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The relationship between sleep disorders and testosterone in men

Asian Journal of Andrology 2014年第2期16卷 262-265,I0009,I0010页

作者： Gary Wittert Discipline of Medicine and Freemasons Foundation Centre for men's Health University of Adelaide Adelaide South Australia Australia.

Plasma testosterone levels display circadian variation, peaking during sleep, and reaching a nadir in the late afternoon, with a superimposed ultradian rhythm with pulses every 90 min reflecting the underlying rhythm of pulsatile luteinizing hormone （LH） secretion. The increase in testosterone is sleep, rather than circadian rhythm, dependent and requires at least 3h of sleep with a normal architecture. Various disorders of sleep including abnormalities of sleep quality, duration, circadian rhythm disruption, and sleep-disordered breathing may result in a reduction in testosterone levels. The evidence, to support a direct effect of sleep restriction or circadian rhythm disruption on testosterone independent of an effect on sex hormone binding globulin （SHBG）, or the presence of comorbid conditions, is equivocal and on balance seems tenuous. Obstructive sleep apnea （OSA） appears to have no direct effect on testosterone, after adjusting for age and obesity. However, a possible indirect causal process may exist mediated by the effect of OSA on obesity. Treatment of moderate to severe OSA with continuous positive airway pressure （CPAP） does not reliably increase testosterone levels in most studies. In contrast, a reduction in weight does so predictably and linearly in proportion to the amount of weight lost. Apart from a very transient deleterious effect, testosterone treatment does not adversely affect OSA. The data on the effect of sleep quality on testosterone may depend on whether testosterone is given as replacement, in supratherapeutic doses, or in the context abuse. Experimental data suggest that testosterone may modulate individual vulnerability to subjective symptoms of sleep restriction. Low testosterone may affect overall sleep quality which is improved by replacement doses. Large doses of exogenous testosterone and anabolic/androgenic steroid abuse are associated with abnormalities of sleep duration and architecture.

关键词： obesity obstructive sleep apnea shift work sleep restriction testosterone

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Testosterone therapy in men with prostate cancer： literature review, clinical experience, and recommendations

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Asian Journal of Andrology 2015年第2期17卷 206-211,I0007页

作者： Abraham Morgentaler William P Conners III men's Health Boston 200 Boylston St Suite A309 Chestnut Hill MA 02467 USA.

For several decades any diagnosis of prostate cancer （PCa） has been considered an absolute contraindication to the use of testosterone （T） therapy in men. Yet this prohibition against T therapy has undergone recent re-examination with refinement of our understanding of the biology of androgens and PCa, and increased appreciation of the benefits of T therapy. A reassuringly low rate of negative outcomes has been reported with T therapy after radical prostatectomy （RP）, radiation treatments, and in men on active surveillance. Although the number of these published reports are few and the total number of treated men is low, these experiences do provide a basis for consideration of T therapy in selected men with PCa. For clinicians considering offering this treatment, we recommend first selecting patients with low grade cancers and undetectable prostate-specific antigen following RP. Further research is required to define the safety of T therapy in men with PCa. However, many patients symptomatic from T deficiency are willing to accept the potential risk of PCa progression or recurrence in return for the opportunity to live a fuller and happier life with T therapy.

关键词： androgen deprivation androgens hypogonadism prostate cancer prostate-specific antigen testosterone testosterone therapy

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Can testosterone therapy be offered to men on active surveillance for prostate cancer？ Preliminary results

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Asian Journal of Andrology 2016年第1期18卷 16-20页

作者： Ravi Kacker Mariam Hult Ignacio F San Francisco William P Conners Pablo A Rojas William C Dewolf Abraham Morgentaler men's Health Boston Brookline MA USA Pontifical Catholic University of Chile Santiago Chile Department of Urology Beth Israel Deaconess Medical Center Boston MA USA

