineering; Co-Director, Berkeley BioMechanics Laboratory University of California Berkeley, CA 94720-1740

Dr. Tony Keaveny

Tony M. Keaveny, Ph.D.
Professor, Departments of Mechanical Engineering and Bioengineering;
Co-Director, Berkeley BioMechanics Laboratory
University of California
Berkeley, CA 94720-1740

MedicalResearch.com: What is the background for this study?

Response: As men age, they experience decreased serum testosterone concentrations, decreased bone mineral density (BMD) and increased risk of fracture. While prior studies have been performed to determine the effect of testosterone treatment on bone in older men, for various reasons those studies have been inconclusive.

The goal of this study was to overcome past limitations in study design and determine if testosterone treatment — versus a placebo — in older men with low testosterone would improve the bone. Specifically, we used 3D quantitative CT scanning to measure changes in BMD and engineering “finite element analysis” to measure changes in the estimated bone strength, both at the spine and hip. The study was performed on over 200 older men (> age 65) who had confirmed low levels of serum testosterone.

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Testosterone Improves Anemia and Bone Strength, Worsens Coronary Plaque and Has No Effect on Memory

MedicalResearch.com Interview with:

Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health

Dr. Ronald Swerdloff

Ronald S. Swerdloff, MD
Chief of the Division of Endocrinology, Department of Medicine and
Director of a World Health Organization Collaborative Center in Reproduction
a Mellon Foundation Center for Contraceptive Development and a
NIH Contraceptive Clinical Trial Center
Director of the Harbor-UCLA Reproductive Program
LA BioMed Lead Researcher
David Geffen School of Medicine
UCLA Health

MedicalResearch.com: What is the background for this study?

Response: While we have long known that testosterone levels decrease as men age, very little was known about the effects of testosterone treatment in older men with low testosterone until last year.

Our team of researchers from LA BioMed and 12 other medical centers in the U.S., in partnership with the National Institute on Aging, conducted a coordinated group of seven trials known as The Testosterone Trials (TTrials). We studied the effects of testosterone treatment for one year as compared to placebo for men 65 and older with low testosterone. The TTrials are now the largest trials to examine the efficacy of testosterone treatment in men 65 and older whose testosterone levels are low due seemingly to age alone.

The first published research from the TTrials last year reported on some of the benefits to testosterone treatment. We have now published four additional studies in the Journal of the American Medical Association (JAMA) and JAMA Internal Medicine that found additional benefits and one potential drawback.

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Testosterone Replacement Did Not Increase Cardiovascular Risk In Androgen-Deficient Men

MedicalResearch.com Interview with:

Dr-Cheetham-Craig.jpg

Dr. Craig Cheetham

T. Craig Cheetham, PharmD, MS
Southern California Permanente Medical Group
Department of Research & Evaluation
Pasadena, CA 91101

MedicalResearch.com: What is the background for this study?

Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California. Continue reading

Starting Testosterone Associated With Increased Risk of Blood Clots

MedicalResearch.com Interview with:
Dr. Carlos Martinez

Institute for Epidemiology, Statistics and Informatics GmbH
Frankfurt, Germany,

MedicalResearch.com: What is the background for this study?

Response: A 10-fold increase in testosterone prescriptions per capita in the United States and a 40-fold increase in Canada in men has occurred over the first decade of this century, mainly for sexual dysfunction and/or decreased energy. Recognised pathological disorders of the male reproductive system remain the sole unequivocal indication for testosterone treatment but there has been increasing use in men without pathological hypogonadism. A variety of studies and meta-analyses have provided conflicting evidence as to the magnitude of the risk of cardiovascular events including venous thromboembolism in men on testosterone treatment.

In June 2014, the US Food and Drug Administration and Health Canada required a warning about the risk of venous thromboembolism to be displayed on all approved testosterone products. Studies have reported contradictory results on an association between testosterone use and the risk of venous thromboembolism. The effect of timing and duration of testosterone use on the risk of venous thromboembolism was not studied and may explain some of these contradictory findings.

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Is Testosterone Therapy Safe in Patients with Treated and Untreated Prostate Cancer?

