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Nathan Goodyear

Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men - 0 views

  • The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins.
  • obesity, but also impaired general health, are the more common causes of low testosterone in aging men
  • Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality,
  • ...30 more annotations...
  • advanced age, obesity, a diagnosis of metabolic syndrome, and poor general health status were predictors of LOH
  • Diabetes mellitus was correlated with hypogonadism in most studies
  • coronary heart disease, hypertension, stroke, and peripheral arterial disease did not predict hypogonadism, they did correlate with the incidence of low testosterone
  • LOH can be defined by the presence of at least three sexual symptoms associated with a total testosterone level of less than 11 nmol/L (3.2 ng/mL) and a free testosterone level of less than 220 pmol/L (64 pg/mL)
    • Nathan Goodyear
       
      the European Male Aging study defined low T as total < 320 ng/dl and free < 64 pg/ml.  
  • Mean weight decreased
  • Waist circumference decreased
  • Total cholesterol decreased
  • Low-density lipoprotein decreased
  • Triglycerides decreased
  • High-density lipoprotein (HDL) increased
  • ratio of total cholesterol to HDL improved
  • Prostate volume increased
  • PSA increased
  • The benefits for men older than 65 years of age were compared with those of younger men, and the improvements in body weight, metabolic factors, psychological functioning, and sexual functioning were of the same magnitude in both age groups
  • weight loss was progressive over the 6-year period, effects of testosterone on lipids and on psychological and sexual functioning reached a plateau after approximately 3 years and these effects were sustained
  • Effects of testosterone on hematopoiesis, on the prostate, and on bladder function were not more severe in older men than in younger men
  • observe a mild increase in prostate volume and serum PSA over time, which is a normal finding in aging men. Maybe somewhat surprising, postvoiding residue and the IPSS did not deteriorate with aging but showed a degree of improvement
  • the severity of the metabolic syndrome is associated with the severity of lower urinary tract symptoms
  • The symptoms of the metabolic syndrome improve upon testosterone treatment and testosterone may thus have a favorable effect on lower urinary tract symptoms
  • it seems reasonable to conclude that the risks of testosterone administration to elderly men are not disproportionately higher in elderly men than in younger men.
  • Despite evidence to the contrary, physicians still harbor a wrongful association between testosterone and the development of prostate pathology (prostate cancer and benign prostate hyperplasia)
  • Not surprisingly, the incidence of prostate cancer was higher in older men; however, it was lower than expected in both groups
  • These observations suggest that the incidence of prostate cancer in patients receiving testosterone therapy, both in the younger and in the older group, was not greater than in the general population not receiving testosterone treatment
  • The historical fear that raising testosterone levels will result in more prostate cancer has been dispelled, particularly by the work of Abraham Morgentaler
  • Higher serum testosterone levels fail to show an increased risk of prostate cancer, and supraphysiological testosterone does not increase prostate volume or PSA in healthy men
  • This apparent paradox is explained by the "saturation model,"
  • Recent studies indicate no increased risk of prostate cancer among men with serum testosterone in the therapeutic range
  • In the present observational study, no cases of major adverse cardiovascular events occurred.
  • the benefits of testosterone therapy are fully achieved only by long-term treatment
  • To achieve maximal benefits, good patient adherence is a prerequisite
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    Study finds new difference in Testosterone benefits and/or side effects between men < 65 with low T and men > 65 with low T.
Nathan Goodyear

The Prevalence of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women: An Epidemiological Study of Women in Four European Countries - Graziottin - 2009 - The Journal of Sexual Medicine - Wiley Online Library - 0 views

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    Low Hormones, post-ovary removal, linked to low libido
Nathan Goodyear

Endocrine actions of pesticides m... [Environ Sci Pollut Res Int. 2014] - PubMed - NCBI - 0 views

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    low dose pesticide (organophosphates) exposure associated with delayed sexual development in boys and girls.  In addition, there was an inverse correlation with free T4 and a positive correlation with TSH.  
Nathan Goodyear

Testosterone may improve sexual function and mood in older men with low levels | The BMJ - 0 views

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    In men older than 65 with low Testosterone, Testosterone therapy improved sexual function and mood.
Nathan Goodyear

