Testosterone decline associated with increased mortality risk

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Men experiencing a pronounced, age-related decline in testosterone level are more likely to die of any cause during a 15-year period vs. men who have testosterone levels in the 10th to 90th percentile, according to findings reported in the European Journal of Endocrinology.

Stine A. Holmboe, MSc, a doctoral student in the department of growth and reproduction at the University of Copenhagen, Denmark, and colleagues analyzed data from 1,167 men aged 30 to 60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study, conducted between November 1982 and February 1984, as well as the follow-up examination 10 years later (MONICA10), conducted between 1993 and 1994. Researchers measured levels of testosterone, sex hormone-binding globulin and luteinizing hormone at baseline and follow-up, and then followed the cohort for up to 18 years (mean, 15.2 years) using data from national mortality registries. Researchers used Cox proportional hazard models, with age as the underlying time scale, to assess the association between intra-individual hormone changes and all-cause, CVD and cancer mortality.

During follow-up, 421 men (36.1%) died (106 cancer-related deaths; 119 CVD-related deaths). The estimated mean intra-individual percentage change in hormone levels per year for the cohort were –1.5% for total testosterone, 0.9% for SHBG, –1.9% for free testosterone and 1% for luteinizing hormone. When estimated cross-sectionally, however, mean percentage changes in hormone levels per year were –0.4% for total testosterone, 1.2% for SHBG, –1.1% for free testosterone and 1.1% for luteinizing hormone, according to researchers.

Researchers observed that men who experienced the most pronounced decline in total testosterone — men in the lowest 10th percentile — saw the greatest increased risk for all-cause mortality (HR = 1.6; 95% CI, 1.08-2.38) vs. the reference category. The risk corresponded with an annual total testosterone decline of at least –0.6 nmol/L.

Across tertiles of SHBG levels, researchers found no significant differences in all-cause mortality; however, there was a U-shaped trend observed, with increases in all-cause mortality for those with a change in SHBG levels below the 10th percentile (< –0.7 nmol/L per year) or above the 90th percentile (> 1.1 nmol/L per year) vs. the middle group.

Men with the most pronounced decline in free testosterone also saw an increased risk for all-cause mortality; however, this was significant only in the tertile model (HR = 1.45; 95% CI, 1.09-1.92), according to researchers. There were no disease-specific associations observed, and associations were independent of age, baseline hormone levels and lifestyle factors.

“A possible causal link between an increased tempo in age-related [testosterone] decline and subsequent health is unknown and remains to be investigated,” the researchers wrote. – by Regina Schaffer

Article Source: https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/in-the-journals/%7Bb9ffabec-a385-4c19-b01b-4981f05e01d1%7D/testosterone-decline-associated-with-increased-mortality-risk

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5 Common Low Testosterone Health Myths Debunked

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As men age, they face a very serious problem than a decline in testosterone levels. In fact, five percent of older males live with low testosterone levels.

Although many of us understand that low testosterone levels can result in changes in health, we may be believing the wrong information when it comes to low testosterone. These misconceptions around low testosterone could prevent you from getting the help you need to feel energized, strong, and essentially like yourself once again. So, instead of still believing the myths around low testosterone, uncover the truth that can help you finally deal with your low testosterone.

5 myths about low testosterone

Low testosterone is normal to aging: This myth is partially true in the sense that yes, testosterone levels do generally decline as you get older but this drop can also be abnormal. Testosterone decline does occur at a normal rate, but for some men, this rate is much greater. So, if you think it’s normal, you could be preventing yourself from getting treatment for this alarming decline in testosterone. When testosterone drops at an abnormal rate, that’s when a man’s overall health can become impacted. If you experience any of these symptoms, your testosterone levels have dropped below normal and you should speak to your doctor.

Low testosterone only affects older men: Because low testosterone is associated with aging, it is believed that only older males live with it. Low testosterone can affect any man at any age. In order to determine whether you have low testosterone, you should discuss any symptoms you experience with your doctor so they can piece them together along with any medical testing.

Testosterone replacement increases sperm count: This is a complete and utter myth, as increasing sperm count is something that testosterone replacement cannot do. In fact, testosterone replacement can actually lower sperm count. On the other hand, testosterone replacement therapy can help you feel like yourself again by reducing fatigue, increasing muscle, and lift mood and libido.

