Hormone profiles,body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of ‘andropause’ in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed.

We examined 664 blue-collar workers aged 40–60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms.

Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1?ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio?=?1.832, p?=?0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI >?28?kg/m² and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level <?1.5?ng/ml compared to men without these risk factors (p <?0.001). Sensitivity and specificity were 75% and 71%, respectively.

The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.     

Examining the effect of the computer-based educational package on quality of life and severity of hypogonadism symptoms in males

Objective: The objective of this study was to determine the effect of the computer-based educational package on men’s QoL and the severity of their hypogonadism symptoms.

Methods: A quasi-experimental study was conducted on 80 male employees. The data collection tool included the ‘Aging Male Symptoms’ (AMS) and ‘Short Form-36’ (SF36) questionnaires. Four sessions were held for the intervention group over a period of 4 weeks. Two months after training, QoL and the severity of hypogonadism symptoms were measured in both the intervention and control groups. The data were analyzed with SPSS 22 software and statistical tests, such as χ², independent t-test, Fisher’s exact test, and paired t-tests.

Results: Significant statistical changes were observed in the intervention group before and 2 months after the training in the QoL score in the overall dimensions of physical–psychological health and all its domains except for three domains of emotional role, social function, and pain. Furthermore, the paired t-tests showed significant differences between 2 months before and after the training in all the domains and the overall hypogonadism score in the intervention group.

Conclusions: Based on our findings, the computer-based educational package has a positive effect on QoL and reduction of hypogonadism symptoms.     

Bystander interventions for sexual assault and dating violence on college campuses: Are we putting bystanders in harm's way?

Objective: The present study investigated the well-being of bystanders who witness and intervene in sexual assault and dating violence situations on campus. Participants: Participants were 321 young men and women from a large university in the southeastern United States. Methods: Participants completed a survey at the end of the Spring semester of 2015 about risky situations they had witnessed, with follow-up questions about their responses to the situations (eg, whether they intervened or not) and feelings about their responses. Participants also completed standardized measures of posttraumatic stress disorder and depression. Results: Over 90% of the participants reported witnessing at least 1 of the risky events presented to them, and approximately 50% reported intervening in events. Intervening was associated with positive feelings, but traumatic stress symptoms were related to witnessing events and intervening. Conclusions: Results have direct implications for developing appropriate training programs for bystander intervention programs on college campuses.     

Soy protein based supplementation supports metabolic effects of resistance training in previously untrained middle aged males

Abstract

Objective.?To determine changes in body composition, physical performance, metabolic and hormonal parameters induced by lifestyle counselling, resistance training and resistance training with soy protein based supplemention in middle aged males.

Design.?Randomised controlled study consisting of resistance training without (RT-G) or with (RTS-G) a soy protein based supplement and a control group with lifestyle education only (LE-G).

Subjects.?Forty healthy middle aged men (50–65 years, BMI 25–29.9 kg/m²).

Measurements.?Changes in body weight (BW) and waist circumference (WC) were measured and body composition (BC), fat mass (FM), lean body mass (LBM) were measured by skin fold anthropometry at baseline and after 12 weeks of intervention. In addition, changes in physical fitness, metabolic and hormonal parameters (lipids, glucose, fructosamines, insulin, insulin-like growth factor-1, Leptin, human growth hormone, dehydroepiandrosterone, testosterone, hs-CRP, Il-6) were evaluated.

Results.?Thirty-five participants completed the 12 week study. No significant changes in BW were noted although RM and WC dropped and LBM increased after training, particularly in the RTS group (FM 22.6?±?5.5?kg to 21.2?±?4.7?kg; LBM 68.5?±?7.2?kg to 70.1?±?7.4; p?<?0.01). Subjects in the RTS group experienced more pronounced improvements in the strength measurements than the RT group. After the training intervention there were significant changes in hormonal and metabolic parameters as well as in glycemic control, particularly in the RTS group.

Conclusions.?Our data suggest that resistance training, particularly in combination with a soy protein based supplement improves body composition and metabolic function in middle aged untrained and moderately overweight males.     

