Androgens, Male Hypogonadism and Traumatic Brain Injury

Abstract

Traumatic brain injury (TBI) is a worldwide public health problem. Populations with a growing number of vehicles are experiencing many traumas and accidents. The highest-risk group is young men. Significant advances in neurosurgery and intensive therapy have resulted in increased survival rates of TBI patients. These higher survival rates, in turn, have led to an increasingly higher number of patients with neurological, cognitive, clinical, and social problems. This lack of knowledge about TBI has been called by some "the silent epidemic". In recent years, studies of patients with moderate and severe TBI are increasing. Glasgow Coma Scale ≤ 8 and abnormal pupils at admission are used to determine the prognosis of patients with moderate or severe TBI. Several biomarkers such as interleukins, thiobarbituric acid reactive species, and some hormones have been studied in an effort to aid prognosis. Testosterone plays a key role in men. Thus, an understanding of androgens in TBI is essential to follow these survivors of head trauma. This review will discuss the epidemiology of TBI, its association with male hypogonadism, and possible treatments.

Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction

“…5 While others have used single serum measurements to define hypogonadism, 11,34,35 our PHH categorization captures a longitudinal definition of hypogonadism, establishing the persistence of hypogonadism for some individuals after TBI. Our multi-measure algorthism may more precisely and accurately reflect men’s hypogonadism status over the first year post-injury.…”

“…Prevalence estimates for chronic hypogonadism after TBI vary widely, from 8–41%, likely due to differences with time of screening, injury severity, and study design. 5–7 Most prior studies use single laboratory measurements to screen for HH, even though clinical guidelines generally recommend repeat testosterone testing for diagnosis if an initial level is found to be low, especially when symptoms are non-specific. 8 Thus, multiple hormone measurements may more accurately determine hypogonadism status.…”

The Influence of Neuroendocrine and Sleep Disturbances on Recovery from Traumatic Brain Injury

“…Other clinical indicators of thyroid deficiency include cold intolerance, constipation, weight gain, hair loss, dry skin, bradycardia, and hoarseness [26,39]. Hypogonadism has been associated with adverse effects on reproductive functioning including infertility, decreased libido and impaired sexual function [51]. Physical symptoms of hypogonadism specific to women include ammenorrhea, osteoporosis, and premature atherosclerosis [51].…”

“…Hypogonadism has been associated with adverse effects on reproductive functioning including infertility, decreased libido and impaired sexual function [51]. Physical symptoms of hypogonadism specific to women include ammenorrhea, osteoporosis, and premature atherosclerosis [51]. Testosterone deficiency in men is associated with decreased muscle and bone mass, erythropoiesis, hair growth, decreased energy, and impaired exercise tolerance [27].…”

Pregnancy After Concussion: A Clarion Call for Attention?

“…In a thermostatic, positive/negative feedback mechanism, the hypothalamic-pituitary-gonadal (HPG) axis regulates the endocrinology of reproduction through the release of gonadotropin-releasing hormone from the hypothalamus follicle-stimulating hormone and/or luteinizing hormone from the anterior lobe of the pituitary gland and estrogen and progesterone from the ovaries in the female; and testosterone from the male testes. [1][2][3][4][5] Mild traumatic brain injury (TBI), commonly referred to as concussion, is a transient disturbance of neurologic function caused by acute trauma to the brain. 6 Concussion has been associated with HPG dysregulation, hypogonadism, and impairments in reproductive function.…”