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Are you ready for testosterone replacement therapy?

It is well known that testosterone plays a role in a mans sex drive, but this vital hormone does more than regulate libido and sperm production. It also has a role in regulating systems throughout the body.

It also affects bone and muscle mass, the way men store fat in the body, and even red blood cell production, according to Healthline. A mans testosterone levels can also affect his mood.

Symptoms of declining testosterone

Testosterone production maxes out in most men around age 17, and then levels stay relatively consistent for the next 10 to 20 years. Sometime between ages 30 and 40, its normal for men to experience a slow decline in testosterone production, averaging about 1% a year, according to Harvard Health.

You lose muscle mass, mental sharpness and libido (sex drive) begins to decline, viTal4men says.

Benefits of testosterone

Research has pinpointed other links between testosterone levels and memory. One study cited by Harvard Health found that World War II veterans who had high testosterone levels in midlife had better preserved tissue in some parts of the brain later in life.

Another study found that men with higher free testosterone levels achieved higher scores on four cognitive function tests, including visual and verbal memory, according to Harvard Health.

Testosterone replacement therapy aims to address the symptoms men experience from low testosterone levels and possibly help protect cognitive function in later life.

You may benefit from testosterone replacement therapy if any of the following apply:

Treatment options

The proper method of testosterone delivery for you is a matter for your physician to determine; however, many find that some gels tend to be messy and less convenient than other treatment modalities, viTal4men says.

These are typical treatment options, according to Harvard Health:

Most men feel improvement in symptoms within four to six weeks of taking testosterone replacement therapy, although changes like increases in muscle mass may take from three to six months, Harvard Health says.

Work with your doctor to find out whether you are experiencing symptoms of low testosterone. Misuse of testosterone can be dangerous, and injections should be administered only by healthcare professionals. Suddenly stopping testosterone treatment can also cause unpleasant withdrawal symptoms, according to

Schedule a free testosterone level test at, and find out if testosterone replacement therapy is right for you.

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Dec 7th, 2019 | Filed under Testosterone

Low testosterone is a medical condition in which your body does not produce (or under produces) testosterone. It is a hormone produced in the testicles and is responsible for fueling a mans sex drive. Low testosterone levels in men may cause fatigue, hair loss, low libido, muscle loss and even mood swings.

This hormone also affects the sexual development and physical appearance of men like facial hair, manly built and a deep voice. It also helps in building muscle and bone mass. A womans body also produces this hormone in small quantities. A low level of testosterone production is also known as low-T.

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What are the signs of low testosterone levels in men? - Times of India

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Dec 7th, 2019 | Filed under Testosterone

IRVINE, Calif. The NHLs top team left quite the impression on the Ducks in their first matchup this season. Some of that impression left a trail of disgust.

The Washington Capitals make their annual visit to Anaheim on Friday night, and Alex Ovechkin is obviously the headliner on their loaded roster. They also have John Carlson, the high-scoring defenseman who is the clear leader in the Norris Trophy race.

Yet, Ovechkin and Carlson might not be the main attractions at Honda Center.

The Ducks and Capitals had a memorable meeting in the nations capital for all the wrong reasons two weeks ago. A wild fracas spurred by a big hit from Capitals forward Brendan Leipsic on Ducks center Derek Grant was capped by Washingtons Garnet Hathaway spitting on Erik Gudbranson in retaliation for a punch the Anaheim defenseman threw as the two were being held by officials.

[ Listen to Point Breakaway for more Ducks coverage ]

The NHL handed...

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Two teams 'full of testosterone': Ducks ready for grudge rematch with Capitals - The Athletic

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Dec 7th, 2019 | Filed under Testosterone

Treatment with Myovant Sciences relugolix induces a long-lasting reduction in testosterone to castrate levels similar to testosterone levels after medical or chemical castration in nearly all men with advanced prostate cancer who are sensitive to androgen deprivation therapy, updated results from the HERO Phase 3 trial show.