Testosterone replacement increases the risk of heart disease and cancer: Early studies have outlined the potential risk to the heart with testosterone replacement therapy, but as of late, findings suggest that the risk of heart disease may actually decrease. In regards to cancer, it is still quite controversial among those men with pre-existing prostate cancer. So far, though, the data does show that testosterone replacement therapy does not cause prostate cancer.

It’s safe to order testosterone replacements online: Testosterone medications are a controlled substance that can only be prescribed by your doctor. Using such therapies without the guidance of your doctor can put your health at risk. Taking in excess testosterone may actually hinder your body’s ability to produce testosterone naturally on its own. Furthermore, excess testosterone can increase the risk of stroke or blood clots. Before going online and purchasing testosterone replacement medications, speak to your doctor first to determine whether or not you have low testosterone.

 

Article Source: https://www.belmarrahealth.com/5-common-health-myths-debunked/

 

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Swings in dad’s testosterone affects the family — for better or worse — after baby arrives

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Postpartum depression is often associated with mothers, but a new study shows that fathers face a higher risk of experiencing it themselves if their testosterone levels drop nine months after their children are born.

The same study revealed that a father’s low testosterone may also affect his partner — but in an unexpectedly positive way. Women whose partners had lower levels of testosterone postpartum reported fewer symptoms of depression themselves nine and 15 months after birth.

High testosterone levels had the opposite effect. Fathers whose levels spiked faced a greater risk of experiencing stress due to parenting and a greater risk of acting hostile- such as showing emotional, verbal or physical aggression — toward their partners.

The study was published in the journal Hormones and Behavior on Sept. 1. The findings support prior studies that show men have biological responses to fatherhood, said Darby Saxbe, the study’s lead author and an assistant professor of psychology at USC Dornsife College of Letters, Arts and Sciences.

“We often think of motherhood as biologically driven because many mothers have biological connections to their babies through breastfeeding and pregnancy.” Saxbe said. “We don’t usually think of fatherhood in the same biological terms. We are still figuring out the biology of what makes dads tick.

“We know that fathers contribute a lot to child-rearing and that on the whole, kids do better if they are raised in households with a father present,” she added. “So, it is important to figure out how to support fathers and what factors explain why some fathers are very involved in raising their children while some are absent.”

Saxbe worked with a team of researchers from USC, University of California at Los Angeles and Northwestern University.

A snapshot of paternal postpartum depression

For the study, the researchers examined data from 149 couples in the Community Child Health Research Network. The study by the National Institute for Child Health and Human Development involves sites across the country, but the data for this study came from Lake County, Illinois, north of Chicago.

Mothers in the study were 18 to 40 years old; African-American, white or Latina; and low-income. They were recruited when they gave birth to their first, second or third child. Mothers could invite the baby’s father to participate in the study as well. Of the fathers who participated and provided testosterone data, 95 percent were living with the mothers.

Interviewers visited couples three times in the first two years after birth: around two months after the child was born, about nine months after birth and about 15 months after birth.

At the nine-month visit, researchers gave the fathers saliva sample kits. Dads took samples three times a day — morning, midday and evening — to monitor their testosterone levels.

Participants responded to questions about depressive symptoms based on a widely-used measure, the Edinburgh Postnatal Depression. They also reported on their relationship satisfaction, parenting stress and whether they were experiencing any intimate partner aggression. Higher scores on those measures signaled greater depression, more stress, more dissatisfaction and greater aggression.

Relatively few participants — fathers and mothers — were identified as clinically depressed, which is typical of a community sample that reflects the general population. Instead of using clinical diagnoses, the researchers looked at the number of depressive symptoms endorsed by each participant.

Men’s testosterone levels were linked with both their own and their partners’ depressive symptoms — but in opposing directions for men and for women.

For example, lower testosterone was associated with more symptoms in dads, but fewer symptoms in moms. The link between their partners’ testosterone levels and their own depression was mediated by relationship satisfaction. If they were paired with lower-testosterone partners, women reported greater satisfaction with their relationship, which in turn helped reduce their depressive symptoms.

