Prevalence of androgen deficiency in chronic spinal cord injury patients suffering from erectile dysfunction

Behnaz, Mohammad; Majd, Z. Karimi; Radfar, Mohammad Hadi; Ajami, H; Qorbani, Mostafa; Kokab, Abas

doi:10.1038/sc.2017.73

Cited by 18 publications

(4 citation statements)

References 32 publications

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“…We observed that SCI patients who were smoking had low testosterone levels as compared to non-smokers; however, we also observed that smoking was not an independent predictor of testosterone levels. Behnaz et al also observed that smoking was not an independent predictor of testosterone level [24].…”

Section: Discussionmentioning

confidence: 94%

Lifestyle-Related Predictors of Testosterone Deficiency Among Male Patients With Chronic Spinal Cord Injury

Sharma,

Prakash,

Urmila

et al. 2023

Asian J Pharm Clin Res

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Objectives: In the current study, the author evaluated the prevalence of low testosterone and its independent predictors among male patients with chronic spinal cord injury (SCI). Design: This descriptive type of observational study was conducted in the department of PMR at SMS Medical College. Methods: In this cross-sectional study, 120 patients with chronic SCI were recruited, serum testosterone levels were assessed, and testosterone levels below 300 ng/dL were considered low. The following eight suspected independent predictors for low testosterone levels were assessed: age, body mass index (BMI), nicotine users, total lipid profile, level of injury, American Spinal Injury Association (ASIA) impairment scale, leisure-time physical activity (LTPA) score (h/week) via LTPA questionnaire, and aging male’s symptom (AMS) score via AMS questionnaire. Results: The mean age of the patients was 33.2±7.8 years. Patients with low testosterone exhibited a significant association with dorsal SCI (70.9%), motor complete (ASIA A and B) SCI (76.4%), nicotine use (65.5%), a higher triglyceride (TG) level (168.5 mg/dL), a higher total lipid level (712.9 mg/dL), and a higher AMS score (35.7). Patients with low testosterone were found to be engaged in lower (9.4 h/week) LTPA. A significant negative correlation of total testosterone levels was observed with TG (r=−0.184, p=0.044), total lipid (r=−0.570, p<0.001), BMI (r=−0.504, p<0.001), and AMS scores (r=−0.549, p<0.001). Whereas there was a significant positive correlation observed between total testosterone and LTPA (r=0.380, p<0.001). Conclusion: The prevalence of low testosterone is found at 45.8%, and BMI, LPTA, AMS, and total lipids are identified as independent predictors of low testosterone.

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Section: Discussionmentioning

confidence: 94%

Lifestyle-Related Predictors of Testosterone Deficiency Among Male Patients With Chronic Spinal Cord Injury

Sharma,

Prakash,

Urmila

et al. 2023

Asian J Pharm Clin Res

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“…We applied both the paired t-test and multilevel mixed model using random intercept and residual maximum likelihood estimation to determine the longitudinal changes in androgens across the period of inpatient rehabilitation. The model was adjusted for age, BMI, level of injury, completeness of injury, time since injury, opioids use, and corticosteroids use in [ 32 ]. All analyses were stratified according to sex and were performed using Stata 16.1 (StataCorp LLC, College Station, TX, USA) for Windows.…”

Section: Methodsmentioning

confidence: 99%

Early Changes in Androgen Levels in Individuals with Spinal Cord Injury: A Longitudinal SwiSCI Study

Itodo

Raguindin

Wöllner

et al. 2022

JCM

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We aimed to explore longitudinal changes in androgen levels in individuals with spinal cord injury (SCI) within initial inpatient rehabilitation stay and identify clinical/injury characteristics associated with hormone levels. Linear regression analysis was applied to explore the association between personal/injury characteristics and androgen hormones (total testosterone, free testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEA-S)) at admission to rehabilitation. Longitudinal changes in androgen levels were studied using linear mixed models. Analyses were stratified by sex and by injury type. We included 70 men and 16 women with SCI. We observed a non-linear association between age, time since injury, and androgens at baseline. At admission to initial rehabilitation, mature serum SHBG (full-length, protein form which lacks the N-terminal signaling peptide) was higher, while DHEA and DHEA-S were lower among opioid users vs. non-users. Serum levels of total testosterone and DHEA-S increased over rehabilitation period [β 3.96 (95%CI 1.37, 6.56), p = 0.003] and [β 1.77 (95%CI 0.73, 2.81), p = 0.01], respectively. We observed no significant changes in other androgens. Restricting our analysis to men with traumatic injury did not materially change our findings. During first inpatient rehabilitation over a median follow up of 5.6 months, we observed an increase in total testosterone and DHEA-S in men with SCI. Future studies need to explore whether these hormonal changes influence neurological and functional recovery as well as metabolic parameters during initial rehabilitation stay.