In addition to meeting its primary goal sustained castration from weeks 5 to 48 of treatment the trial met six additional secondary goals. These included a faster testosterone suppression than standard treatment with leuprolide acetate, and a rapid drop in prostate specific antigen levels, which are a marker of prostate cancer.

The results will support the submission of a new drug application (NDA) to the U.S. Food and Drug Administration (FDA) in the second quarter of 2020, as well as submissions to Japans and Europes regulatory agencies.

With the exciting results from the HERO study demonstrating the potential of relugolix to provide unique benefits compared to leuprolide, we look forward to submitting an NDA to the FDA, Lynn Seely, MD, president and CEO of Myovant Sciences, said in a press release. We are now closer to our goal of bringing a precision oral medicine to the broad spectrum of men with advanced prostate cancer.

Testosterone, the primary male sex hormone, is a major driver of prostate cancer. A common approach for treating such cancer is reducing the amount of testosterone produced in the body. This approach is called hormone therapy, or androgen-deprivation therapy, and aims to reduce testosterone below castrate levels.

Hormone therapy is often delivered in the form of luteinizing hormone-releasing hormone (LH-RH) agonists, such as leuprolide acetate, which is marketed under the brand names Eligard and Lupron.

These treatments work to reduce the amount of sex hormones in circulation estrogen in women and testosterone in men but have some limitations. One such limitation in men is an initial rise in the sex hormone levels, known as testosterone flare, which can exacerbate symptoms and delay testosterone recovery after the end of the treatment.

Relugolix is a different form of hormone therapy that reduces testosterone by inhibiting the gonadotropin-releasing hormone (GnRH) receptor. Essentially, its a different mechanism for reducing sex hormones.

The randomized, international HERO trial(NCT03085095) was designed to determine if relugolix is better than standard leuprolide acetate at lowering testosterone levels to castrate levels, which is less than 50 nanograms per microliter.

It was expected to enroll 1,100 men with advanced prostate cancer who had been receiving continuous androgen-deprivation therapy for at least one year. The study is being conducted at more than 180 clinical centers across North and South America, Europe, and the Asia-Pacific region.

The trial met its primary goal, with 96.7% of participants achieving sustained castration levels from week 5 through week 48. This was non-inferior to the response obtained in the leuprolide acetate group (88.8%).

In addition, the trial met several secondary endpoints by showing that relugolix suppressed testosterone, prostate-specific antigen (PSA), and follicle-stimulation hormone (FSH) faster and more effectively than leuprolide.

The therapy was not associated with testosterone flares, and hormone levels returned to normal within three months after the end of treatment, the results showed.

The occurrence of adverse events was similar for relugolix and leuprolide 92.9% vs. 93.5% and a similar proportion of participants discontinued treatment due to adverse events (3.5% vs. 2.6%).The most frequent adverse events in the relugolix group were hot flashes, fatigue, constipation, diarrhea, and joint pain.

An oral gonadotropin-releasing hormone, or GnRH, antagonist for advanced prostate cancer has been an aspiration for many years, said Neal Shore, MD, medical director of the Carolina Urologic Research Center and HERO program steering committee member. If approved, relugolix would become the first-of-its-kind oral option for men with advanced prostate cancer.

Alejandra has a PhD in Genetics from So Paulo State University (UNESP) and is currently working as a scientific writer, editor, and translator. As a writer for BioNews, she is fulfilling her passion for making scientific data easily available and understandable to the general public. Aside from her work with BioNews, she also works as a language editor for non-English speaking authors and is an author of science books for kids.

Total Posts: 282

Ins holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer. Before that, she studied Cell and Molecular Biology at Universidade Nova de Lisboa and worked as a research fellow at Faculdade de Cincias e Tecnologias and Instituto Gulbenkian de Cincia.Ins currently works as a Managing Science Editor, striving to deliver the latest scientific advances to patient communities in a clear and accurate manner.

