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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Renal insufficiency is responsible for gonadal impairment, but the pathogenesis of testicular dysfunction remains unresolved. This study examines the possible role of the endocrine disturbance and angiotensin II-induced physiological abnormality for the pathogenesis of gonadal dysfunction of two different types of chronic renal failure. Chronic renal insufficiency was induced in rats given an adenine-excessive diet or in 5/6 nephrectomized animals. Circulating levels of blood urea nitrogen, creatinine, renin-angiotensin-aldosterone (R-A-A) system androstenedione, 17 alpha-hydroxy progesterone (17 alpha-OHP), testosterone, luteinizing hormone, and follicle-stimulating hormone were assayed. Systolic blood pressure, renal blood flow, and testicular blood flow were also determined. High serum levels of 17 alpha-OHP, androstenedione, and low testosterone were noted in the normotensive group. Enhanced R-A-A system decreased testicular blood flow and low testosterone were seen in the hypertensive group. The data provide evidence that gonadal dysfunction in adenine-induced renal failure appears to be caused by the suppression of 17 beta-hydroxysteroid oxydoreductase activity, and gonadal impairment in 5/6 nephrectomized uremia can be evoked by enhanced renin-angiotensin-aldosterone system and hypertension.
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PMID:Effect of experimentally induced renal failure on testicular testosterone synthesis in rats. 1044 3

The aim of this paper is to describe metabolic and endocrine alterations in the male, partners of infertile couples. One hundred and six consecutive men were taken in order to analyze their serum samples. Each serum sample was analyzed by duplicate for luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), free-testosterone (T), 17 alpha-hydroxyprogesterone (17OHP), androstenedione (A), dehydroepiandrosterone-sulphate (DHEA-S), prolactin (PRL), insulin, glucose, total cholesterol and triclylcerides. The data analysis evidenced different metabolic or endocrine alterations in the group. A dysplipidemia incidence of 65% was found (isolated hypercholesterolemia, isolated triglyceridemia or both), where 80% of these patients were younger than 40 years. There was no correlation with obesity, overweight any endocrine alteration and the type of sperm alterations. There was a positive correlation between E2 and FSH (r = 0.67, p < 0.0001) in the group of 106 patients, which remained significant in the group of hyperestrogenic men (n = 27, r = 0.68, p < 0.0001), but not in men with normal serum estrogen levels (n = 79, r = 0.10, NS). Other alterations: obesity in 18%, overweight in 30.2%, diabetes mellitus 4.7%, glucose intolerance 15%, hypertension 26% (14/53), hypergonadotropic hypogonadism 3.8% (one of them with an Emty Sella syndrome). Unexpectedly only nine patients (8.4%) out of the 106 consecutive patients recluted did not have any of the metabolic or endodrine abnormalities here described. These are more significant since 83% of the patients are younger than 40 years. The most interesting non previously described finding was the positive correlation observed between E2 and FSH when estradiol levels exceeds 50 pg/mL.
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PMID:[High incidence of hyperestrogenemia and dyslipidemia in a group of infertile men]. 1090 92

The purpose of the present study was to investigate whether treatment of male rats with the calcium antagonist amlodipine, used in the treatment of hypertension and angina, interferes with the reproductive function of male rats. Amlodipine treatment (0.04 mg amlodipine besylate/rat/day for 30 days) decreased plasma follicle-stimulating hormone and testosterone but not luteinizing hormone or prolactin concentrations (measured by double-antibody radioimmuno-assay). A significant reduction (23%) was observed in sperm density (sperm suspension collected from the cauda epididymidis) as well as in the amount of mature spermatids (14%) and Sertoli cells (9%) counted in seminiferous tubule cross-sections (400 x magnification). The results reveal the deleterious effects of subacute amlodipine treatment on the reproductive function of male rats.
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PMID:Antireproductive effect of the calcium channel blocker amlodipine in male rats. 1098 90

Erectile dysfunction (ED) represents an important quality-of-life issue for many ageing men. Low serum testosterone level and other factors may be involved. Sildenafil is effective and well tolerated in patients with ED of various aetiologies, showing an efficacy of about 75%. However, few efficacy and adverse effect studies have focused specially on ageing men. In 150 patients below 65 years and 44 patients over 65 years, sildenafil was used to treat ED. Efficacy in the younger group (89.1%) was greater than in the older group (65.7%; p < 0.01). Mean serum luteinizing hormone (LH) and follicle-stimulating hormone concentrations (11.0 and 18.9 mIU/mL, respectively) in the older group were higher than in younger group (5.2 and 8.7 mIU/mL, respectively; p < 0.01). Serum testosterone and prolactin (PRL) were similar between groups. Older patients showed higher prevalence of diabetes mellitus, hypertension, and benign prostatic hyperplasia. Only diabetes appeared to decrease efficacy of sildenafil in older patients (p=0.019). A high prevalence of diabetes might be one of the many causes of lower efficacy rate of sildenafil in older men, although efficacy in patients even without diabetes in older men was relatively low. Sildenafil can be used safely and it is still effective for ageing male, because nearly two-thirds of our older subjects had a good response to the drug and no adverse effect was specific to older patients.
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PMID:The clinical studies of sildenafil for the ageing male. 1186 74