“It may be that the fathers with lower testosterone were spending more time caring for the baby or that they had hormone profiles that were more synced up with mothers,” she said. “For mothers, we know that social support buffers the risk of postpartum depression.”

Fathers with higher testosterone levels reported more parenting stress, and their partners reported more relationship aggression .

To measure parenting stress, parents were asked how strongly they related to a set of 36 items from the Parenting Stress Index-Short Form. They responded to statements such as “I feel trapped by my responsibilities as a parent” and “My child makes more demands on me than most children.” A high number of “yes” responses signaled stress.

Relationship satisfaction questions were based on another widely-used tool, the Dyadic Adjustment Scale. Parents responded to 32 items inquiring about their relationship satisfaction, including areas of disagreement or their degree of closeness and affection. Higher scores signaled greater dissatisfaction.

Mothers also answered questions from another scientific questionnaire, the HITS (Hurts, Insults, and Threats Scale), reporting whether they had experienced any physical hurt, insult, threats and screaming over the past year. They also were asked if their partners restricted activities such as spending money, visiting family or friends or going places that they needed to go.

“Those are risk factors that can contribute to depression over the long term,” Saxbe said.

Treating fathers with postpartum depression

Although doctors may try to address postpartum depression in fathers by providing testosterone supplements, Saxbe said that the study’s findings indicate a boost could worsen the family’s stress.

“One take-away from this study is that supplementing is not a good idea for treating fathers with postpartum depression,” she said. “Low testosterone during the postpartum period may be a normal and natural adaptation to parenthood.”

She said studies have shown that physical fitness and adequate sleep can improve both mood and help balance hormone levels.

In addition, both mothers and fathers should be aware of the signs of postpartum depression and be willing to seek support and care, Saxbe said. Talk therapy can help dads — or moms — gain insight into their emotions and find better strategies for managing their moods.

“We tend to think of postpartum depression as a mom thing,” Saxbe said. “It’s not. It’s a real condition that might be linked to hormones and biology.”

Story Source:

Materials provided by University of Southern California. Original written by Emily Gersema. Note: Content may be edited for style and length.

 

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Is testosterone replacement therapy the right thing for aging males?

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A study suggests that exercise can reduce the risk of heart damage for middle-aged adults and seniors. According to the study, even those who are obese will benefit from physical activity. Wochit

Testosterone (T) is a naturally occurring hormone in men, and most of it is produced in the testicles.

At puberty, T production escalates, bringing about masculinizing changes in muscle mass.  also promotes sex drive, sperm and red blood cell production, bone mass and determines how men store body fat.

It can impact quality of life issues as well, like mood, energy and motivation.

Beginning at about age 30, T production begins to decline on average by about 1 percent per year, plummeting late in life. This causes all sorts of problems, including lack of sex drive, inability to sleep, loss of muscle and bone mass, increased belly fat, the list goes on. Reversing these symptoms and improving the quality of life is the reason T replacement therapy (TRT) clinics supervised by physicians have sprung up around the country.

Although it is considered a male hormone, women also produce a modest amount of T in the ovaries. After menopause, estrogen production declines, which alters the ratio of estrogen to T, explaining why women begin taking on some male characteristics, like storing more fat around the midsection, rather than on the hips, thighs and buttocks as occurs earlier in life.

TESTOSTERONE REPLACEMENT THERAPY

Is TRT a good thing? It can be when managed responsibly. If you are older, and your T level is very low and falls below the normal range, it makes sense to address it with TRT because it can negatively impact health, increasing risks associated with diabetes, obesity and osteoporosis. Low T also may shorten life, but this is controversial because when TRT raises T levels it has not been shown to extend life.

More is not always better, and many TRT clinics are viewed with suspicion because they advertise that it’s possible to feel like you are 25 years old again, even though you are decades older. Perhaps this is possible, but at what price, and if you are taking huge doses of T, could you be damaging your health?

Research studies in 2013 and 2014 indicated that TRT increased the risk of heart disease in men 65 and older, and in younger men with a history of heart disease. However, subsequent studies refute these findings and some show a deceased risk of heart disease. Another area of concern is an increased risk of prostate cancer, but this, too, is controversial. There does appear to be solid evidence that TRT can increase the risk of blood clots and stroke, plus sleep apnea, acne and breast enlargement.