Does increased aromatase activity in adipose fibroblasts cause low sexual desire in patients with HIV lipodystrophy? -- Goldmeier et al. 78 (1): 64 -- sexually Transmitted Infections - 0 views

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    increased testosterone to estrogen conversion, in part, stimulated by inflammatory cytokines: TNF, and IL-6.  They propose aromatase inhibition to decrease testosterone to estrogen conversion.  This study looked at individuals with HIV.
Nathan Goodyear

Estrogens in Men: Clinical Implications for Sexual Function and the Treatment of Testosterone Deficiency - Kacker - 2012 - The Journal of Sexual Medicine - Wiley Online Library - 0 views

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    Several flaws with this study. First, the majority of testing done in the meta-analysis was serum--unreliable.  Second, this study flies in the face of many other studies that have shown elevated estrogens contribute to low testosterone in men.  Third, this flies in the face of observation.  I see over and over again, by lowering a male's estrogen level, he in turn will start producing more Testosterone.  And finally, the environmental xenoestrogens have helped to contribute to a all time low of testosterone/infertility rate in men today.
Nathan Goodyear

Efficacy and safety of testosterone in the managem... [J Sex Med. 2012] - PubMed - NCBI - 0 views

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    review of the literature finds that Testosterone therapy in women with low libido improves sexual activity without CVD and breast cancer risk in postmenopausal women.  Post menopause is a time associated with an increased risk of CVD in women.
Rachna Clinic

Why Are You Searching Repudiated Sexual Ayurvedic Medico in Delhi? - 0 views

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    Sex is one of the most significant and pleasurable activities for men and women. Persons don't have sex only to conceive offspring. Why persons extend to have sex after having children? I have renowned numerous persons who relish sex even after the age of seventies so sex has no expiry time.
Nathan Goodyear

Impact of Low Testosterone on Response to Treatment ... [Urology. 2014] - PubMed - NCBI - 0 views

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    Here is where science and particularly conclusions fail the public.  The authors conclusions are that tadalifl improves ED and sexual function irrespective of Testosterone levels.  However, the results say something different.  The group with normal Testosterone responded better versus the low Testosterone group.  This difference didn't reach statistical significance though.  This lack of statistical significance does not exclude the fact that there indeed was a difference.  The authors conlcusions take no part in reporting the whole truth, just that which supports their hypothesis. The diagnosis of low T in this study was < 300 ng/dl
Nathan Goodyear

High Estrogen in Men After Injectable Testo... [Am J Mens Health. 2014] - PubMed - NCBI - 0 views

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    Again, Testosterone and here Estradiol are merely there for libido and sex.  What tunnel vision?!  What about hsCRP?  What about fibrinogen?  What about IL-1beta?  What about TNF-alpha?  These inflammatory cytokines have all been reported to elevate as a result of estrogen production in men.   And PSA?  No mention of it here.   This linear, tunnel vision thinking on hormones has got to stop! The study points out that all clients were using AIs and SERMs irregardless of whether they had elevated estrogens or not.  That is not a well designed study.  One group should have had AI's if elevated estrogens were present and another group should not--this would compare the effects of aromatase activity.  Second, this was simply a retrospective chart review.  Third, a 50% conversion of 34,000 + men is very high when you look at the literature.  Fourth, they point to gynecomastia as a means of negative?  The cardiovascular implications are more significant.  These studies just seem to focus on superficial things.  Fifth, did libido problems exist before?  What were the free levels?   This falls in the paucity of data (2 studies) that point to excessive lowering of estradiol effecting libido and sexual performance.
Nathan Goodyear

The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis: The Journal of Clinical Endocrinology & Metabolism: Vol 99, No 10 - 0 views

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    Review of the data points to poor quality of evidence dealing with DHEA in post-menopausal women with normal adrenal function.  Yet if DHEA is low, which is >95% produced by adrenals in women, then how can the adrenal function be "normal".   The meta-analysis found no improvement in libido and/or sexual function, and no improvement in lipids, glucose, weight... was noted.  Essentially not positive or negative effects were noted.  Abstract only available here, so dosage is a question.
Nathan Goodyear

Androgen Therapy in Women: A Reappraisal: An Endocrine Society Clinical Practice Guideline: The Journal of Clinical Endocrinology & Metabolism: Vol 99, No 10 - 0 views