MedicalResearch.com Interview with:

Dr. Jesse Ory Department of Urology, Faculty of Medicine Dalhousie University, Halifax Nova Scotia, Canada

Dr. Jesse Ory

Dr. Jesse Ory
Department of Urology, Faculty of Medicine
Dalhousie University, Halifax
Nova Scotia, Canada 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The use of Testosterone Therapy (TT) in men diagnosed with and treated for prostate cancer (CaP) has been highly controversial for several decades. Unfortunately, this controversy is largely founded on the results of a single patient in a study by Huggins and Hodges in the 1940s [1]. This wasn’t challenged until recently, when Morgentaler reviewed the literature on the topic and found no scientific basis for the assumption that TT will act like fuel on the fire of prostate cancer [2]. He also proposed a mechanism, the “saturation hypothesis” that helps account for why TT may in fact be safe for men with prostate cancer. [3]. Over the past decade, retrospective evidence has been accumulating that supports the safety of Testosterone Therapy in hypogonadal men with CaP on Active Surveillance, or in those who have been definitively treated for prostate cancer..

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Testosterone Therapy Improved Sexual Function in Older Men

MedicalResearch.com Interview with:
Glenn Cunningham, MD
Departments of Medicine and Molecular and Cellular Biology
Division of Diabetes, Endocrinology and Metabolism
Baylor College of Medicine and Baylor St. Luke’s Medical Center
Houston, Texas 77030

MedicalResearch.com: What is the background for this study?

Response: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of testosterone in symptomatic men ≥65 years with unequivocally low testosterone levels. Previous studies in older men have been limited and the results have been conflicting. Initial results of the Sexual Function Trial showed that testosterone improved sexual activity, sexual desire and erectile function.

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Does Testosterone Therapy Worsen Prostate Cancer Progression?

MedicalResearch.com Interview with:
Ryan Flannigan MD FRCSC
PGY 5 Urology Resident
Department of Urological Sciences
University of British Columbia

MedicalResearch.com: What is the background for this study?

Dr. Flannigan: In the aging population the incidence of both prostate cancer and testosterone deficiency (TD) increase and even overlap in many patients. However, since Huggins’ original research in 1940, we have understood that prostate cancer is largely regulated by the androgen receptor (AR). Thus, the thought of treating someone with exogenous testosterone (T) was concerning for fear of further activation of the androgen receptor, and therefore promoting prostate cancer growth. However, further research has continued to add clarity to this complex interaction between androgens and the prostate. The saturation theory describes the observation that prostate specific antigen (PSA) responds to increasing serum testosterone levels only to a value of approximately 8.7nmol/L, with no inflation of PSA beyond these T levels. This is likely not the whole story when it comes to the interaction of T and the prostate, but it does suggest the prostate may not experience changes in cellular function with serum testosterone beyond low levels. It is also understood that prostate cancer requires AR activation to grow but is not caused by AR activation. Thus, we hypothesized that among those with un-treated prostate cancer, ie. patients on active surveillance, would not experience changes in biochemical recurrence (BCR) or changes in disease progression. In addition, we hypothesized that patients with previously treated prostate cancer would not have viable prostate cancer cells and thus, PSA would not increase.

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Ejaculatory Issues Common and Not Helped By Testosterone Treatment

Darius A. Paduch, MD, PhDAssociate  Professor of Urology and Reproductive Medicine Director Sexual Health and Medicine Research Director of Male Infertility Fellowship Co-Director Male Infertility Genetics Laboratory Weill Cornell Medical College Dept of Urology New York, NY 10065MedicalResearch.com Interview with:
Darius A. Paduch, MD, PhD
Associate  Professor of Urology and Reproductive Medicine
Director Sexual Health and Medicine
Research Director of Male Infertility Fellowship
Co-Director Male Infertility Genetics Laboratory
Weill Cornell Medical College
Dept of Urology
New York, NY 10065

Medical Research: What is the background for this study? What are the main findings?

Dr. Paduch: Ejaculatory dysfunction, inability to ejaculate or delayed ejaculation affects 10-8% of men. Inability to ejaculate either intravaginally or at all is independent of erectile function.

Men with normal erection may take very long time to ejaculate (>30 min) or not able to ejaculate at all. The men in our study had either normal erections or minimal erectile dysfunction.

Men of all ages have spontaneous erections but don’t ejaculate just from erection, it is progression of arousal and activation of spinal cord motor generator for ejaculation which is necessary for ejaculation.