This report presents our experience with T therapy in a cohort of T-deficient men on active surveillance （AS） for Gleason 3 ＋ 3 and Gleason 3 ＋ 4 prostate cancer （PCa）. A retrospective chart review identified 28 men with T deficiency who underwent T therapy （T group） for at least 6 months while on AS for PCa. A comparison group of 96 men on AS for PCa with untreated T deficiency （no-T group） was identified at the same institution. The AS protocol followed a modified Epstein criteria and allowed inclusion of men with a single core of low-volume Gleason 3 ＋ 4 PCa. Mean age was 59.5 and 61.3 years, and mean follow-up was 38.9 and 42.4 months for the T and no-T groups, respectively. Of all 28 men in the T group, 3 （10.7%） men developed an increase in Gleason score while on AS. Of 22 men in the T group with Gleason 3 ＋ 3 disease, 7 （31.8%） men developed biopsy progression including 3 men （13.6%） who developed Gleason 3 ＋ 4 PCa. Of 6 men with Gleason 3 ＋ 4 disease at baseline, 2 （33.3%） men developed an increase in tumor volume, and none developed upgrading beyond Gleason 3 ＋ 4. All 96 men in the no-T group had Gleason 3 ＋ 3 disease at baseline and, 43 （44.7%） developed biopsy progression, including 9 men （9.38%） with upgrading to Gleason 7 （3 ＋ 4）. Biopsy progression rates were similar for both groups and historical controls. Biopsy progression in men on AS appears unaffected by T therapy over 3 years. Prospective placebo-controlled trials of T therapy in T-deficient men on AS should be considered given the symptomatic benefits experienced by treated men.

关键词： active surveillance prostate cancer testosterone

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Estradiol is an independent risk factor for organic erectile dysfunction in eugonadal young men

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Asian Journal of Andrology 2020年第6期22卷 636-641页

作者： Hui-Rong Chen Ru-Hui Tian Peng Li Hui-Xing Chen Shu-Jie Xia Zheng Li Department of Andrology The Center for Men's HealthUrologic Medical CenterShanghai Key Laboratory of Reproductive MedicineShanghai General HospitalShanghai Jiao Tong UniversityShanghai 200080China

Erectile dysfunctio n attributable to testosterone deficiency is less comm on in young males,and the effect of estradiol on erectile function in eug on adal young males is un *** an a lyzed data from 195 male participa nts,including 143 eug on adal patients with erectile dysfunction and 52 healthy *** distinguish psychogenic and organic erectile dysfunction,penile rigidity was measured using the nocturnal penile tumescenee rigidity *** levels of sexual hormones were quantified by electrochemiluminescence,and penile vascular status was assessed by penile color Doppler *** serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy *** erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone,and estradiol was the only sign ifica nt risk factor for orga nic erectile dysf un ction(odds ratio:1.094;95%con fide nee interval:1.042-1.149,P=0.000).Moreover,serum estradiol levels were negatively correlated with penile *** estradiol levels were higher and penile rigidity was lower in patients with venous erectile dysfunction than in patients with nonvascular erectile dysf *** con elude that elevated serum estradiol levels may impair erectile function and may be involved in the pathoge nesis of organic erectile dysfunction in eugonadal young men.

关键词： erectile dysfunction estradiol organic etiology testosterone young

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Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care

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Asian Journal of Andrology 2023年第4期25卷 448-453页

作者： Winston Wu Justin La Kathryn M Schubach Daniel Lantsberg Darren J Katz Department of Urology Western HealthSt AlbansVIC 3021Australia Department of Urology Kaiser Permanente San Rafael Medical CenterSan RafaelCA 94903USA men’s Health Melbourne MelbourneVIC 3000Australia Reproductive Services Unit The Royal Women’s HospitalParkvilleVIC 3052Australia Melbourne IVF East MelbourneVIC 3002Australia Department of Surgery Western PrecinctUniversity of MelbourneParkvilleVIC 3010Australia

In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective;however, a gap exists in the understanding of men’s experiences of male infertility treatment. This review aims to synthesize theexisting evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patientneeds during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychologicalevaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure canlead to feelings of depression, grief, and inadequacy. men tended to have an avoidant coping mechanism throughout fertilitytreatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds canbe strengthened by mutual support and enhanced communication;couple separation, however, has been noted as a predominantreason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe maleinfertility. Surgical treatments can affect the sexual functioning of infertile men;however, the impact of testicular sperm extractionoutcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident inhypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to addressreported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility andfollow-up in cases of surgical treatment failure are likely beneficial.

关键词： male infertility male infertility treatment patient experience patient-centered care psychosocial sexual

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The importance of sexual function in men with spinal cord injuries

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Asian Journal of Andrology 2016年第3期18卷 391-391页

作者： Jason R Kovac Larry I Lipshultz men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scott Department of Urology Baylor College of Medicine Houston Texas77030 USA

Spinal cord injuries （SCIs） are often devastating to patients and their families. In those men young enough to consider families and unfortunate enough to be unable to ejaculate, multiple options exist. The attached manuscript by Dr. Ibrahim et al. contains a detailed outline of a multitude of techniques available to the Andrologist to both evoke ejaculation and harvest sperm from these patients. The authors, pioneers in the field of male fertility research for SCI patients, detail very high success rates for penile vibratory stimulation （86% success if above T10, 15% if below） and electroejaculation （91.9% success）.