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    data on androgen therapy in women is sparse at best.  The conclusion here is suspect: "evidence supports the short-term efficacy and safety of high physiological doses of T" for women with with hypoactive sexual desire, yet the same authors recommend against long-term therapy.  How do those 2 go together???  They don't.  Support with physiologic Testosterone when appropriate testing reveals low T and symptoms support the same.  This is a practice guideline that lacks evidence to strongly back it up because so little evidence exists.  Practice guidelines are for lazy physicians.
Nathan Goodyear

Gender Bias in Autoimmunity Is Influenced by Microbiota - 0 views

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    autoimmune disease sexual preference appears to have Gut origins.
Nathan Goodyear

Prenatal letrozole produces a subpopulation of male rats with same-... - PubMed - NCBI - 0 views

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    Now this is an interesting study.  In utero exposure to letrozole (femara) which is an aromatase inhibitor, is associated with same sex preference.  Only abstract available, but this study points to environment, hormone effects in early development and future sexual preference.  No difference in serum hormone levels were seen.  
My Wellness

Studies Find Big Benefits in Marriage - 0 views

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    One of the strongest and consistent benefits of marriage is better physical health and its consequence longer life,Marriage Increases the Quality of Life, Sexual fulfillment.
Nathan Goodyear

Complete reversal of adult-onset isolated hypo... [Fertil Steril. 2006] - PubMed - NCBI - 0 views

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    study finds restoration of HPA in men with low T.  This was performed via clomid therapy at 25 to 50 mg daily for 4 months.  Increase in pulsatile LH, increase in serum Testosterone levels, and increase in sexual function was found.  Clomid restores HPA function that is suppressed from estrogen inhibition.  In this case, clomid is function as an estrogen antagonist.
Nathan Goodyear

http://press.endocrine.org/doi/pdf/10.1210/jc.2014-1872 - 0 views

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    New study finds Testosterone therapy provides less than statistical significant improvement in constitutional/sexual symptoms, in obese men with type II diabetes with symptoms classified as mild-moderate with modest reductions in Total Testosterone.  This study highlights that low Testosterone is a biomarker of poor health and multiple comorbidities and that simply adding in Testosterone therapy will not cure all male woes.  The authors did state that ED and low T are separate issues and I will differ with them on this--they are in fact link.  This association may vary between individuals, but to flatly state they are completely separate issues is devoid of the fact that testosterone has been shown to reduce inflammatory cytokines and improve PDE5 therapy.  
Nathan Goodyear

Testosterone for peri- and postmenopausal women. - PubMed - NCBI - 0 views

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    Cochrane review for Testosterone therapy for women points to lacking data.  The lengths of study reached a maximum of 2 years with the average at 6 months.  Improvement in sexual function was found in post-menopausal women, but safety and long-term data is lacking.
Nathan Goodyear

The Benefits and Harms of Systemic Testosterone Therapy in Postmenopausal Women With Normal Adrenal Function: A Systematic Review and Meta-analysis: The Journal of Clinical Endocrinology & Metabolism: Vol 99, No 10 - 0 views

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    Only abstract available.  Meta-analysis of Testosterone therapy in post-menopausal women finds significant bias, some improvement in sexual function and cholesterol levels, yet safety and long-term data is significantly lacking.  Take this with studies on endogenous Testosterone in women, significant caution needs to be followed with Testosterone in women. Only abstract available here.
laabidi1987

If offered a picture of an unknown woman in front of a man, and asked him if he liked it? - 0 views

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    His answer would be probably after a little thinking: "Yes" or "No", he will know the answer clearly and completely. But if our offer image unknown man and we raised the same question on the mirror, it will be assumed her answer: "I'm still not sure, it comes to how I would feel after in-depth knowledge and deal with it, and maybe then you will know." Difference in libido between the sexes! Differences in approach in the expression of feelings is not a coincidence, it is a clear and distinct. Is it possible that women are more reluctant than men? Or maybe the point of view based on the components did not know the men? Studies suggest that women need more information to see her passion and expression of feelings toward the man standing front of them, including. http://www.weightloss24.tk/2015/02/is-sexual-arousal-vary-according-to.html
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