The Adolescent Sexual Development of African American Gay Men with AIDS: Implications for Community-Based Practice

ABSTRACT

This qualitative study describes the adolescent sexual development of ten African American gay men living with AIDS. The informants retrospectively describe the challenges of being a gay adolescent in a mostly heterosexist and homophobic environment. They report unsupportive homophobic and heterosexist family members, community members and school officials. They also describe their burgeoning sexual orientation, sexual initiation as well as consensual and non-consensual sexual experiences with their peers. Additionally, several informants describe seeking sexual experiences with adult men. Later they suggest the adult men became their primary sources of emotional and psychological support. Implications for community practice, intervention and research with both African American gay adolescents and adult men living with AIDS are discussed.     

Factors Influencing the Sexual Relationships of Lesbians and Gay Men

ABSTRACT

This study examined the rewards and costs that lesbians and gay men experience in their sexual relationships. Participants were 23 lesbians and 15 gay men who completed questionnaires and participated in a semi-structured interview. Frequently identified sexual rewards included emotional and physical intimacy, feeling accepted and supported, communication, and a positive view of self. Sexual costs included feeling vulnerable and negative social and cultural attitudes toward same-sex relationships. Sexual rewards and costs tended to cluster into three main categories: relationship factors, sexual factors, and factors related to being a sexual minority. The participants' responses illustrate the limitations of applying conventional (biomedical) models of sexual response to men as well as to women. Moreover, they strengthen calls for theories of sexual functioning that are based on diverse experiences and that consider sociocultural, political, economic, relational, psychological, and medical factors.     

The effects of a pedometer-based intervention on first-year university students: A randomized control trial

ABSTRACT

Objectives: To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior, health-related quality of life (HRQOL), and psychological well-being of first-year university students. Participants: First-year university students (N = 184) were recruited during September 2012 and randomly assigned to an intervention or a control group. Methods: Intervention participants were provided with a pedometer, monthly tracking logs, and follow-up e-mails. Control participants received no intervention. Physical activity, HRQOL, and psychological well-being were measured at baseline and post intervention. Data were analyzed using multivariate/univariate analysis of variance (MANOVA/ANOVA). Results: All participants experienced an increase in mild physical activity (p < .01) from baseline to follow-up. The intervention failed to produce significant differences between groups for physical activity (p = .28), HRQOL (p = .80), or psychological well-being (p = .72). Psychological well-being (p < .001), vigorous physical activity (p = .04), and mental health status (p < .001) decreased across the duration of the study. Conclusions: More intensive interventions may be required to elicit physical activity behavior change.     

Assessment of college students with the revised Conflict Tactics Scale (CTS2): Sociodemographic characteristics and relationship

ABSTRACT

This paper presents prevalence data gathered from the fast-growing metropolitan southeast in the United States college campus representative sample through an on-line 28-question survey on the sexual, physical, and psychological harm in university/college dating and domestic violence relationships. The study questions were 1) what is the prevalence of dating and domestic violence on college campus? and 2) what are the characteristics of those affected by it? The results, derived from the Revised Conflict Tactics Scale (CTS2) and the dating experiences survey, reveal that college students’ gender identity, sexual orientation, grade point average (GPA), number of missing classes, current relationship status that they were associated with dating and domestic violence among college students. Statistically significant relationships were found between sexual violence and participants’ sexual orientation and the length of their romantic relationship as well as physical violence, including hitting and shoving, and participants’ sexual orientation and their class attendance. Institutional responses to prevent campus violence through prevention training, education, and intervention services could lower the prevalence of dating and help alleviate the adverse effects that it could have on college students.     

Preoperative sexual status of Japanese localized prostate cancer patients: comparison of sexual activity and EPIC scores

Objective: This study aimed to evaluate the relationship between sexual activity and sexual function using questionnaires distributed to middle-aged Japanese patients with localized prostate cancer.

Methods: A total of 145 patients who underwent radical prostatectomy were enrolled in the survey reported on herein. Sexual activity and sexual function were investigated via the Expanded Prostate Cancer Index Composite (EPIC) and an original self-reported questionnaire.

