Cross-sectional analysis between prostate volumes and serum sex hormones in Japanese men attending a urological clinic

Aim: To evaluate epidemiologically the association between measured prostate volume and sex hormones.

Methods: Between December 2012 and September 2014, 226 patients attending the urological clinic were assessed for the relationship between prostate volume (PV) and, serum sex hormones, physical size, personal habits, etc. Prostate volume was measured by using transabdominal ultrasonography. Statistically, the Pearson correlation coefficients test was used.

Results: Total cases, the cases of PV?≤?25?ml, and the cases of PV?>?25?ml were evaluated respectively. Total cases and the cases of PV?>?25?ml showed a positive significant correlation with testosterone (T), but the cases of PV?≤?25?ml showed no such correlation. The cases of PV?>?25?ml had a positive significant correlation with estradiol (E2), but total cases and cases of PV?≤?25?ml did not. Dehydroepiandrosterone sulfate (DHEAS) showed no correlation with any case of PV, however it decreased significantly with age and had a correlation with alopecia. The E2/T ratio had no correlation with any case of PV, but on the other hand, the T/DHEAS and E2/DHEAS ratios had significant positive correlation with PV?>?25?ml.

Conclusions: Serum T and E2 had significant positive correlation with measured PV especially in larger prostates. This result seems to correspond with the conventional theory that T and E2 have an etiological effect on benign prostatic hyperplasia. DHEAS did not show direct correlation with PV, however it appeared to suppress the role of T and E2 on benign prostatic hyperplasia growth. DHEAS might be a key to understanding the etiology of benign prostatic hyperplasia with aging.     

Association of serum calcium with serum sex steroid hormones in men in NHANES III

Abstract

Background: Bone is a positive regulator of male fertility, which indicates a link between regulation of bone remodeling and reproduction or more specifically a link between calcium and androgens. This possibly suggests how calcium is linked to prostate cancer development through its link with the reproductive system. We studied serum calcium and sex steroid hormones in the Third National Health and Nutrition Examination Survey (NHANES III).

Methods: Serum calcium and sex steroid hormones were measured for 1262 men in NHANES III. We calculated multivariable-adjusted geometric means of serum concentrations of total and estimated free testosterone and estradiol, androstanediol glucuronide (AAG), and sex hormone binding globulin (SHBG) by categories of calcium (lowest 5% [<1.16?mmol/L], mid 90%, top 5% [≥1.30?mmol/L]).

Results: Levels of total and free testosterone, total estradiol or AAG did not differ across categories of serum calcium. Adjusted SHBG concentrations were 36.4 for the bottom 5%, 34.2 for the mid 90% and 38.9?nmol/L for the top 5% of serum calcium (P_trend?=?0.006), free estradiol levels were 0.88, 0.92 and 0.80?pg/ml (P_trend?=?0.048).

Conclusions: This link between calcium and sex steroid hormones, in particular the U-shaped pattern with SHBG, may, in part, explain why observational studies have found a link between serum calcium and risk of prostate cancer.     

An association between bone mineral density and anabolic hormones in middle-aged and elderly men with prediabetes

Introduction: Prediabetes (PD) leads to reduced testosterone (T) in males, but the association between the anabolic hormones and bone mineral density (BMD) remains unknown.

Objectives: We investigated an association between the anabolic hormones and BMD in middle-aged and elderly men with PD.

Methods: We investigated 84 prediabetic and 56 control men. Total T (TT), calculated free T (cFT), and dehydroepiandrosterone sulfate (DHEAS) were measured, and BMD was assessed using DXA methods.

Results: Patients with PD had lower TT (p?p?<?.005), and DHEAS (p?<?.02) than control group. BMD values of the lower lumbar spine (p?<?.02) and total body (p?<?.05) in prediabetic men were lower than in control group. Lumbar spine BMD correlated with TT (r?=?0.376), cFT (r?=?0.235), and HbA1c (r?=??0.368); femoral neck BMD correlated with TT (r?=?0.412) and cFT (r?=?0.421). The high lumbar spine and femur neck BMD was associated with high TT, cFT, and low HbA1c, while the high total body BMD with high TT, cFT, and low HbA1c.

Conclusion: The anabolic hormones significantly affect BMD in male with PD, and screening for low BMD is necessary in these patients.     