All in all, some experts believe the benefits outweigh the risks, while others are more cautious because TRT hasn’t been around long enough or impacted enough men to draw meaningful conclusions. Time will tell. In the meantime, like most things in life, moderation is the best approach.

THE BOTTOM LINE

TRT has a place and can be beneficial if managed prudently. Just be careful of extreme approaches and promises that seem too good to be true. As for AS, there is no justifiable reason for athletes to be taking them. Ever!

Written by: Bryant Stamford

Article Source: http://www.courier-journal.com/story/life/wellness/health/2017/09/07/testosterone-replacement-therapy-aging-males/569708001

 

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Testosterone therapy improves sexual, urinary function in men

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Men with hypogonadism treated long-term with testosterone therapy experience improvements in sexual and urinary function compared with men who are not treated, according to findings published in The Journal of Urology.

Abdulmaged M. Traish, PhD, of the department of biochemistry and department of urology at Boston University School of Medicine, and colleagues evaluated data on men with total testosterone levels of 12.1 nmol/L or less and symptoms of hypogonadism assigned to parenteral testosterone undecanoate 1,000 mg for 12 weeks (n = 360; mean age, 57.4 years) or no testosterone (n = 296; mean age, 64.8 years) for up to 10 years to determine the effect of long-term testosterone therapy on urinary and sexual functions and quality of life. Follow-up was a mean of 6.5 years.

Total testosterone levels were restored to the physiological range (500 ng/dL) in the treated group during the first year and the levels remained stable through follow-up; however, mean testosterone levels remained less than 300 ng/dL in the untreated group.

The untreated group experienced increases in the international prostate symptom score during follow-up compared with decreases in the treated group. At baseline, 50% of the treated group reported mild symptoms and 50% reported moderate symptoms, and 91.5% of the untreated group reported mild symptoms and 8.5% reported moderate symptoms. At the last visit, all the treated group had mild symptoms, and 61% of the untreated group reported mild symptoms and 39% reported moderate symptoms.

Post-voiding bladder volume and score on the Aging Males’ Symptoms scale decreased in the treated group but increased in the untreated group.

Among the treated group, 17.1% had no erectile dysfunction, 30.5% had mild erectile dysfunction, 20.7% mild to moderate, 25.6% moderate and 6.1% severe. At the last visit, the proportion of treated participants without erectile dysfunction increased to 74.4%, 17.1% had mild, 7.3% had mild to moderate and 1.2% had moderate. Among the untreated group, 1.2% had no erectile dysfunction, 31.7% had mild, 52.4% had mild to moderate and 14.6% had moderate. The severity of erectile dysfunction increased in the untreated group through follow-up to 51.2% having moderate and 48.8% having severe.

Prostate volume remained stable in the untreated group but increased from 31.4 mL to 33.2 mL in the treated group.

 

Article Source: https://www.healio.com/endocrinology/hormone-therapy/news/in-the-journals/%7B0c2f828d-0812-42fa-8f66-181eb9a8ee0f%7D/testosterone-therapy-improves-sexual-urinary-function-in-men

 

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Low Plasma Testosterone Is Associated With Elevated Cardiovascular Disease Biomarkers

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BACKGROUND:

The relation between testosterone (T) plasma concentration and cardiovascular (CV) risk is unclear, with evidence supporting increased risk in men with low and high T levels. Few studies have assessed CV risk as a function of plasma T levels using objective biomarkers.

AIM:

To determine the relation between T levels and high-sensitivity CV risk biomarkers.

METHODS:

Ten thousand forty-one male patients were identified in the database of a commercial clinical laboratory performing biomarker testing. Patients were grouped by total T concentration and associations with the following biomarkers were determined: cardiac troponin I (cTnI), endothelin-1 (ET-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-17A, N-terminal pro-B-type natriuretic peptide (NTproBNP), high-density lipoprotein (HDL) cholesterol, high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1c), and leptin.

OUTCOMES:

Association of CV risk markers with levels of T in men.