Results: Of participants, 24.1% and 20.7% had sexual activity within a month period as investigated via the EPIC and original questionnaire, respectively. However, 29.7% of all those who reported sexual activity rate reported “about once every 2?months to a year,” as shown in the original questionnaire. Regarding sexual function as addressed through EPIC, no results within that questionnaire’s measure of sexual function showed significant differences among patients with a rate of actual sexual activity.

Conclusions: The present survey showed that more than quarter of preoperative middle-aged Japanese prostate cancer patients surveyed had actual sexual activity, though not within the preceding 4?weeks. To precisely evaluate sexual function of middle-aged Japanese patients, it is necessary to consider actual sexual activity.     

Are the Aging Male’s Symptoms (AMS) scale and the Androgen Deficiency in the Aging Male (ADAM) questionnaire suitable for the screening of late-onset hypogonadism in aging Chinese men?

Abstract

The Aging Male’s Symptoms (AMS) scale and the Androgen Deficiency in the Aging Male (ADAM) questionnaire have been widely used for screening men suspected of late-onset hypogonadism (LOH). We evaluated the consistency of the two questionnaires with sex hormone levels. A total of 985 men completed the two questionnaires, as well as an analysis of the serum levels of total testosterone (TT), bioavailable testosterone (BT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), prolactin (PRL) and sex hormone-binding globulin (SHBG). No correlation was observed between any hormone level and the psychological or somatic section of the AMS score, whereas the sexual section was correlated with the levels of FT, LH, FSH, SHBG and BT. Significant correlations were observed between the result of the two questionnaires and these hormone levels. When LOH was defined as TT?<?300?ng/dl and FT?<?5?ng/dl, the sensitivity and specificity of the AMS scale were 54.0% and 41.2% compared with 78.7% and 14.8% for the ADAM questionnaire. Several sex hormone levels correlated with the two questionnaires, but neither of these questionnaires had sufficient sensitivity and specificity. It is necessary to provide a new questionnaire applicable to the Chinese population to screening LOH.     

Intimate Partnerships and Sexual Health in Gender-Dysphoric Individuals Before the Start of Medical Treatment

ABSTRACT

Objectives: This study focuses on sexual health aspects in partnered gender-dysphoric individuals at the start of medical treatment by examining their partnership constellations, sexual experiences, and reports of psychological problems. Methods: As part of the cross-national European Network for the Investigation of Gender Incongruence Study, 168 adult male-to-females (MFs) and female-to-males (FMs; MF:FM sex ratio = 1:1.2) were surveyed by means of self-administered questionnaires prior to any gender-confirming hormonal and surgical interventions. Results: MFs were often found to have androphilic (female) partners (sexually oriented toward males), noncomplementary with their female gender identity. In contrast, FMs frequently had androphilic (female) partners, complementary with their male gender identity and sexual orientations toward females. Conclusions: In both genders, complementary partnership constellations were associated with more avoidance of sexual experiences and more negative sexual experiences.     

Mental Health and Clinical Correlates in Lesbian,Gay, Bisexual,and Queer Young Adults

Abstract

Objective: This study examined the prevalence of mental health disorders and their clinical correlates in a university sample of lesbian, gay, bisexual, and queer (LGBQ) students. Participants: College students at a large public university. Methods: An anonymous, voluntary survey was distributed via random e-mail generation to university students during April and May of 2011. LGBQ students were compared with their heterosexual counterparts on psychological and physical status as well as academic performance. Results: LGBQ students reported worse depressive symptoms, higher levels of perceived stress, considered themselves less attractive, and were more likely to be overweight. LGBQ students were significantly more likely to report histories of affective, substance use, and certain anxiety disorders as well as compulsive sexual behavior and compulsive buying. Conclusions: The higher rates of many psychiatric conditions among LGBQ students underscore the need for universities to provide LGBQ students a nonjudgmental environment to discuss sexual orientation and health issues.     

Adding to the controversy: Pitfalls in the diagnosis of testosterone deficiency syndromes with questionnaires and biochemistry

Purpose. To determine the value of available questionnaires used for the diagnosis of testosterone deficiency syndromes (TDS) by correlating their ratings with a panel of hormonal determinations in a male population.