关键词： @@

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Improved spontaneous erectile function in men with mild-tomoderate arteriogenic erectile dysfunction treated with a nightly dose of sildenafil for one year： a randomized trial

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Asian Journal of Andrology 2007年第1期9卷 134-141页

作者： Frank Sommer Theodor Klotz Udo Engelmann Department of men＇s Health University Medical Center Hamburg-Eppendorf Hamburg 20214 Germany Department of Urology University Medical Center Hamburg-Eppendorf Hamburg 20214 Germany Department of Urology Klinikum Weiden Weiden 92637 Germany Department of Urology University of Cologne Cologne 50924 Germany

Aim： To test the hypothesis that sildenafil （50 mg nightly for one year） can improve spontaneous erectile function （EF） in men with mild-to-moderate arteriogenic erectile dysfunction （ED） responsive to erectogenic treatment. Methods： In a prospective open-label trial, 112 men with ED were randomized to sildenafil 50 mg nightly or sildenafil 50 or 100 mg as needed for 12 months, followed by one-month and 6-month non-medicated periods. Non-randomized, non-medicated men with ED were also assessed. The EF domain of the International Index of Erectile Function （IIEF EF） and the peak systolic velocity （PSV） of penile cavernous arteries were used to measure the efficacy. Results： After sildenafil treatment and a subsequent non-medicated month, IIEF EF was normal in 29 of 48 （60.4%, 95% confidence interval [CI]： 45.3-74.2%） of the nightly group vs. 4 of 49 （8.2%, 95% CI： 2.3-19.6%） of the as-needed group. PSV improved by 11.2 cm/s （95% CI： 4.7-21.4; P = 0.012） in the nightly group but only by 3.4 cm/s （-5.1- 14.7; P = 0.435） in the as-needed group. IIEF EF normalized in 1 of 18 （5.6%, 95% CI： 0.1-27.3%） non-medicated men and the PSV declined slightly. Six months after treatment, the IIEF EF remained normal and PSV was stabilized in most （28/29, 97%） nightly group men who had initially normalized. Conclusion： Sildenafil nightly for one year resulted in ED regression that persisted well beyond the end of treatment, so that spontaneous EF was characterized as normal on the IIEF in most men. The results from this open-label, randomized trial warrant verification under double-blind, placebo-controlled conditions.

关键词： phosphodiesterase sexual dysfunctions psychological sildenafil citrate erectile funcion

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Clinical outcomes for men with positive surgical margins after radical prostatectomy—results from the South Australian Prostate Cancer Clinical Outcomes Collaborative community-based registry

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Asian Journal of Urology 2023年第4期10卷 502-511页

作者： Kerri R.Beckmann Michael E.O'Callaghan Andrew D.Vincent Kim L.Moretti Nicholas R.Brook Cancer Epidemiology and Population Health Research University of South AustraliaAdelaideAustralia Translational Oncology and Urology Research Division of Pharmaceutical and Cancer StudiesKings College LondonLondonUK South Australian Prostate Cancer Clinical Outcomes Collaborative Flinders Medical CentreAdelaideAustralia The Freemason's Foundation Centre for men's Health Adelaide Medical SchoolUniversity of AdelaideAdelaideAustralia Discipline of Surgery University of AdelaideAdelaideAustralia Department of Urology Royal Adelaide HospitalAdelaideAustralia

Objective Positive surgical margins(PSMs)after radical prostatectomy(RP)indicate failure of surgery to completely clear *** confer an increased risk of biochemical recurrence(BCR),but how more robust outcomes are affected is *** study investigated factors associated with PSMs following RP and determined their impact on clinical outcomes(BCR,second treatment[radiotherapy and/or androgen deprivation therapy],and prostate cancer-specific mortality[PCSM]).Methods The study cohort included men diagnosed with prostate cancer(pT2-3b/N0/M0)between January 1998 and June 2016 who underwent RP from the South Australian Prostate Cancer Clinical Outcomes Collaborative *** associated with risk of PSMs were identified using Poisson *** impact of PSMs on clinical outcomes(BCR,second treatment,and PCSM)was assessed using competing risk *** Of the 2827 eligible participants,28%had PSMs—10%apical,6%bladder neck,17%posterolateral,and 5%at multiple *** follow-up was 9.6 years with 81 deaths from prostate cancer *** of PSM increased with higher pathological grade and pathological tumor stage,and greater tumour volume,but decreased with increasing surgeon volume(odds ratio[OR]:0.93;95%confidence interval[CI]:0.88-0.98,per 100 previous prostatectomies).PSMs were associated with increased risk of BCR(adjusted sub-distribution hazard ratio[sHR]2.5;95%CI 2.1-3.1)and second treatment(sHR 2.9;95%CI 2.4-3.5).Risk of BCR was increased similarly for each PSM location,but was higher for multiple margin *** found no association between PSMs and *** Our findings support previous research suggesting that PSMs are not independently associated with PCSM despite strong association with *** PSM rates remains an important objective,given the higher likelihood of secondary treatment with associated comorbidities.