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Relugolix Induces Sustained Testosterone Reduction in Advanced PC, Phase 3 Trial Results Show - Prostate Cancer News Today

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Dec 7th, 2019 | Filed under Testosterone

Erectile dysfunction is not an uncommon problem in men. It has been seen that many men suffer from the problem but refuse to accept the same and dont great treatment for it as well. As a result, the problem keeps on increasing and becomes quite serious after a point of time. Infact when not treated at the right time and in the right manner, erectile dysfunction could lead to heart problems and cause strokes or heart attacks. Thus, addressing the problem of erectile dysfunction needs to be done at the earliest. Instead of spending thousands of dollars on Viagra and similar medicines and supplements, other natural ways have to be sought for combating the problem of erectile dysfunction in men.

It is quite evident from the name itself that in erectile dysfunction, a man is not able to get proper erections and even if he gets one, he is not able to maintain the erection. It is quite obvious that with this problem, ones relationships will go downhill and might lead to breakups and separation. Having a healthy sexual life is very important for a successful relationship and with erectile dysfunction, relationship goes for a toss. Along with relationship conflicts, this problem adds to immense stress for males along with loss of self-confidence and self-esteem.

There are many reasons which can contribute to the problem of erectile dysfunction in men. One of the most common reasons is low testosterone levels in the body, which is quite common with men after a certain age. Testosterone is one of the most important hormones, which controls various functions in the male body, including sexual actions and activities. However, natural testosterone levels start depleting from as early as 30 years of age and continue doing so. The rate of depletion is also quite alarming 3-4% annually. With low levels of testosterone in the male body, erectile dysfunction can take place.

Another reason is lack of production of nitric oxide in the body, which leads to erectile dysfunction in men. Nitric oxide helps in boosting blood circulation in the body, particularly to the penis and the penile area. Moreover, the penile chamber is able to hold blood for a long period of time leading to longer and firmer erections. Though there are medications and surgeries for solving this problem, they might come with side effects. Resorting to natural ways for dealing with erectile dysfunction problem is the best thing that can be done.

[ Recommended Read: 6 Top Herbs To Help Erectile Dysfunction]

Your doctor might ask you to change your lifestyle a bit as that might prove to be effective in treating the problem of erectile dysfunction successfully. When blood flow to the penis is impaired, it leads to the problem of erectile dysfunction and it is difficult to get an erection. There are some lifestyle habits, which might contribute to ED as they reduce the blood flow in the body.

Mentioned below are some healthy lifestyles, which can be followed for improving blood supply to the penis and getting proper erections.

There are many reasons why a healthy diet and good foods can help in preventing ED. Infact in some cases, food and diet have also reversed the effects of erectile dysfunction. When people eat healthy foods and follow a balanced diet, risks of health issues decrease significantly. There is reduced risks of common vascular problems, which are caused due to high blood sugar levels, high cholesterol, being overweight and high triglyceride levels. The problem of erectile dysfunction is connected to issue of blood flow. So when the blood vessels remain in good health, chances of erectile dysfunction are minimized.

In various studies, it was found that there is direct connection between erectile dysfunction and diet. It was found that men who consumed lots of vegetables, fruits and whole grains and avoided things like processed grains and red meat, were at reduced risk of erectile dysfunction.

Refraining from the consumption of drugs and alcohol completely

The problem of erectile dysfunction can be caused due to alcohol use, particularly people who drink frequently or are chronic drinkers. Along with this, drug abusers are also at high risk of erectile dysfunction.

If you want to fight this problem, it is recommended that you give up drinking completely. You will see instant improvements in your sex life with this lifestyle change. Quitting drugs and alcohol might not be very easy for you if you are a regular and chronic abuser of the substances. Help is available and do not hesitate in taking the same in any manner.