One of important factors in our ability to ejaculate is testosterone (T), testosterone allows for normal function of CNS centers for ejaculation, it is a modulator and is necessary; preadolescent boys don’t ejaculate because their spinal cord centers for ejaculations are not mature – process dependent on testosterone. However testosterone is just one of many neurotransmitters and hormones needed of normal ejaculation.

Actually our study showed that in men who achieved normal levels of testostosterone the ejaculatory function have improved. As this was first double blinded and randomized clinical trial we had to report our results based on radomization to testosterone treatment or placebo. Unfortunately only 70-80% of men treated with topical testosterone preparation will achieve normal testosterone level , we simply didn’t reach statistical significance based on randomization and  considering relatively low number of patients in each group. But in men who achieved normal testosterone levels the difference was statistically significant.

Testosterone should not be used to treat any conditions, including ejaculatory dysfunction, in absence of low testosterone  level.

EjD is very common but it bares significant embarrassment stigma, it is difficult for the couple to bear fact that male partner can’t ejaculate, it also creates issues within couple and question about attraction and fidelity.

We have previously showed that treatment with tadalafil improves ejaculatory and orgasmic dysfunction and these data has been published.

This study was focused on effect of testosterone, but its main significance was it’s design: we developed new tools to assess ejaculatory function and learned a lot about when patients or their partners start to be bothered by EjD. If time to ejaclate takes > 30 min

We are now looking into novel and available pharmacotherapy modulating dopaminergic and canabioid signaling and reward mechanisms. I am also very excited about our potential work in direct spinal cord motor generator nano stimulator, this could be very useful for men with spinal cord injuries and diabetic patients. We paved the road for others and I am sure new treatments are just a matter of time.

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Low Testosterone Linked To Obesity and Depression In Men

Michael S. Irwig MD Division of Endocrinology Medical Faculty Associates George Washington UniversityMedicalResearch.com Interview with:
Michael S. Irwig MD
Division of Endocrinology Medical Faculty Associates
George Washington University

Medical Research: What is the background for this study? What are the main findings?

Response: Many factors are associated with lower testosterone levels and many men who have their testosterone levels checked have non-specific depressive symptoms. The main finding is a remarkably high rate of depression and depressive symptoms (56%) in men who are referred for borderline testosterone levels. Other significant findings include a prevalence of overweight and obesity higher than the general population.

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Testosterone Therapy Lowered Mortality In Hypogonadal Men

Ranjith Ramasamy MD Assistant Professor of Urology University of MiamiMedicalResearch.com Interview with:
Ranjith Ramasamy MD
Assistant Professor of Urology
University of Miami

Medical Research: What is the background for this study?

Dr. Ramasamy: The association between testosterone supplementation therapy (TST) and thrombotic risk in elderly men remains controversial. We evaluated the prevalence of thrombotic events and all-cause mortality in men older than 65 years with hypogonadism treated with testosterone therapy. We compared men treated with testosterone to an age and comorbidity matched cohort of hypogonadal men not treated with testosterone supplementation therapy.

Medical Research: What are the main findings?

Dr. Ramasamy: No man who received testosterone supplementation therapy died, whereas 6 hypogonadal men who did not receive TST died (p=0.007). There were 4 thrombotic events (1 MI – myocardial infarction, 2 CVA/TIA – stroke, 1 PE – pulmonary embolism) in men who received testosterone supplementation therapy compared to 1 event (CVA/TIA) among men who did not receive TST (p = 0.8). All the events (except one death which took place at 6 months of follow–up) occurred 2 years or more after follow–up. Strengths of the study include long follow–up (>3 years), availability of serum testosterone levels before and after therapy and of a control group (hypogonadal men not treated with TST) for comparison. Limitations included retrospective study design, and a small sample size.
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Low Testosterone May Affect More Than 25% of US Males

MedicalResearch.com Interview with: Jim Dupree, MD, MPH Assistant Professor Department of Urology, Division of Andrology University of MichiganMedicalResearch.com Interview with:
Jim Dupree, MD, MPH

Assistant Professor
Department of Urology, Division of Andrology
University of Michigan

Medical Research: What is the background for this study? What are the main findings?

Dr. Dupree: There are increasing discussions in the United States about testosterone therapy and men with clinical hypogonadism (or low testosterone).  Yet, to date, there have not been any nationally-representative studies of the prevalence of low testosterone in the United States.  Using a validated national health examination program from the CDC, we found that the national prevalence of low testosterone (serum testosterone ≤ 300 ng/dL) in adult males in the US was 28.9%.  Among other factors, men who were older, had a higher body mass index (BMI), or had a larger waist circumference were at risk for having lower testosterone levels.