Although it may be 20 years before a male contraceptive is marketed, researchers continue to explore various options. Part of the difficulty with male contraception is the fact that the oral contraceptives were so successful in women that they cornered the market. Another problem is that it is easier to control one egg per month than hundreds of millions of sperm cells each day. Another is that it is more expensive to do research on male than on female rats since the males require separate cages. The physiologic targets for male birth control are 1) the process of spermatogenesis, 2) the process of sperm maturation, and 3) the process of capacitation. The substance gossypol, which suppresses sperm without affecting androgen levels, has been the subject of male contraceptive research in the US since the 1970s. Clinical trials of gossypol are planned by a collaborative groups of investigators from developing countries. Research has also continued for more than 20 years on compounds to alter male hormone levels. The use of one such compound, testosterone enanthate, required weekly injections, so current research is centered on finding a more marketable product, such as a 3-month injectable that uses testosterone buciclate. The combination of testosterone enanthate with cyproterone acetate is also showing promise in achieving complete azoospermia in trials in men. The dosing schedule makes this regimen unmarketable, however. Protocols have also been completed for a clinical trial using two implanted rods to deliver a GnRH analog and a specially developed androgen. Work is also proceeding on the development of a GnRH vaccine and on a vaccine specific only to follicle-stimulating hormone. Other avenues of research are focusing on nifedipine, a drug used to treat high blood pressure, on mifepristone (RU-486) which temporarily blocks calcium, and on etoprine, which suppresses rapidly dividing sperm cells. Research has halted on two compounds that protect cells from oxidative damage (superoxide dismutase and glutathione peroxidase) because of the potential damage to sperm DNA, which could cause early miscarriage or birth defects.
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PMID:Pills, shots, implants, vaccines: can the elusive sperm be reined in? Male contraceptive research extremely slow, but promising. 1229 Jul 17

The article is primarily a general discussion of the pill's medical aspects, prefaced by a discussion of the normal human menstrual cycle. Aspects of oral contaceptives reviewed include mechanisms, effectiveness, product formulation, instructions for use, adverse reactions, contraindications, and current developments. Oral contraceptive mechanisms include 1) blockage of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) release, 2) alteration of motility in the fallopian tubes 3) modification of endometrial maturation, and 4) rendering the cervical mucus hostile to sperm migration. Mild side effects of various oral contraceptives include nausea, mastalgia, edema, psychological changes, headaches, and failure of withdrawal bleeding. Moderate side effects include breakthrough bleeding, androgenic side effects, patches of increased skin pigmentation, and prolonged amenorrhea and infertility. Severe side effects include impaired liver function and jaundice, hypertension, and thromboembolic disorders. Topics of current research in steroidal contraception include depot therapy, continuous low-dose progestogen therapy, and postcoital estrogen therapy.
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PMID:Pharmacology of contraceptive agents - new compounds with new problems? 1230 37

Since the last in a series of childbirth education classes discusses contraception, educators must know about various family planning methods. Oral contraceptives (OCs) comprise combined OCs, phasic OCs, and minipills. Combined OCs inhibit secretion of gonadotropin-releasing hormone, which in turn keeps the follicle-stimulating hormone from inducing the ovarian follicle to grow and keeps luteinizing hormones from activating ovulation. They also thicken cervical mucus. Minipills also thicken cervical mucus and render the endometrium unreceptive to fertilized egg implantation. They do not always inhibit ovulation, however. OCs can induce side effects, such as nausea, hypertension, increased risk of atherosclerosis, and fatigue. The IUD prevents pregnancy either by inhibiting implantation of a fertilized egg or by an inflammatory reaction of the endometrium resulting in a release of macrophages which may destroy sperm. The no-longer-produced Dalkon Shield IUD increased the risk of pelvic inflammatory disease and damaged the reputation of other IUDs. Rare IUD complications are uterine perforation, salpingitis, tubal scarring, pelvic inflammatory disease, and infertility. Diaphragms, cervical film, and condoms serve as barriers between the egg and sperm. The main problem with barrier methods is the increased risk of developing toxic shock syndrome. Spermicide increase the effectiveness of diaphragms, cervical caps, and condoms. Vasectomy keeps sperm from arriving at storage sites. Shortterm side effects are swelling, discomfort, and occasional rejoining of the cut ends of the vas. Research hints at a link between vasectomy and prostate cancer. Some complications of tubal ligation are urinary tract infections, accidental electrical burns, and pelvic infections. Natural family planning methods include withdrawal, the rhythm method, and the sypto-thermal method. Controversial injectable contraceptives are Depo-Provera (medroxyprogesterone acetate) and Noristerate (norethisterone enanthate).
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PMID:Birth control update for childbirth educators. 1234 29