There are many food items which help in dealing with the problem of erectile dysfunction successfully. Some of them include the following:

1. Pistachios

If you thought that pistachios are just snacks, you are mistaken. They are more than that and the green nut is a favorite with people. Eating pistachios had a great effect on the problem of erectile dysfunction (1). Various parameters of ED were dealt with the help of these nuts. Along with bettering the problem of erectile dysfunction, pistachios also help in bettering blood pressure and cholesterol levels.

2. Cocoa

For maintaining an erection, good blood flow to the penile region is needed and for that nitric oxide is required in greater amounts in the body. Antioxidant compounds known as flavonoids help in improving cardiovascular health. Dark chocolate abounds in flavonoids thus increasing nitric oxide in the body, leading to increased blood flow.

3. Watermelon

This juicy fruit helps in dealing with ED and improves sexual functions (2). Watermelon contains a compound known as citrulline, which helps in relaxing the blood vessels in the body. Blood flow is increased leading to better erections.

Try these steps and see how the problem of erectile dysfunction is resolved within a short span of time without any side effects.

How Food And Diet Helps In Erectile Dysfunction - WSU Guardian

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Dec 7th, 2019 | Filed under Testosterone

A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed on Tuesday in Belgrade, Serbia, by an international team of surgeons.

The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable, and to enable him to father children, said Dr. Dicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure.

The operation was only the third known transplant of this type. The first two were performed 40 years ago in St. Louis, also for identical twins, each pair with a brother lacking testicles.

The absence of testicles is an exceedingly rare condition, but doctors say that the surgery may have broader applications for transgender people, accident victims, wounded soldiers and cancer patients. But the procedure raises questions about the ethics of transplants that are not lifesaving, and about the possibility of recipients someday fathering children with sperm from donors who may not even be related to them.

The surgery was performed at the University Childrens Clinic in Tirsova, a section of Belgrade. The Serbian brothers are doing well, doctors said. By Friday, the recipient already had normal testosterone levels.

Hes good, he looks good, his brother looks good, Dr. Ko said in a telephone interview on Friday. The donor, who already has children, should remain as fertile as he was before, despite giving up a testicle.

Dr. Ko said the brothers, who have been sharing a hospital room, were expected to go home this weekend. They preferred not to be identified or interviewed, the doctors said.

Because the patients are identical twins with the same genetic makeup, there is no concern that the recipients body will reject the transplant, so he does not have to take the immune-suppressing drugs that most transplant patients need.

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Surgeons operated on the brothers simultaneously, in adjoining rooms. The procedure was challenging because it required sewing together two arteries and two veins that were less than 2 millimeters wide.

Once you remove the testicle from the donor, the clock starts ticking very fast, said Dr. Branko Bojovic, an expert in microsurgery at Harvard Medical School and part of the team in Belgrade.

Within two to four hours, you have to have it re-perfused and working again, Dr. Bojovic said. Without a blood supply, a testicle is viable for only four to six hours.

It can take 30 to 60 minutes to make each of the four blood-vessel connections. But the team managed to complete them all in less than two hours, he said.

The team did not connect a structure called the vas deferens, which carries sperm out of the testicles. The surgeons could not find the tissue in the recipient needed for the connection, which means that for now, he cannot father children in the usual way.

Another operation to make the connection may be possible. Otherwise, if the recipient wants children, he might undergo a procedure to extract sperm from the testicle for in vitro fertilization. Or his twin brothers sperm could be used.

Dr. Ko and Dr. Bojovic were both part of the surgical team that performed the first penis transplant in the United States, in 2016, on a man whose penis had been removed because of cancer.

Dr. Miroslav Djordjevic, who led the team in Belgrade, specializes in urologic reconstruction and sex reassignment surgery at Mount Sinai Hospital in New York and at the University of Belgrade. He said the brothers approached him after learning that he had performed a successful uterus transplant between twins sisters, which enabled the recipient to give birth.