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Testosterone May Protect Against Mood-Related Disorders

Mohamed Kabbaj, PHD Professor of Biomedical Sciences & Neurosciences College of Medicine Florida State UniversityMedicalResearch.com Interview with:
Mohamed Kabbaj, PHD
Professor of Biomedical Sciences & Neurosciences
College of Medicine
Florida State University

Medical Research: What is the background for this study? What are the main findings?

Dr. Kabbaj: While anxiety and depressive disorders a major public health concern worldwide, so too are the pervasive sex differences that exist within these pathologies. Fluctuations in the predominant female reproductive hormones, estradiol and progesterone, are thought to be a major contributor to the higher prevalence of anxiety and depression in women compared to men. However, many studies in humans and rodents alike have demonstrated that testosterone, the primary male sex hormone, also influences affective status and may yield protective benefits against the development of mood-related disturbances. Indeed, hypogonadal males with low testosterone levels experience increased rates of anxiety and depressive symptoms. In many of these cases, testosterone replacement alone or in addition to antidepressant medication have been shown to effectively improve mood. How this hormone acts in the brain to exert its beneficial effects, however, is much less clear. Interestingly, it is well-known that many of testosterone’s effects in the brain occur via its conversion to estrogen by the enzyme aromatase. What remained unclear was whether or not this conversion to estrogen was critical for testosterone’s protective anxiolytic and antidepressant effects—so Nicole Carrier and Samantha Saland from Dr. Kabbaj’s lab aimed to figure out just that.

To do this, Carrier and Saland targeted an area of the hippocampus in the brain involved in mood regulation where testosterone is known to act to carry out some of its anxiolytic and antidepressant effects in male rats. Here, they inhibited the enzyme responsible for the conversion of testosterone into estrogen and investigated performance in mood-related behaviors. In doing so, they discovered that testosterone’s anxiolytic- and antidepressant-like effects were lost unless this hormone was first converted into estrogen. Importantly, they also found that continuous testosterone and estrogen treatments had very similar effects on the expression of genes within this brain region that are highly implicated in the regulation of mood as well as antidepressant treatments.

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Low Levels of Testosterone May Raise Risk of Heart Disease

Abraham Morgentaler, MD Director and Founder Men’s Health BostonMedicalResearch.com Interview with:
Abraham Morgentaler, MD

Director and Founder
Men’s Health Boston

Medical Research: What is the background for this study? What are the main findings?

Response: There has been  tremendous media attention over the last 15 months to two retrospective studies that reported increased cardiovascular risks with testosterone. Those reports anchored a variety of stories critical of testosterone therapy for non-scientific reasons, such as alleged dangers of direct-to-consumer advertising.  In this review we investigated the two recent studies in depth, as well as the broader literature regarding testosterone and cardiovascular issues. One primary finding was that the studies alleging risk were remarkably weak and flawed- one reported low rates of MI and had no control group, and the other had such large data errors (nearly 10% of the all-male population turned out to be female!) that 29 medical societies have called for its retraction. In contrast, there is substantial literature suggesting that testosterone therapy, or naturally occurring higher levels of testosterone, is protective against atherosclerosis, and mortality.  Several small randomized controlled trials in men with known heart disease- angina and congestive heart failure- have even shown benefits for men that received testosterone compared with placebo.

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Animal Studies Suggest Testosterone May Increase Prostate Cancer Risk

Maarten C. Bosland, DVSc, PhD Professor of Pathology Department of Pathology, College of Medicine University of Illinois at Chicago Chicago, IL 60612MedicalResearch.com Interview with: 
Maarten C. Bosland, DVSc, PhD
Professor of Pathology
Department of Pathology, College of Medicine
University of Illinois at Chicago
Chicago, IL 60612

Medical Research: What are the main findings of the study?

Dr. Bosland: The two main findings are :

(1) that long-term, low-dose testosterone treatment induces prostate cancer in rats (none occurred in control rats) and increases the number of rats with malignant tumors at any site in the body compared to control rats, and

(2) that in rats treated long-term with testosterone after a single prostate-targeted chemical carcinogen treatment a high incidence of prostate cancer is induced, even at a very low testosterone dose.
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Is Testosterone Protective Against Heart Attack in Older Men?