关键词： Prostate cancer Positive surgical margin Biochemical recurrence Radical

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Evaluation of Relationship Between Clothing Pressure of men's Suit and Comfort

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Journal of Donghua University(English Edition) 2004年第1期21卷 152-156页

作者：白越陈东生甘应进 Donghua University Shanghai 200051 PRC & Changchun University of Technology Changchun Changchun University of Technology Changchun 130012 Changchun University of Technology Changchun 130012n investigation on relationship between clothing pressure of men's suit and wearing comfort is conducted. With the pressure measurements at different parts of men's suit under normal standing posture and in motion the objective assessment of the total comfort are related to the subjective ratings of clothing pressure. There is a common strong sensation of pressure on shoulder with normal standing posture and a strong relationship between total comfort and clothing pressure in back armhole and the front of upper arm with posture in motion.

An investigation on relationship between clothing pressure of men's suit and wearing comfort is conducted. With the pressure measurements at different parts of men's suit under normal standing posture and in motion, the objective assessment of the total comfort are related to the subjective ratings of clothing pressure. There is a common strong sensation of pressure on shoulder with normal standing posture, and a strong relationship between total comfort and clothing pressure in back armhole and the front of upper arm with posture in motion.

关键词： clothing pressure men's suit wearing comfort grey correlation analysis

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Sexual health in Polish elderly men with coronary artery disease:importance, expectations,and reality

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Asian Journal of Andrology 2020年第5期22卷 526-531页

作者： Lestaw Rusiecki Romuald Zdrojowy Jana Gebala Michal Rabijewski Matgorzata Sobieszczariska Ryszard Smolinski Witold Pilecki Wioletta Dziubek Anna Janocha Maciej Womperski Dariusz Kalka Cardiosexology Unit Department of PathophysiologyWroclaw Medical UniversityWroclaw 50-368Poland Department and Clinic of Urology Wroclaw Medical UniversityWroclaw 50-556Poland Cardiosexology Students'Scientific Club Wroclaw Medical UniversityWroclaw 50-368Poland Department of Reproductive Health Centre of Postgraduate Medical EducationWarsaw 01-004Poland Department of Geriatrics Wroclaw Medical UniversityWroclaw 50-369Poland Consultant Sexologist Clinical Hospital Wroclaw Medical UniversityWroclaw 50-556Poland Departm ent of Physiotherapy University School of Physical EducationWroclaw 51-612Poland Department of Physiology Wroclaw Medical UniversityWroclaw 50-368Poland Lower Silesian Center for mental Health Wroclaw 50-226Poland Centre for men's Health Wroclaw 53-151Poland.

Deterioration in overall health,hormonal disturbances,and erectile dysfunction(ED)contributes to limitations in sexual activity in the elderly,which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac *** aimed to analyze the occurrence of ED in elderly men,their perception of the relevance of good sexual function,and their expectations of physicians.A cross-sectional study encompassed 731 patients with coronary artery disease(CAD)subjected to cardiac *** data and data on modifiable risk factors and patient expectations were *** was assessed using the IIEF-5 *** among the risk factors for ED,occurrence of ED,and patient expectations,as well as the changes in the indicators between 2012 and 2016,were *** mean age of men was 70.7±5.1 *** prevalence of ED was 93.0%.The IIEF-5 score was significantly associated with age,tobacco smoking,exercise tolerance,time to diagnosis of CAD,and treatment with calcium channel blockers and *** declared that sexual activity was overall important(47.9%)or very important(25.6%).Three hundred and sixty(49.3%)patients expected their physician to show interest in their sexual health,but the topic was addressed in only 12.5%.Over the past few years,we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients’expectations of physicians to show interest in their sexual ***’expectations of discussing and receiving treatment for ED remain an unmet medical need.

关键词： advanced age cardiac rehabilitation erectile dysfunction ischemic heart disease sexual disorders

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