Dr. Bojovic said that after the penis transplant, the surgical team received inquiries from people undergoing female-to-male sex reassignment who wondered if they might receive transplants instead of the usual surgery, which creates a penis from the patients own tissue.

But a transplant from any donor other than an identical twin would require immune-suppressing drugs to prevent rejection. The drugs have side effects that lead some experts to argue that the bar for such transplants must be very high.

Its becoming more of a popular topic for these patients, Dr. Bojovic said. They say, If immunosuppression is getting safer, I dont want to use a big piece of tissue from my forearm or thigh or back for something that looks like phallus but isnt.

He added that in patients having male-to-female reassignment surgery, the penis and testicles that were surgically removed are discarded, but in theory could be used for transplants.

The lead surgeon, Dr. Djordjevic, said that he had developed a surgical plan for transplanting a penis onto a body that is anatomically female, and that he hoped to begin performing that surgery within the next year or so.

We have to do this as soon as possible, to stop putting healthy organs in the garbage, he said.

But he would not transplant testicles as part of transgender surgery, he said. Doing so would open up the thorny possibility that the recipient could have children produced by the donors sperm. If the idea were extended to deceased organ donors, special permission would be required from them before death, or from their families.

Then the offspring is technically whose child? asked Dr. Ko, who is also chief medical officer at St. Elizabeths Hospital in Boston. It raises much debate in the literature of medical ethics.

Last year, when surgeons at Johns Hopkins Hospital transplanted a penis, scrotum and other tissue to a young soldier who had been maimed in combat, they deliberately left out the testicles. The idea that he might father children who were genetically someone elses was considered unacceptable.

The first report of a testicle transplant, by Dr. Sherman J. Silber, a fertility specialist in St. Louis, was published in a medical journal in 1978. In that case, the twin brothers were 30 when they consulted Dr. Silber.

The brother without testicles had not reached puberty until he was given testosterone at age 18, which caused a growth spurt that left him four inches taller than his brother. He needed regular testosterone injections to maintain his masculine characteristics, but the hormone levels fluctuated and sometimes caused mood swings.

He spent five years searching for a doctor who could perform a testicle transplant before he found Dr. Silber, after reading a New York Times article about his work published in 1975.

Dr. Silber said that he had performed more than 2,000 kidney transplants in rats, which required microsurgical techniques to sew together minute blood vessels the same size as those in human testicles.

So doing a testicle transplant was not a big deal, he recalled in an interview on Thursday. It was like just another kidney transplant in a rat. He said the operation took two hours.

Dr. Silber said that the donor was gay and the recipient straight, and that the brothers told him they wondered if the transplanted testicle might somehow alter the recipients sexual orientation. There is no scientific reason for such an effect, and none occurred.

The transplant was a success, and the recipient eventually had five children, Dr. Silber said. A year or so later, he performed the surgery again for another pair of identical twin brothers, though he did not write up their case in a journal.

Regarding the operation in Belgrade, Dr. Silber said, I imagine these surgeons must be pretty good, because most people wouldnt dare to try this.

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Surgeons Transplant a Testicle From One Brother to His Twin - The New York Times

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Dec 7th, 2019 | Filed under Testosterone

The Mens Health Clinic, founded by Dr Robert Stevens MBChB MRCGP Dip.FIPT, is the first clinic of its kind in the UK. From very humble beginnings they now have their very own private medical clinic that attracts people from all over the world. The clinic specialises in the diagnosis and treatment of Testosterone Deficiency. Their clinic offers a uniquely progressive approach to patient care, understanding the need for a personalised approach, not a one-size-fits all model.

