The role of testosterone in men’s health: is it time for a new approach?

Diokno, Ananias C.

doi:10.1007/s11255-022-03292-4

Cited by 2 publications

(2 citation statements)

References 72 publications

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“…et al, 2022), lowers the risk of breast cancer (in Korea) (Baek et al, 2022), and reduces COVID-19 deaths (Sund et al, 2022). Testosterone replacement therapy (TRT) is recommended for late-onset hypogonadism in aging males over 65 years old (Nieschlag, 2020;Burte et al, 2021), but it is still a subject of controversy (Diokno, 2022;Mian et al, 2022). Regardless of testosterone levels, most symptomatic late-onset hypogonadism has been shown not to be correlated (Li et al, 2020c;Ishikawa et al, 2020;La Vignera et al, 2020;Tsuru et al, 2022).…”

Section: Window Of Cellular Regeneration-rejuvenation: Window Of Oppo...mentioning

confidence: 99%

“…Altogether, this new approach and strategy (Brennan and Davey-Smith, 2022;Diokno, 2022;Zhang et al, 2022) can provide clarity of concepts and patterns to determine the causes of declining vascularity hemodynamics (blood flow) and physiological oxygenation perfusion (physoxia) related to oxygen homeostasis and vascularity that cause hypoxia (hypovascularity hypoxia).…”

Section: Introductionmentioning

confidence: 99%

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Understanding human aging and the fundamental cell signaling link in age-related diseases: the middle-aging hypovascularity hypoxia hypothesis

Phua

2023

Front. Aging

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Aging-related hypoxia, oxidative stress, and inflammation pathophysiology are closely associated with human age-related carcinogenesis and chronic diseases. However, the connection between hypoxia and hormonal cell signaling pathways is unclear, but such human age-related comorbid diseases do coincide with the middle-aging period of declining sex hormonal signaling. This scoping review evaluates the relevant interdisciplinary evidence to assess the systems biology of function, regulation, and homeostasis in order to discern and decipher the etiology of the connection between hypoxia and hormonal signaling in human age-related comorbid diseases. The hypothesis charts the accumulating evidence to support the development of a hypoxic milieu and oxidative stress-inflammation pathophysiology in middle-aged individuals, as well as the induction of amyloidosis, autophagy, and epithelial-to-mesenchymal transition in aging-related degeneration. Taken together, this new approach and strategy can provide the clarity of concepts and patterns to determine the causes of declining vascularity hemodynamics (blood flow) and physiological oxygenation perfusion (oxygen bioavailability) in relation to oxygen homeostasis and vascularity that cause hypoxia (hypovascularity hypoxia). The middle-aging hypovascularity hypoxia hypothesis could provide the mechanistic interface connecting the endocrine, nitric oxide, and oxygen homeostasis signaling that is closely linked to the progressive conditions of degenerative hypertrophy, atrophy, fibrosis, and neoplasm. An in-depth understanding of these intrinsic biological processes of the developing middle-aged hypoxia could provide potential new strategies for time-dependent therapies in maintaining healthspan for healthy lifestyle aging, medical cost savings, and health system sustainability.

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Section: Window Of Cellular Regeneration-rejuvenation: Window Of Oppo...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding human aging and the fundamental cell signaling link in age-related diseases: the middle-aging hypovascularity hypoxia hypothesis

Phua

2023

Front. Aging

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Voiding function improves under long-term testosterone treatment (TTh) in hypogonadal men, independent of prostate size

et al. 2023

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Background Functional hypogonadism is a condition in which some, but not all, older men have low testosterone levels. Rather than chronological age per se, the causality of hypogonadism includes obesity and impaired general health (e.g., metabolic syndrome). An association between testosterone deficiency and lower urinary tract symptoms (LUTS) has been reported, yet due to prostate safety concerns, men with severe LUTS (IPSS score > 19) have invariably been excluded from entering testosterone trials. Irrespective, exogenous testosterone has not been demonstrated to cause de novo or worsen mild to moderate LUTS. Objective This study investigated whether long-term testosterone therapy (TTh) could have a protective effect on improving the symptoms of LUTS in hypogonadal men. However, the exact mechanism by which testosterone exerts is beneficial effect remains uncertain. Patients and methods In this study 321 hypogonadal patients with an average age of 58.9 ± 9.52 years received testosterone undecanoate in 12-week intervals for 12 years. One hundred and forty-seven of these males had the testosterone treatment interrupted for a mean of 16.9 months before it was resumed. Total testosterone, International Prostate Symptom Scale (IPSS), post-voiding residual bladder volume and aging male symptoms (AMS) were measured over the study period. Results Prior to TTh interruption, it was observed that testosterone stimulation improved the men’s IPSS, AMS and post-voiding residual bladder volume, while their prostate volume significantly increased. During the TTh interruption, there was a significant worsening in these parameters, although the increase in prostate volume continued. When TTh was resumed, these effects were reversed, implying that hypogonadism may require lifelong treatment.

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The role of testosterone in men’s health: is it time for a new approach?

Cited by 2 publications

References 72 publications

Understanding human aging and the fundamental cell signaling link in age-related diseases: the middle-aging hypovascularity hypoxia hypothesis

Understanding human aging and the fundamental cell signaling link in age-related diseases: the middle-aging hypovascularity hypoxia hypothesis

Voiding function improves under long-term testosterone treatment (TTh) in hypogonadal men, independent of prostate size

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