Editorial Comment

Lorenzini, Fernando

doi:10.1016/j.juro.2014.05.131

Cited by 2 publications

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“…High levels of BP and circulating cholesterol in the blood are risk factors for male sexual function, especially in testicular action, acting on spermatogenesis and being able to reduce serum levels of testosterone, estradiol and LH (3)(4)(5)22). Studies have also associated hypertension with erectile dysfunction, decreased libido and ejaculation (6,7).…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Renin-Angiotensin System Blockers on Testicular Morphology

Alves-Pereira

Frantz

Ramos

2017

Avicenna J Med Biochem

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Background: The renin-angiotensin system (RAS) is a set of peptides, enzymes, and receptors specially involved in the control of extracellular fluid volume and blood pressure (BP); however, some of its components have already been identified in the testis, such as angiotensinogen, angiotensin converting enzyme, and renin. Objectives: The aim of this study was to evaluate whether renin-angiotensin system blockers have effects on the testicular morphology of animals fed a high energy density (HED) diet. Materials and Methods: Male C57BL/6 mice were fed initially a standard chow (SC) or a HED diet. After 8 weeks, HED animals were randomized into 4 groups, each group receiving one of the following treatments for the next 6 weeks: HED-A: aliskiren (50 mg/kg/d); HED-E: enalapril (30 mg/kg/d); HED-L: losartan (10 mg/kg/d); and untreated HED group. The BP was measured biweekly. At the end of treatment, all animals were killed and the testes were processed for morphometric and stereological parameters including density of seminiferous tubules per area, density of length and the total length of the seminiferous tubules, height of the epithelium, and diameter of the seminiferous tubules. Samples were tested for their homoscedasticity and the differences between the groups were tested by one-way analysis of variance (ANOVA), followed by the Holm-Sidak post-test. In all cases, the significance level adopted was P ≤ .05. Results: Compared to SC, HED groups presented an increase in BP, normalized by all RAS blockers. However, the HED diet caused testis alterations that were not affected by aliskiren or losartan. Only enalapril maleate was capable of reversing such alterations. Conclusions: Further studies are still needed to answer why only enalapril was able to reveal the morphological changes caused by the high energy diet; so enalapril could be suggested as the drug of choice for patients with previous reproductive dysfunction.

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Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Renin-Angiotensin System Blockers on Testicular Morphology

Alves-Pereira

Frantz

Ramos

2017

Avicenna J Med Biochem

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Cardiovascular/Pulmonary Medications and Male Reproduction

Drobnis

Nangia

2017

Impacts of Medications on Male Fertility

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Cardiovascular and respiratory medications are used by men of reproductive age although use of the former is most prevalent in advanced age. Many of these drugs have been associated with sexual dysfunction, including erectile and ejaculatory dysfunction, but for most there is insufficient evidence to link their use with testicular dysfunction, reduced semen quality or infertility. Some exceptions are the irreversible α-adrenergic antagonist phenoxybenzamine, which carries a high risk of retrograde ejaculation; the specific α-adrenergic antagonists silodosin and tamsulosin, used primarily to treat BPH/lower urinary tract symptoms, which can cause retrograde ejaculation; and the peripheral β-adrenergic antagonist atenolol, used to treat hypertension, which may decrease testosterone/free-testosterone levels. In this chapter, we review the evidence available regarding adverse reactions on male reproduction of adrenergic receptor agonists/antagonists, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, diuretics, digoxin, and hydralazine. For some of these medications, there is some evidence for male reproductive effects, along with some solid work in experimental and companion animal species suggesting negative effects. In contrast, and of special note, are calcium channel blockers, which have long been included on lists of medications with the potential to cause male infertility. This turns out to be a good example of a substance with profound effects on sperm function in vitro, but with limited evidence for in vivo effects on semen quality or fertility, even in experimental species. We hope that the evidence provided in this chapter will stimulate additional studies for these important classes of medications.

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Editorial Comment

Cited by 2 publications

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Beneficial Effects of Renin-Angiotensin System Blockers on Testicular Morphology

Beneficial Effects of Renin-Angiotensin System Blockers on Testicular Morphology

Cardiovascular/Pulmonary Medications and Male Reproduction

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