Testosterone levels during systemic and inhaled corticosteroid therapy

Morrison, Douglas; Capewell, Simon; Reynolds, Sarah; Thomas, J. Hywel; Ali, N.J.; Read, G F; Henley, R; Riad-Fahmy, D

doi:10.1016/s0954-6111(05)80062-9

Cited by 60 publications

(39 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This finding is less surprising considering the plethora of documentation supporting the negative impact of steroids on serum hormone levels and their effects on the hypothalamic-pituitary axis. 28,29 The observation that patients had worse sexual dysfunction in the setting of prior but not current cytoreduction treatment may be explained if patients are in advanced stages of disease and cytoreduction is no longer used, perhaps as a result of intolerance or resistance.…”

Section: Correlations With Current and Prior Therapiesmentioning

confidence: 99%

The role of sexuality symptoms in myeloproliferative neoplasm symptom burden and quality of life: An analysis by the MPN QOL International Study Group

Geyer

Andréasson

Kosiorek

et al. 2016

Cancer

View full text Add to dashboard Cite

BACKGROUND:Patients with myeloproliferative neoplasms (MPNs) including polycythemia vera, essential thrombocythemia, and myelofibrosis, are faced with oppressive symptom profiles that compromise daily functioning and quality of life. Among these symptoms, sexuality-related symptoms have emerged as particularly prominent and largely unaddressed. In the current study, the authors evaluated how sexuality symptoms from MPN relate to other patient characteristics, disease features, treatments, and symptoms. METHODS: A total of 1971 patients with MPN (827 with essential thrombocythemia, 682 with polycythemia vera, 456 with myelofibrosis, and 6 classified as other) were prospectively evaluated and patient responses to the Myeloproliferative Neoplasm Symptom Assessment Form (MPN-SAF) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ C30) were collected, along with information regarding individual disease characteristics and laboratory data. Sexuality scores were compared with an age-matched, healthy control population. RESULTS: Overall, patients with MPN were found to have greater sexual dysfunction compared with the healthy population (MPN-SAF score of 3.6 vs 2.0; P<.001), with 64% of patients with MPN describing some degree of sexual dysfunction and 43% experiencing severe symptoms. The presence of sexual symptoms correlated closely with all domains of patient functionality (physical, social, cognitive, emotional, and role functioning) and were associated with a reduced quality of life. Sexual problems also were found to be associated with other MPN symptoms, particularly depression and nocturnal and microvascular-related symptoms. Sexual dysfunction was more severe in patients aged >65 years and in those with cytopenias and transfusion requirements, and those receiving certain therapies such as immunomodulators or steroids. Conclusions:The results of the current study identify the topic of sexuality as a prominent issue for the MPN population, and this area would appear to benefit from additional investigation and management. Cancer 2016;122:1888-96.

show abstract

Section: Correlations With Current and Prior Therapiesmentioning

confidence: 99%

The role of sexuality symptoms in myeloproliferative neoplasm symptom burden and quality of life: An analysis by the MPN QOL International Study Group

Geyer

Andréasson

Kosiorek

et al. 2016

Cancer

View full text Add to dashboard Cite

show abstract

“…37,38 Where possible, removing these medications allows recovery of endogenous HPT axis function and is the preferred strategy. 37,38 Where possible, removing these medications allows recovery of endogenous HPT axis function and is the preferred strategy.…”

Section: Medical Comorbiditiesmentioning

confidence: 99%

“…Both ES and ESA discuss the situation of men treated with systemic glucocorticoids or opioids, both of which are associated with reduced HPT axis function and low testosterone concentrations. 37,38 Where possible, removing these medications allows recovery of endogenous HPT axis function and is the preferred strategy. A therapeutic role for androgens in this setting needs to be established by well-designed randomized controlled trials.…”

Section: Medical Comorbiditiesmentioning

confidence: 99%

Clinical practice update on testosterone therapy for male hypogonadism: Contrasting perspectives to optimize care

Yeap

2018

Clinical Endocrinology

View full text Add to dashboard Cite

US Endocrine Society (ES) published a clinical practice guideline on testosterone therapy in men with hypogonadism, and Endocrine Society of Australia (ESA) a position statement on management of male hypogonadism. Both emphasize the importance of diagnosing men who are androgen deficient due to organic (classical or pathological) hypogonadism arising from disorders of the hypothalamus, pituitary or testes, who assuredly benefit from testosterone therapy. Both recognize that men with an intact gonadal axis may have low testosterone concentrations, for instance older men or men with obesity or other medical comorbidities. ES guidelines classify such symptomatic men as having organic (advanced age) or functional (obesity, medical comorbidities) hypogonadism, giving an option for testosterone therapy as a shared decision between clinicians and individual patients. ESA did not recommend testosterone therapy in these men. ES offers a reference range for total testosterone established in young men, while ESA cites age‐standardized reference ranges. ES recommends using free testosterone as well as total testosterone to identify men with hypogonadism in conditions where sex hormone‐binding globulin (SHBG) is altered, or when total testosterone is borderline. ESA recommends confirmatory biochemical testing with total testosterone, recognizing that this may be lower than expected if SHBG concentrations are low. Both emphasize the importance of identifying pre‐existing prostate and cardiovascular disease prior to initiating testosterone therapy, with ES providing specific recommendations for PSA measurement, deferring testosterone therapy after major cardiovascular events and indications for pituitary imaging. These contrasting approaches highlight gaps in the evidence base where individualized patient management is required.

show abstract

“…5,11 It is important to remember that testosterone levels may also be suppressed by certain medications, such as oral glucocorticoids, opioids and antipsychotics. [12][13][14][15] Table 2 lists the factors associated with an increased prevalence of TD.…”

Section: Aetiology Of Tdmentioning

confidence: 99%