Adrenocortical tumors (ACT) are rare in childhood. Determination of malignant potential is difficult. To assess the presentation, clinical behaviour, and histology of these tumors in our center, the records of nine patients with ACTs between 1989 and 2000 were analyzed. The age, sex, clinical presentation, investigations, treatment, follow-up data, and current status were determined. The pathological features were reanalyzed by our pathologist. The endocrine profile of the tumors was also retrieved from the records. There were two males and seven females; the median age at referral was 2.5 years. Two patients (one male, one female) presented with clinical features of Cushing's syndrome with hypertension. Four girls had features of Cushing's syndrome with associated virilization. One 11-year-old girl presented with hypertension, hypokalemia, and pseudoparalysis due to an aldosterone-secreting tumor. One girl presented with precocious pubic hair and clitoromegaly. One male had evidence of true precocious puberty. The endocrine profile was available in eight cases: cortisol levels were raised in four, testosterone in four, and aldosterone in one. One boy had pubertal levels of follicle-stimulating hormone and testosterone. Surgery was the only modality of therapy used. Histopathology showed capsular invasion in four patients and vascular invasion in two. The median tumor weight was 80 g (15-550 g) and the size ranged from 1.5 x 1.5 to 12 x 12 cm. Five patients are alive without tumor recurrence at a median follow-up time of 2 years. Tumor recurrence was seen in two patients, one with capsular rupture during surgery and another with a tumor weight of 16 g with associated capsular and vascular invasion. Atypical modes of presentation like pseudoparalysis must be kept in mind. Histologic criteria for malignancy in ACT are unreliable. Tumor weight may not always be accurate in predicting tumor behaviour. Complete surgical excision remains the only effective and potentially curative treatment.
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PMID:Adrenocortical tumors in childhood. 1288 50

Extensive differences in the osteoporosis epidemiological pattern among geographic and ethnic groups have been reported. The evidence concerning association of multiple pregnancies, lactations, and other menstrual history factors with low bone mineral density (BMD) remains inconclusive. Previous local studies addressing these issues in Jordan are very restricted. We present a cross-sectional study of Jordanian women who visited outpatient clinics between August 2000 and August 2002 at two community hospitals in Amman City. BMD measurement was performed for all subjects, while comprehensive appraisal of clinical issues related to reproductive status and past medical history was carried out using a structured questionnaire administered to 50% of the subjects. We also attempted to examine the current hypothesis of possible influence of hyperlipidemia and thyroid abnormalities on decreased BMD. According to WHO criteria, 119 (29.6%) were identified as having osteoporosis, 176 (43.8%) were osteopenic, and 107 (26.6%) had normal BMD. The multiple-linear regression analyses at different bone sites revealed that age, years of menopause, low-density lipoprotein (LDL), and follicle-stimulating hormone (FSH) have strong independent associations with decreased BMD at all lumbar and femoral neck regions. The negative effect associated with number of children (live births) and frequency of lactations was only evident at femoral neck. Although years of menstruation, age at menopause, days of menstrual cycle, number of pregnancies, and duration of hormone replacement therapy (HRT) were positively correlated with BMD, they had weaker associations than previous variables. Moreover, in the final multivariable logistic regression model, variables which rendered significantly independent risk factors after adjustment for age and BMI were: current smokers of more that 25 cigarettes/day, postmenopausal women irrespective of HRT use, menopausal years of > or =5 year intervals, natural early menopause, gastrointestinal disease, rheumatoid arthritis, osteoarthritis, hypertension, and thyroid replacement therapy. Ever-lactation, frequent lactation of 4 or more times, duration of lactation interval of 1-6 months and clinical hyperthyroidism were significant protective factors. Hysterectomy with or without oophorectomy, premature ovarian failure, gravidity, menstrual flow pattern, family history of osteoporosis, clinical hypothyroidism, hyperlipidemia, HRT, and corticosteroids therapy were not independent predictors of osteoporosis among our population. It was concluded that the prevalence of this worldwide public health problem among the Jordanian female population is extremely high, and is even found in younger age categories compared to previous international surveys. Though, the number of pregnancies in our multiparous female population showed a negative impact on femoral neck BMD, no evidence of increased risk of osteoporosis among ever-pregnant women was noted. Conversely, the current data analysis highlight many potential risk factors including associated medical illnesses, and other hormonal alterations experienced during menopausal period. Therefore, increased health awareness and intensive screening programs are mandatory for early detection of low bone mass.
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PMID:Prevalence of osteoporosis and its reproductive risk factors among Jordanian women: a cross-sectional study. 1453 Sep 8

The study demonstrates that arterial hypertension itself, judging by main anthropometric variables such as body weight index and waist to hip ratio, together with the estrogen-producing function of the ovaries, evaluated by measuring follicle-stimulating hormone levels, contributes substantially to the forming of abdominal obesity in normo- and hypertensive women. All the above confirms close correlation between hemodynamic and metabolic disturbances which eventually result in coronary heart disease in young and middle-aged women.
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PMID:[Hormone-producing function of the ovaries in young and middle-aged women with arterial hypertension and coronary heart disease]. 1580 31


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