Enablers and barriers affecting medication-taking behaviour in aging men with benign prostatic hyperplasia

Abstract

Objectives: To identify the enablers and barriers affecting medication-taking behaviour in aging men with benign prostatic hyperplasia.

Methods: A total of 40 patients attending the urology outpatient clinic in Melbourne in 2012 were screened. Patients who successfully met the inclusion criteria were interviewed using a structured interview schedule. Information regarding the patient’s medication, demographic data and presence of co-morbidities was collected. Content analysis was compared with patient demographic and medical data, contributing to the analysis.

Results: Problems with medication-taking were reported in 58% of patients. All patients without co-morbidities reported issues regarding their medications, whereas only 27% of patients with co-morbidities reported concerns regarding their medications. Statistical analysis revealed that patients without co-morbidities were significantly more likely (p?=?0.002) to have complaints with their medications compared to those with co-morbidities. Furthermore, patients with co-morbidities who required help of caregivers to assist with their medication-taking were significantly less likely (p?=?0.05) to have complaints with their medications compared to patients who self-managed.

Conclusions: Older patients with caregivers who assisted managing their medication-taking had better adherence. Those receiving aid from their caregivers were significantly less likely to have complaints regarding their medications as opposed to those not requiring a caregiver. This highlights the importance of having support for medication-taking in patients with co-morbidities to assist with better adherence.     

Prevalence of low testosterone and its relationship to body mass index in older men with lower urinary tract symptoms associated with benign prostatic hyperplasia

Abstract

Purpose: We examined the prevalence of low testosterone (LT) and its relationship with body mass index (BMI) in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH), who were enrolled in a clinical trial of drug therapy, the Medical Therapy of Prostatic Symptoms (MTOPS) Study.

Materials and methods: MTOPS enrolled 3047 men, and of these, 1896 had total testosterone (TT) measured at baseline. LT was defined as a single measurement of TT of <300?ng/dL.

Results: The overall prevalence of LT was 25.7%. Prevalence increased with increasing BMI; 14.7% among men who were normal weight (BMI <25?kg/m²) and 24.2% and 39.3% among overweight (BMI 25 to <30?kg/m²), and obese (baseline BMI ≥30?kg/m²) men, respectively.

Conclusions: LT was observed in about one in four MTOPS study participants with baseline TT measurements. The prevalence of LT increased markedly with increasing BMI. Our findings suggest a high prevalence of LT in obese men with LUTS/BPH. Physicians should be alert to the possibility of symptoms of hypogonadism in this population.     

Gender-biased behavior at work: Exploring the relationship between sexual harassment and sex discrimination

This paper examines survey-based reports of sexual harassment and sex discrimination in order to identify the stylized facts about the nature of the relationship between them. In particular, we are interested in assessing whether these concepts measure similar forms of gender-biased behavior and whether they have the same effect on workers’ job satisfaction and intentions to leave their jobs. Our results provide little support for the notion that survey-based measures of sexual harassment and sex discrimination capture the same underlying behavior. Respondents do appear to differentiate between incidents of sexual harassment and incidents of sex discrimination in the workplace. There are gender differences in the consequences, however. Both sex discrimination and sexual harassment are associated with a higher degree of job dissatisfaction. However, women’s intended job changes appear to be more sensitive to experiencing sex discrimination, while men’s are more sensitive to experiencing sexual harassment. Although exploratory, when taken together these results give us hope that in the future sufficiently detailed surveys could provide a useful foundation for quantifying the link between sexual harassment and sex discrimination. They also suggest that the best prospect for developing—and then testing—a conceptual framework of gender bias lies in adopting a multi-disciplinary approach incorporating the insights of disciplines such as sociology, psychology, and economics.     

The relationship between Black and gay community involvement and HIV-related risk behaviors among Black men who have sex with men

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing, and health promotion behaviors. Closeness with the gay community was associated with greater pre-exposure prophylaxis (PrEP) knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of self-reported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.     