Jacques Baillargeon, PhD Director, Epidemiology Division Associate Professor Department of Preventive Medicine and Community Health University of Texas Medical Branch MedicalResearch.com Interview with:
Jacques Baillargeon, PhD
Director, Epidemiology Division
Associate Professor
Department of Preventive Medicine and Community Health
University of Texas Medical Branch

MedicalResearch: What are the main findings of the study?

Dr. Baillargeon: The main findings of the study were that older men who were treated with testosterone did not appear to have an increased risk of Myocardial Infarction.  For men with high MI risk, testosterone use appeared to be modestly protective against MI.

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Testosterone Treatment Linked to Weight Loss in Obese Men

Dr. Farid Saad Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany; Gulf Medical University School of Medicine Ajman, United Arab Emirates;MedicalResearch.com Interview with:
Dr. Farid Saad
Global Medical Affairs Men’s Healthcare, Bayer Pharma, Berlin, Germany;
Gulf Medical University School of Medicine
Ajman, United Arab Emirates

MedicalResearch: What are the main findings of the study?

Dr. Saad: There are two ongoing registry studies in men with testosterone deficiency (hypogonadism, defined by two separate measures of low serum testosterone and the presence of symptoms which are typical for testosterone deficiency). The studies are being conducted by office urologists. The total number of men who have been treated for a maximum duration of six years is 561, mean age just under 60 years. All men received three-monthly intra-muscular injections of a long-acting testosterone depot preparation.

The main findings were that at baseline only five per cent of these men had normal weight, some 25 per cent were overweight and the majority obese. Both overweight and obese men showed reductions in weight and waist circumference. The more obese men were, the more they lost. Men in the highest obesity category grade III (BMI ≥ 40 kg/m2), had a mean weight loss of 26 kg and a reduction of waist size by 12 cm.

In parallel, all components of the metabolic syndrome improved in a clinically meaningful magnitude, i.e., blood pressure, lipid profile, and glycemic control. When we analyzed a subgroup of 156 men with type 2 diabetes, we found marked improvements in their diabetes as a result of adding testosterone to the standard diabetes treatment men are receiving by their famaily physicians.

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Does Testosterone Lower Risk of Heart Attacks and Stroke?

Robert S. Tan MD, MBA, AGSFMedicalresearch.com Interview with:
Robert S. Tan MD, MBA, AGSF
Clinical Director & Chief Geriatrics, Michael DeBakey VAMC
Director, Opal Medical, LLC
Clinical Professor of Family & Community Medicine, UTHSC-Houston
Associate Professor of Medicine (Geriatrics), Baylor College Medicine

Medicalresearch: What are the main findings of the study?

Dr. Tan: Our findings¹ are similar to that of an early study by Shores et al ² and other studies on endogenous testosterone that found testosterone lowered mortality. In the analysis of 39,937 patients at the Low T Centers up to 5 years, the rate ratios of new MI and strokes on testosterone as compared to general community based data sets (3,4) was 0.12 (C.I. 0.08-0.18, p<0.0001) and 0.05 (C.I 0.02-0.13, p<0.0001) respectively. Thus, there appears to be a lower risk of heart attacks and strokes with patients on testosterone. While the compared population sets are not identical or real controls; our study does suggest that rates of MI and strokes in real life practice with testosterone treated patients are even lower than the general population registries (which may include older patients).
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Prostate Cancer: Low Testosterone Levels Linked to Aggressive Disease

dr_san_franciscoMedicalResearch.com Interview with:
Dr. Ignacio F. San Francisco
Departamento de Urología, Facultad de Medicina,
Pontificia Universidad Católica de Chile, Santiago, Chile

MedicalResearch: What are the main findings of the study?

Answer: Increasingly, men with low-risk prostate cancer are undergoing a close monitoring regimen called active surveillance, instead of moving forward immediately with treatment. However it is still unclear which men will develop evidence for worsening or more aggressive disease during active surveillance. In this study of 154 men with Gleason 6 prostate cancer followed for 38 months, we found that low levels of free testosterone were significantly associated with increased risk of developing more aggressive disease. We found no significant association with total testosterone concentrations, although there was a general trend towards increased risk with lower levels.
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