Testosterone Deficiency is a medical condition characterised by the negative symptoms associated with low testosterone, along with confirmatory blood test results. The British Society for Sexual Medicine has set out national guidance to support doctors in making the diagnosis. Prominent symptoms of Testosterone Deficiency include an element of low mood, anxiety, and-or depersonalisation. Men often describe a brain fog, fatigue and low libido. Other symptoms can include erectile dysfunction, weight gain, loss of lean muscle mass and a decrease in bone mineral density. As there can be several possible diagnoses for each symptom, it is important to have a comprehensive assessment by a clinician who specialises in the area, before commencing any treatment. There can also be potential reversible causes for low testosterone and so these should always be addressed before committing to, what should be considered, a lifelong therapy.

From the outside, TRT can appear straightforward; if you have a deficiency you restore the testosterone level using exogenous testosterone. Unfortunately, this is a simplistic perspective. Exogenous testosterone suppresses the release of Lutenising Hormone (LH) and Follicle Stimulating Hormone (FSH) from the pituitary gland. As there are LH receptors in numerous organs, most notably the testes and the brain, traditional testosterone monotherapy often causes azoospermia and male infertility due to the suppression of LH. TRT should therefore be addressed as hormone replacement therapy. The aim of TRT and hormone replacement therapy should be to maintain function, in addition to restoring male androgen levels using exogenous testosterone.

Human Chorionic Gonadotropin (HCG) has been used by the NHS to treat male infertility for many years. HCG mimics LH and so The Mens Health Clinic utilises HCG alongside testosterone in testosterone therapy to help preserve fertility and testicular size. Dr Stevens reported nineteen pregnancies in his patients so far with the use of concurrent TRT and HCG. In addition to the fertility aspect, men often report a qualitative improvement in their sense of well-being and libido with the use of HCG alongside their testosterone treatment.

In 2019, The Mens Health Clinic was delighted to be the first clinic in the UK to be granted a licence by the MHRA for the import of Testosterone Cypionate, their gold standard TRT option. Dr Stevens is a proponent of daily injections of Testosterone Cypionate to help mimic the diurnal variation of endogenous testosterone that occurs naturally within the body. He also reports more stable male androgen levels using this methodology. Dr Stevens is also a proponent of subcutaneous injections, over shallow intramuscular ones, as they are less painful and result in less aromatisation of testosterone to oestrogen. Less side effects mean happier, more content patients.

Hormonal balance is fundamental to overall health and well-being. You need a clinician who understands that all hormones are dependent, whether that be direct or indirect. The ratio of testosterone : oestradiol : dihydrotestosterone, is as important as the absolute numbers. The purpose of TRT is normalisation of your male androgen levels to within normal physiological parameters. We aim to reverse the negative symptoms of low testosterone and help you maintain a sustainable improvement in your long-term physical and psychological well-being.


The Mens Health Clinic9-10 Longham Business Park168 Ringwood RoadFERNDOWNDorsetBH22 9BUTel: 01202 091593Email:

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The First 'Bespoke' TRT Clinic in the UK - News Anyway

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Dec 4th, 2019 | Filed under Testosterone

Yizhou Tang,1 Bolu Chen,1 Wuding Hong,1 Ling Chen,1,2 Liyang Yao,1 Yu Zhao,1 Zoraida P Aguilar,3 Hengyi Xu1

1State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, Peoples Republic of China; 2The Second Affiliated Hospital of Nanchang University, Nanchang 330000, Peoples Republic of China; 3Zystein, LLC., Fayetteville, AR 72704, USA

Correspondence: Hengyi XuState Key Laboratory of Food Science and Technology, Nanchang University, 235 Nanjing East Road, Nanchang 330047, Peoples Republic of ChinaTel +86-791-8830-4447 ext 9520Fax +86-791-8830-4400Email