Testosterone and leptin in older African-American men: relationship to age,strength, function,and season

Reproduced with permission     

The relationship between plasma androgens (dehydroepiandrosterone sulfate and testosterone), insulin,coagulation and fibrinolytic factors in men with coronary arteriosclerosis

Thrombosis plays an important role in the pathogenesis of myocardial infarction and stroke. It is known that a decrease in estradiol plasma concentration in postmenopausal women results in an increase in fibrinogen, plasminogen activator inhibitor (PAI) and tissue-type plasminogen activator (tPA) concentrations, whereas estradiol replacement therapy decreases the plasma concentrations of these factors. In men, the risk of developing myocardial infarction is higher than in premenopausal women. However, the role of male sex hormones in the pathogenesis of arteriosclerosis, although the subject of many studies, has not yet been elucidated. The aim of this study was to determine the plasma levels of and correlation between androgens, insulin, coagulation and fibrinolytic factors in men with coronary arteriosclerosis with and without a history of myocardial infarction. The study was carried out in a group of 109 non-obese men, aged 28-60 years, with coronary artery disease demonstrated by coronary angiography. In this group, 64 men had a history of one myocardial infarction and ten reported two or more such episodes. The control group consisted of 14 volunteers, who were healthy men aged 39-63 years with normal body weight. In men with coronary arteriosclerosis, the plasma levels of dehydroepiandrosterone sulfate (DHEAS) and testosterone were lower, whilst insulin, fibrinogen, PAI, PAI activity and lipoprotein(a) were higher in comparison with the group of healthy controls. We found that, in men with coronary arteriosclerosis, those with the highest incidence of infarction demonstrated the most advanced hyper-insulinism, had lower levels of DHEAS and testosterone, the highest fibrinogen plasma concentrations, as well as PAI-1, tPA and PAI activity. A positive correlation between insulin, PAI-1, tPA and fibrinogen has been shown. In conclusion, low androgen and high insulin concentrations, high PAI-1 and PAI activity, high tPA and fibrinogen concentration may be prognostic indicators of myocardial infarction in men with arteriosclerosis.     

Metabolic and hormonal responses to different resistance training systems in elderly men

Objective: To compare acute and sub-acute responses in hormonal profile and metabolic parameters in elderly people who participated in two methods of strength training (ST) with equalized loads.

Methods and materials: A total of 12 elder individuals (65?±?3 years) were randomly assigned to two training methods: constant intensity (CI, 3 sets of 10 repetitions with 75% of 1RM) and variable intensity (VI, 1st set: 12 repetitions at 67% of 1RM?>?2nd set: 10 repetitions at 75% of 1RM and 3rd set: 8 repetitions at 80% of 1RM). Both methods included the following exercises: leg press, knee extension, and squat with 1?min rest intervals between sets. Free speed of execution and maximum range of movement were encouraged throughout each set for both protocols. Blood samples were analyzed included glucose, testosterone (T), cortisol (C), T/C rate, growth hormone (GH), and lactate at 2 and 24?h post intervention.

Results: There were no observed differences in glucose, testosterone, GH, and lactate concentrations both at 2 and 24?h after the execution of the two training methods. However, significant increases in the levels of T/C rate and decrease on cortisol were observed immediately post exercise for both protocols.

Conclusions: Although no significant differences were observed between the two interventions in relation to the hormonal and metabolic parameters analyzed, both training methods promoted a favorable response, with a slight superiority noted for the CI method relative to the hormonal profile.     

Correlation between sex hormone levels and obesity in the elderly male

Objective: To investigate the levels of sex hormones and androgen receptor (AR) in elderly male patients and to explore a possible correlation with obesity. Methods: The cross-sectional study included 314 Elderly males (age ≥ 65 year). Of these subjects, 104 were healthy (age range 65–92 year; mean 71.38 ± 5.154 year), 74 were obese (65–87 year; 71.32 ± 4.74 year), and 111 were overweight (65–85 year; 71.43 ± 5.03 year). The following parameters were measured: total testosterone (TT), free testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), estradiol (E2), luteinizing hormone, follicle-stimulating hormone and AR. Results: (i) The levels of TT and SHBG in the obesity group were significantly lower than those in non-obese subjects. (ii) Body mass index (BMI) negatively correlated with TT and SHBG. (iii) Multiple regression analysis revealed that TT (β: ?0.230; p = 0.045) and SHBG (β: ?0.163; p = 0.02) were statistically correlated with BMI. Conclusion: Testosterone levels in the obese population were significantly lower than in the non-obese population and there is a significant association between testosterone levels and the extent of obesity.     

Gene expression of insulin receptor,insulin-like growth factor increases and insulin-like growth factor-binding protein-3 reduces with increase in prostate size in benign prostatic hyperplasia

Introduction: Although the role of insulin in the development of benign prostatic hyperplasia (BPH) is well established, there are no studies regarding alteration in the gene expression of components of insulin-signaling pathway and their association with prostate size in BPH. Hence, the study was designed to analyze the gene and protein expression of insulin receptor and its related components in patients with BPH.