Materials and methods. Participants completed the ADAM questionnaire and underwent biochemical evaluation at the local site. Assessments determined entry into Group A (symptomatic) or Group B (non-symptomatic). After stratification, subjects provided a morning sample of blood, completed the Aging Male Survey (AMS) and the newly developed Canadian Society for the Study of the Aging Male (CSAM-Q) questionnaires. Serum aliquots were analysed at a central lab for 8 putative markers commonly associated with symptomatic testosterone deficiency associated with aging: total testosterone (T); bioavailable T (BT); dehydroepiandrosterone sulphate (DHEA-S); sex-hormone binding globulin (SHBG); luteinizing hormone (LH), prolactin (PRL); thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1).

Results. 92 men were screened; of these 59 (mean age of 58 ± 11 years) completed the study, 30 (51%) scored positively (mean 61.5 years) to the ADAM while 29 (49%) did not (mean 54.1 years). For the AMS the weight of the three domains (psychological, somato-vegetative and sexual) was significantly greater in Group A (p < 0.001) than in Group B. Equally, for the CAS questionnaire, the scores for the variables energy, global performance, frequency of intercourse, mood and quality of sleep were lower in Group A than in their asymptomatic counterparts (p < 0.001). The domain of memory assessment within the CSSAM-Q was not discriminatory. ADAM and AMS are self-administered and completed within 10 minutes. CSSAM-Q is more time consuming, requires an investigator to administer, and memory domain is biased in favour of specific professional training.

No difference was found between the two groups in 6 of 8 biochemical tests. However, significant lower values (p < 0.001) were found for DHEA-S and IGF-1 in the symptomatic group as compared with the non-symptomatic cohort.

Conclusions. This study confirms that newer, more complex tools perform similarly to the simpler ADAM questionnaire. The lack of correlation between the clinical picture and the most commonly used biochemical confirmatory tests, again, clearly points to the paramount importance of the clinical evaluation. An emphasis and reliance on serum T alone hinders the clinician's ability to manage testosterone deficiency syndromes (TDS).     

Performance of Massachusetts Male Aging Study (MMAS) and androgen deficiency in the aging male (ADAM) questionnaires in the prediction of free testosterone in patients aged 40 years or older treated in outpatient regimen

Abstract

Objective: At present, calculated free testosterone assessment is considered as the gold standard in diagnosing male hypogonadism. However, this assessment is not available for all the individuals diagnosed with decreased testicular function. The investigators of this study were, thus, prompted to evaluate whether the androgen deficiency in the aging male (ADAM) and the Massachusetts Male Ageing Study (MMAS) questionnaires could be used to replace biochemical parameters in the diagnosis for hypogonadism in men aged 40 years and above.

Methods: We evaluated 460 men, aged 40 years and above, all volunteers of a screening program for prostate cancer based at the Hospital de Clínicas of Porto Alegre. In this study, we assessed the efficiency of the ADAM and MMAS questionnaires in diagnosing Brazilian men with low levels of total, calculated free and bioavailable testosterone.

Results: The sensitivity of the ADAM questionnaire in diagnosing the calculated free testosterone was 73.6%, whereas specificity was 31.9%. ADAM could be used to properly classify our cohort into normal or hypogonadal individuals in 52.75% of the cases. The sensitivity of the MMAS questionnaire was 59.9%, whereas the specificity was 42.9%, resulting in a successful classification of 51.4% of the patients.

Conclusion: The ADAM and MMAS questionnaires showed adequate sensitivity in diagnosing male patients with low levels of free testosterone. However, because of the lack of specificity, these tools cannot replace calculated free testosterone assessments in men aged 40 years and above.     