RESULTS:

The median age of the cohort was 58 years (interquartile range = 48-68), and the median plasma T level was 420 ng/dL (interquartile range = 304-565); T levels did not vary with patient age. An inverse relation between plasma T levels and CV risk was observed for 9 of 10 CV markers: cTnI, ET-1, IL-6, TNF-α, NTproBNP, HDL cholesterol, hs-CRP, HbA1c, and leptin. Even after adjusting for age, body mass index, HbA1c, hs-CRP, and HDL cholesterol levels, the CV markers IL-6, ET-1, NTproBNP, and leptin were significantly associated with a T level lower than 250 ng/dL.

CLINICAL IMPLICATIONS:

Men with low T levels could be at increased risk for increased CV disease as seen by increased CV risk markers.

STRENGTH AND LIMITATIONS:

This study was performed in a group of 10,041 men and is the first study to examine CV risk associated with circulating T levels using a large panel of 10 objective biomarkers. This study is limited by an absence of clinical data indicating whether men had pre-existing CV disease or other CV risk factors.

CONCLUSION:

Men with low plasma T levels exhibit increases in CV risk markers, consistent with a potential increased risk of CV disease. Pastuszak AW, Kohn TP, Estis J, Lipshultz LI. Low Plasma Testosterone Is Associated With Elevated Cardiovascular Disease Biomarkers. J Sex Med 2017;XX:XXX-XXX.

Article Source: https://www.ncbi.nlm.nih.gov/pubmed/28757119

 

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Infertility in men could point to more serious health problems later in life

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Poor sperm quality affects about one in ten men and may lead to fertility problems. These men also have an increased risk of developing testicular cancer, which is the most common malignant disease of young males. And, even if they don’t develop testicular cancer, men with poor sperm quality tend to die younger than men who don’t have fertility problems.

Couples who can’t achieve pregnancy usually go to fertility clinics for treatment. At these clinics, emphasis is put on deciding whether the couple needs assisted reproduction or not, and, if so, to choose between different methods (such as IVF, IUI, or ICSI) for doing this. In most cases, these treatments lead to pregnancy and a live birth. So the problem seems to be solved. But if infertility is an early symptom of an underlying disease in the man, fertility clinics won’t pick it up.

Missed opportunity

Testicular cancer is easy to detect. In men seeking treatment for fertility problems, a simple ultrasound scan of the testes can reveal early cancer, so a life-threatening tumour can be prevented. If detected, 95% of all cases can be cured. But, unfortunately, testicular ultrasound scans are rarely performed at fertility clinics as the focus tends to be on sperm numbers and which method of assisted reproduction to use.

And testicular cancer is not the only threat to young infertile men’s health. Serious health problems, such as metabolic syndrome (high blood pressure, high blood sugar and obesity), type 2 diabetes and loss of bone mass are also much more common conditions among infertile men. These disorders are possible to prevent, but if left untreated often lead to premature death.

A possible culprit

At Lund University in Malmö, Sweden, we have – together with other research groups – made a number of studies focusing on the link between male fertility problems and subsequent risk of serious diseases. We cannot yet explain the causes, but testosterone deficiency is a strong candidate. My research team found that 30% of all men with impaired semen quality have low testosterone levels. And men totally lacking the hormone have early signs of diabetes and bone loss.

We recently conducted a study in which we investigated almost 4,000 men below the age of 50 and who had had their testosterone measured 25 years ago. We found that the risk of dying at a young age was doubled among those with low testosterone levels compared with men with normal levels of this hormone.

Although testosterone treatment may not necessarily be the best preventive measure, these findings makes it possible to identify men at high risk so that they can be advised about lifestyle changes, such as losing weight or quitting smoking – lifestyle changes that will help reduce the risk of developing type 2 diabetes, cardiovascular disease and osteoporosis.

A relatively high proportion of men get in touch with their doctor about infertility problems and, as they represent a high-risk group for some of the most common diseases occurring later in life, perhaps it is time to change the routines for managing them. With the knowledge we now have regarding these men’s health, the least we can demand from doctors is to identify those who are at risk of serious diseases after they have become fathers. This is cheap and only requires simple tests. It is no longer enough to just evaluate the number of sperm.

 

Written by:  Aleksander Giwercman And Yvonne Lundberg Giwercman, The Conversation

Article Source: https://medicalxpress.com/news/2017-05-infertility-men-health-problems-life.html

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