Materials and methods: Twenty-seven BPH patients aged between 55 and 75 years were recruited in the study and prostatic tissues were obtained after transurethral resection of the prostate. Gene expression levels of Insulin receptor (IR), insulin receptor substrate (IRS), insulin-like growth factor (IGF) and insulin-like growth factor-binding protein-3 (IGFBP-3) were assessed by q-PCR.

Results: Insulin receptor (IR-A and B) and insulin-like growth factors (IGF-1 and IGF-2) gene expression were significantly increased and IGFBP-3 gene expression was reduced in BPH patients with larger prostate size. Also, serum insulin was significantly increased and IGFBP-3 was significantly reduced in patients with larger prostate size.

Conclusion: Increased expression of IR-A, B and IGF-1, 2 genes and reduced IGFBP-3 gene expression was associated with larger prostate size in BPH.     

Sex hormones, neurotransmitters, and psychopharmacological treatments in men with paraphilic disorders

Paraphilic disorders are psychiatric syndromes primarily characterized by deviant sexual thoughts, cravings, urges, and/or behaviors. Paraphilic men may engage in inappropriate sexual behaviors when cravings for socially unacceptable sexual acts become overpowering. These often chronic disorders may not only cause emotional distress and social embarrassment to the afflicted patient but also to the targets of their paraphilic focus. The primary objective of this article is to examine and review data on the efficacy and tolerability of the testosterone-lowering agents medroxprogesterone acetate, cyproterone acetate, and leuprolide acetate. The secondary goal is to review data on less conventional and more innovative pharmacological treatments, particularly the serotonin-specific reuptake inhibitors.     

Prevalence of low testosterone in aging men with benign prostatic hyperplasia: data from the Proscar Long-term Efficacy and Safety Study (PLESS)

Abstract

Objectives: We examined the prevalence of low testosterone (LT) in the subset of men in the Proscar Long-term Efficacy and Safety Study (PLESS) who had serum total testosterone (TT) measured at baseline.

Methods: PLESS enrolled 3040 men with benign prostatic hyperplasia (BPH). Of these men, 299 had TT and body mass index (BMI) measurements at baseline. Patients were classified as having LT if their baseline TT was <300?ng/dl.

Results: Of the 299 PLESS patients with baseline TT and BMI measurements, 65 (21.7%) had LT. The prevalence of LT increased with increasing BMI, occurring in 8/78 (10.3%) normal weight patients (baseline BMI <25?kg/m²), 35/160 (21.9%) overweight patients (baseline BMI ≥25–<30?kg/m²), and 22/61 (36.1%) obese patients (baseline BMI ≥30?kg/m²).

Conclusions: LT was observed in more than one in five PLESS patients with baseline TT and BMI measurements. The prevalence of LT increased with increasing BMI – more than one in three obese PLESS patients with baseline TT measurements had LT.     

Association of general and abdominal obesity with age,endocrine and metabolic factors in Asian men

Objective: This study made use of the percent abdominal fat to define abdominal obesity (AbO) and examined the differential associations of general obesity (GOb) and AbO with age, metabolic and endocrine factors.

Methods: Metabolic, endocrine and anthropometric factors and body composition were measured in 481 Asian men.

Results: A DEXA-derived ≥25% abdominal fat (PAbdF) was used to define men with AbO. Age was directly associated with PAbdF and percent total body fat (PBF). Exercise intensity was negatively associated with PBF. Both PBF and PAbdF were associated with HDL and LDL, but have opposite correlation with triglyceride. Furthermore, both PBF and PAbdF were associated with the number of metabolic syndrome (MetS) risk factors. Men with GOb had lower levels of percent lean mass (PLM), testosterone and bioavailable testosterone, and higher insulin and glucose levels. Men with AbO had lower arm and leg fat, higher insulin levels and triglycerides.

Conclusions: Men with GOb and AbO had different pattern of body composition. Age may be a contributory factor in AbO and a sedentary lifestyle may contribute to GOb. Both GOb and AbO are associated with an increased risk of MetS, with GOb more predispose to risk of diabetes, while AbO more at risk for cardiovascular diseases.     