Changes in Sexual Distress,Depression and Sexual Function after Clitoral Reconstruction in Women with Female Genital Mutilation/Cutting

Abstract

Background: Female genital mutilation/cutting (FGM/C) links health complications and psychological distress. However, there is scarce literature on how women with FGM/C respond to treatment interventions. Objective: In this study, we aimed to assess changes in depression symptomatology, sexual function, and distress following clitoral reconstructive surgery combined with a psychoeducational intervention. Methods: The reconstructive surgery consisted of recovering the remaining clitoris and placing it externally and as close to the vagina as possible. FGM/C patients (n?=?27) received psychological support and sexual counseling upon undergoing the surgical intervention and were further assessed at 6-month follow-up. Moreover, they completed the Beck Depression Inventory and the Female Sexual Distress Scale Revised at these two time points. Patients’ sexual dysfunction was assessed according to DSM-5 criteria. Results: Statistically significant clinical changes after FGM/C were reported. Overall, patients presented reduced depression and sexual distress levels, and decreased female sexual interest/arousal disorder prevalence. Results also revealed that sexual distress improvements were more significant in Type I FGM/C patients. Conclusions: Significant improvements in sexual distress, psychopathology, and sexual function were observed in our sample following reconstructive surgery, suggesting that combined interventions are effective for treatment.     

Validation of an Arabic ADAM questionnaire for androgen deficiency screening in the Arab community

Background.?It is well documented that testosterone levels decline with age, this decline is associated with symptoms which could be assessed denoting androgen deficiency. We investigated the validity of an Arabic version of the Saint Louis University androgen deficiency in ageing men (ADAM) questionnaire to screen for androgen deficiency in Saudi and non Saudi Arabic speaking men.

Methods.?It was a cross sectional study of ambulatory community-based Arabic Saudi men recruited from Volunteers in Riyadh city, Capital of Saudi Arabia, aged 18–80 years. Seven hundred thirty men agreed to fill the Arabic ADAM questionnaire, they were invited to a morning blood sample for total testosterone and sex hormone binding globulin and those who agreed to complete the whole study were only 407 men. Low serum bioavailable testosterone (BT) levels (androgen deficiency) were defined as <10th percentile of serum BT levels in young healthy Saudi men (18–30 years).

Results.?Cronbach's Alpha of 0.71 (n?=?730) showed a good internal consistency of the Arabic ADAM questionnaire. Among participants, 18.2% and 77.6% had low serum BT levels and a positive ADAM questionnaire, respectively. The prevalence of positive ADAM and low serum BT is increasing with age. The Arabic ADAM questionnaire had a high sensitivity of 86.5%, a low specificity of 24.3%, and positive predictive values (+PVs) and negative (?PVs) of 20.3% and 89%, respectively.

Conclusion.?The Arabic ADAM questionnaire has a very good sensitivity but very low specificity for screening of androgen deficiency in Saudi men, therefore biological confirmation is needed especially when clinical symptoms of androgen deficiency are present.     

Application of multivariate longitudinal models in SIRT6, FBS,and BMI analysis of the elderly

Abstract

Objective: SIRT6 is a main regulator of metabolism and lifespan and its importance has been implicated in the prevention against aging-related diseases. The objective of this study was to examine the application of multivariate longitudinal models in SIRT6, FBS, and BMI analysis in the elderly men after eight weeks concurrent training with supplementation of l-arginine (l-Arg).

Methods: Thirty two elderly men with mean age of 63.09?±?3.71 years were randomly divided into four equal-sized groups (each n?=?8); Exercise?+?supplement (ES) group; exercise?+?placebo (EP) group; supplement (S) group and control (C) group. The ES and EP groups performed the eight weeks of concurrent training, three sessions per week. Group ES and group S consumed 1000?mg of l-Arg per day at 8:00?pm. Measurements of biochemical variables were done by ELISA Reader method. For analytical purposes, we used the paired sample t-test and multivariate longitudinal modeling with generalized estimating equation (GEE) methodology. All analyses have been implemented in R-3.4.1. p Values less than .05 were considered statistically significant.

Results: With respect to significant association between sirt6, FBS, and BMI, this study showed that synergy effect of training and supplementation was greater than the sum of their individual effects on SIRT6 (β?=?0.79, p?<?.001), FBS (β?=??5.56, p?=?.022), and BMI (β?=??3.89; p?=?.041). Also exercise alone had a significantly larger effect than supplementation alone on responses.

Conclusions: It can be concluded that the joint usage of concurrent training and supplement of l-Arg for elderly men could improve the metabolism and body composition.