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“…The presence of some spared long ascending and descending propriospinal pathways responsible for interlimb coordination can alter neural circuitry at the lumbosacral level, providing a potential mechanism through which forelimb exercise may affect BSM burst duration. In relation to the PDFR, decreases in latency and burst duration suggest increased local reflex synaptic efficacy, where the longer onset of PDFR suggests increased descending tonic inhibition.Serum testosterone is known to decline after SCI and may play an additional role in sexual dysfunction apart from neurological deficits[173,174,[203][204][205]. After SCI in the current study, rats had a significant decrease in urine testosterone levels that remained depressed for the duration of the study.…”

mentioning

confidence: 57%

“…As ex copula sexual reflexes can pertain to multiple aspects of sexual responses in the rat animal model, and these reflexes can be elicited through multiple different methodologies, we felt it best to use the term "penile dorsiflexion reflex" (PDFR) as it is all encompassing of this particular sexual reflex elicited in this particular method as a whole. Additionally, because testosterone levels are known to decrease after SCI [173,174], levels were periodically examined to determine if there was an effect of ABT. behavioral assessments (see below) were conducted at regular intervals throughout the study.…”

Section: Potential Therapeutic Target For Recovery Of Sexual Functionmentioning

confidence: 99%

The effect of spinal cord injury on sexual function.

Steadman¹

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Spinal cord injury (SCI) causes severe neurological impairment with widespread motor, autonomic and sensory deficits, leading to a substantial quality of life impairment. The number of individuals with SCI increases by approximately 12,500 annually, and over 80% of individuals with SCI are males. SCI individuals rate sexual function as a top priority quality of life issue, and men with SCI likely suffer from sexual dysfunction, such as erectile and ejaculatory dysfunction, as well as infertility. Regardless of the high status of importance of sexual function, limited numbers of experimental studies in SCI animal models have focused on sexual function after SCI. Interestingly, human clinical research participants with SCI undergoing daily locomotor treadmill training have reported changes in sexual function. To advance targeted recovery of sexual function after SCI, a better understanding of the post-injury neural circuitry is necessary. The objective of this project was to determine the effect of activity-based training (ABT) on sexual function in a rat model of SCI and examine the effects of a contusion SCI on sexual function using improved quantifiable measures. Two wellestablished measures of sexual function were used to determine the effects of ABT on sexual function after SCI: the penile dorsiflexion reflex (PDFR) and vi bulbospongiosus electromyography. The second and third studies focused on determining the effect of a clinically relevant contusion injury of varying severities using kinematic analysis of the PDFR and real-time intracavernosal pressure recordings from the penis of rats undergoing mating behavior testing. ABT was shown to positively affect sexual function after SCI, where taskspecific stepping and/or hindlimb loading impacts the local spinal cord circuitry responsible for sexual function. ABT may strengthen the residual fibers crossing the lesion epicenter, providing better coordination of supraspinal influences on the spinal cord sexual circuitry. Sexual function after SCI was determined to be correlated with the percent of white matter spared (a measure of injury severity), further supporting the disruption of spinobulbospinal coordination as the cause of sexual dysfunction after SCI. Kinematic analysis of the penile dorsiflexion reflex and telemetric recording of intracavernosal pressure may provide improved quantifiable measures for examining sexual function after SCI.

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Prevalence of androgen deficiency in chronic spinal cord injury patients suffering from erectile dysfunction

Abstract: Tehran University of Medical Sciences.

Cited by 18 publications

References 32 publications

Lifestyle-Related Predictors of Testosterone Deficiency Among Male Patients With Chronic Spinal Cord Injury

Lifestyle-Related Predictors of Testosterone Deficiency Among Male Patients With Chronic Spinal Cord Injury

Early Changes in Androgen Levels in Individuals with Spinal Cord Injury: A Longitudinal SwiSCI Study

The effect of spinal cord injury on sexual function.

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