Purpose: The aim of this study was to evaluate the adverse effects of ZnO NPs on male reproductive system and explore the possible mechanism.Methods: In this study, the effect of oral administration of 50, 150 and 450 mg/kg zinc oxide nanoparticles (ZnO NPs) in adult male mice was studied over a 14-day period.Results: The results showed that the number of sperms in the epididymis and the concentration of testosterone in serum were decreased with an increased dose of ZnO NPs. Testicular histopathological lesions like detachment, atrophy and vacuolization of germ cells were observed. The results showed that increased dosage of ZnO NPs correspondingly up-regulated the IRE1, XBP1s, BIP, and CHOP (P<0.05) which are genes related to ER stress. These observations indicated that ZnO NPs had adverse effects on the male reproductive system in a dose-dependent manner possibly through ER stress. The expression of caspase-3 was significantly increased in all the treated groups (P<0.001), which reflected the possible activation of apoptosis. Additionally, there was significant down-regulation of the gene StAR (P<0.05), a key player in testosterone synthesis. When an ER-stress inhibitor salubrinal was administered to the 450 mg/kg ZnO NPs treatment group, the damages to the seminiferous tube and vacuolization of Sertoli and Leydig cells were not observed. Furthermore, the testosterone levels in the serum were similar to the control group after the subsequent salubrinaltreatment.Conclusion: It may be inferred that the ZnO NPs reproductive toxicity in male mice occurred via apoptosis and ER-stress signaling pathway.

Keywords: zinc oxide nanoparticles, male reproductive toxicity, endoplasmic reticulum stress

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

ZnO Nanoparticles Induced Male Reproductive Toxicity Based on the Effe | IJN - Dove Medical Press

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Dec 4th, 2019 | Filed under Testosterone

Men are often portrayed as wanting to have sex all the time. In reality, a sluggish sex drive is something many men deal with at some point in their lives.

Several studies, including the often-cited Massachusetts Male Ageing Study from the University of Boston (conducted between 1987 and 1989), suggest erectile dysfunction affects more than half of all men to some degree, and is more prevalent in older men.

A low libido does not just take a toll on a man's emotional well-being; it can affect his partner and relationship, too, says Dr Angela Tan, a Singapore-based family doctor and intimacy coach.

"For starters, your male partner may feel that he is not satisfying you, and this may make him feel inadequate. It may also affect his identity and how he sees himself as a man. And if your once fulfilling sex life is now non-existent or no longer making you happy, you may wonder if [he] is attracted to you any more. This may create problems like anger and resentment, and may even lead to arguments and affairs later."

To help your partner and prevent misunderstandings, it is useful to know what may be affecting his libido.

According to Dr Colin Teo Chang Peng, a urologist at Colin Teo Urology in Singapore, one of the top causes of a low libido in men is low testosterone.

This is sometimes referred to as andropause or male "manopause", testosterone deficiency syndrome (TDS) or late onset hypogonadism (LOH).

"A man's testosterone levels start to decrease at a rate of about one per cent to two per cent every year from the age of 40," Teo explains.

"While testosterone is essential to sexual health and libido, it is also a metabolic hormone that has an effect on a man's blood-sugar control, cardiac health, psychological well-being, motivational drive, memory and physical fitness."

Low testosterone is also commonly linked with other medical conditions such as diabetes, hypertension, metabolic syndrome, coronary heart disease, obesity and renal failure, he adds.

An online survey of more than 5,000 men revealed that male sexual desire is complex and cannot be reduced to a single equation.

The researchers behind the European survey found that low confidence in their ability to achieve and maintain an erection, a lack of attraction to their partner, and being in a long-term relationship were some of the factors associated with the respondents' low sex drive. The results were published in 2014 in medical journal The Journal of Sexual Medicine.

There may be other reasons your partner cannot get in the mood for sex. Tan says that these may be medical - brain conditions like stroke, for instance; conditions that require chemotherapy, like cancer, which may deflate him emotionally; and liver problems that can cause hormonal issues.

Depression and anxiety disorder are also known to be mood killers.

If your partner is on medication, for instance some types of antidepressants and antipsychotics, he may experience a low libido, too. Even alcohol can decrease his sexual desire.