Cognitive functions and health-related quality of life in men with benign prostatic hyperplasia and symptoms of overactive bladder when treated with a combination of tamsulosin and solifenacin in a higher dosage

Aim: To study the cognitive functions and health-related quality of life (HRQoL) in individuals taking a combination of tamsulosin and solifenacin in a higher dosage.

Methods: All patients (n?=?262) were assigned to group A (N?=?93, tamsulosin 0.4?mg?+?solifenacin 10?mg per day), group B (N?=?83, tamsulosin 0.4?mg?+?solifenacin 20?mg), and control group C (N?=?86; tamsulosin 0.4?mg?+?placebo). The lower urinary tract (LUT) condition was assessed on the scales International Prostate Symptom Score, Over Active Bladder Awareness Tool and uroflowmetry. The state of cognitive status was assessed on the scales Mini-mental State Examination, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler III, Color Trails Test, California Verbal Learning Test.

Results: The values of cognitive function indicators in the individuals from all groups after treatment did not significantly differ from the respective values at the baseline (p?>?.05). The values of most HRQoL parameters of the functional state of the LUT significantly improved in groups A and B. A significant correlation between the state of cognitive status and HRQoL, as well as LUT was absent (r?<0.3).

Conclusion: The combination of solifenacin in a double dosage along with tamsulosin can be recommended for elderly benign prostatic hyperplasia patients with overactive bladder symptoms.     

The relationship between circulating testosterone and inflammatory cytokines in men

Testosterone is the predominant gonadal androgen in men. Low testosterone levels are found to be associated with an increased in metabolic risk and systematic inflammation. Since adipose tissue is a source of inflammatory cytokines, testosterone may regulate inflammation by acting on adipose tissue. This review aimed to explore the role of testosterone in inflammation and its mechanism of action. Both animal studies and human studies showed that (1) testosterone deficiency was associated with an increase in pro-inflammatory cytokines; (2) testosterone substitution reduced pro-inflammatory cytokines. The suppression of inflammation by testosterone were observed in patients with coronary artery disease, prostate cancer and diabetes mellitus through the increase in anti-inflammatory cytokines (IL-10) and the decrease in pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α). Despite these, some studies also reported a non-significant relationship. In conclusion, testosterone may possess anti-inflammatory properties but its magnitude is debatable. More evidence is needed to validate the use of testosterone as a marker and in the management of chronic inflammatory diseases.     

HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.     

Designing out vulnerability, building in respect: violence, safety and sex work policy

One recent finding about the prostitution market is the differences in the extent and nature of violence experienced between women who work on the street and those who work from indoor sex work venues. This paper brings together extensive qualitative fieldwork from two cities in the UK to unpack the intricacies in relation to violence and safety for indoor workers. Firstly, we document the types of violence women experience in indoor venues noting how the vulnerabilities surrounding work-based hazards are dependent on the environment in which sex is sold. Secondly, we highlight the protection strategies that indoor workers and management develop to maintain safety and order in the establishment. Thirdly, we use these empirical findings to suggest that violence should be a high priority on the policy agenda. Here we contend that the organizational and cultural conditions that seem to offer some protection from violence in indoor settings could be useful for informing the management of street sex work. Finally, drawing on the crime prevention literature, we argue that it is possible to go a considerable way to designing out vulnerability in sex work, but not only through physical and organizational change but building in respect for sex workers rights by developing policies that promote the employment/human rights and citizenship for sex workers. This argument is made in light of the Coordinated Prostitution Strategy.     

Perceptions of HIV testing venues among men who have sex with men in London and the Midlands,United Kingdom

Undiagnosed HIV and late HIV diagnosis increase the risk of poor disease prognosis in infected individuals and of onward HIV transmission. It is vital to encourage regular HIV testing among men who have sex with men (MSM), a group disproportionately affected by HIV. A sample of 18 MSM from London and the East Midlands in England were interviewed regarding their perceptions of testing in the following three contexts: genitourinary medicine (GUM) clinics, community settings, and at home using a self-testing kit. The data were analyzed using qualitative content analysis. Perceived stigma from health care professionals, fear of being seen by significant others, and delays in being attended to were seen as barriers to testing in GUM clinics. While community settings were viewed as more accepting of sexual identity, concerns around homophobia and HIV stigma impeded access to testing for some individuals. HIV self-testing alleviated confidentiality concerns, but interviewees doubted the accuracy of the test results and worried about the lack of social support in the event of a reactive test result. Recommendations are offered for improving the acceptability of HIV testing in these contexts.