"Other causes may be related to your man's lifestyle - he may be stressed at work or under financial stress, for example; or perhaps his relationship with you feels strained, and that is affecting his desire to have sex with you," Tan says.

"Some men also have certain cultural or religious beliefs and values that may influence their views on sex, which may in turn dampen their libido."

Many men feel uneasy discussing their lack of sexual desire, especially in Asian societies, where talking about sex is considered taboo. However, Teo believes that this is slowly changing, with more men seeking their doctors' advice.

"The culture seems to be a bit more open now," he says. "More patients and doctors are aware that many sexual problems are also medical conditions. They also know that these conditions can be treated safely and effectively. We do see more men consulting their doctors about low libido and other andropause symptoms like lethargy, and many of these patients are accompanied by their partners."

The men who seek Teo's advice as soon as they notice symptoms tend to be in their 40s and 50s, leading fast-paced lives at or near the peak of their careers. A decline in their work, fitness or sexual performance is usually what motivates them to look for solutions to help restore their quality of life.

Patients who do not have fast-paced, active or career-driven lives may not notice the effects of andropause straight away and often take a while to ask their doctor for help.

It is not easy broaching the subject of low sex drive with your man, but you should not sweep the issue under the carpet, either. Tan suggests communicating your concerns in a calm, positive and non-threatening manner.

"Communication is key in this kind of situation," Tan says. "You want to be honest but not rude, and what you should not do is blame your partner or yourself, as this can have a detrimental effect on your relationship as well as your and your man's emotional well-being."

Tan advises couples to get professional help to determine the cause of a man's low sex drive and then explore ways to solve it together.

In the meantime, she says it is still possible to be intimate and maintain your physical and emotional connection, by cuddling and engaging in oral sex. Your man can also satisfy you using sex toys.

Fortunately, there are many solutions to help men get their sex lives back on track. Teo says that when a patient complains about andropause symptoms and his testosterone levels are found to be below normal, he is diagnosed with TDS and advised to begin testosterone replacement therapy (TRT).

Safe and effective, this treatment can be delivered orally with capsules, through the skin with daily gel applications, or as an injection every three months.

If the patient also has a chronic medical condition, he will be advised to undergo treatment for it, as the condition may impact his libido.

"Once testosterone levels are restored, other sexual dysfunctions can be actively remedied," says Teo. "These include erectile dysfunction, which can be treated with erectogenic medications in the form of oral tablets, injectables, and the recently available low-intensity shock wave therapy [LIST]."

In LIST, a wand-like device delivers mild shock waves to the penis that assists in the growth of new blood vessels.

Teo adds that, for patients with premature ejaculation, oral medications can help, giving the patient better control and helping the couple achieve satisfaction during sex.

In cases that do not respond to drugs or other therapies, penile implant surgery is a popular option.

A holistic approach is key when addressing low libido, so it may be necessary to include other forms of treatment, such as psychotherapy and couples' counselling.

Ultimately, while all forms of sexual dysfunction can be treated, Teo says a healthy lifestyle goes a long way towards helping men enjoy a satisfying sexual relationship.

"Exercising regularly relaxes the body and triggers the release of feel-good chemicals called endorphins, which boost your emotional well-being, while eating wholesome foods can counter some of the symptoms of andropause. You should also keep any chronic medical conditions in check and work towards strengthening your relationship with your partner."

This article was first published inSouth China Morning Post.

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Erectile dysfunction: When he's (not) in the mood for love - AsiaOne

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Dec 4th, 2019 | Filed under Testosterone

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There's a rare genetic mutation that triggers testosterone production in boys as young as two years old. It causes what doctors call precocious puberty, or testotoxicosis.

Patrick Burleigh wrote about his experience growing up with the mutation for New York magazine. We talk with him about it in the second of a two-part conversation.

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Part II: He Started Puberty At Age 2 Growing Up With Rare Genetic Mutation - Here And Now

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Dec 4th, 2019 | Filed under Testosterone
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