What’s New: Hot Topics – Male Sexual Dysfunction

Penile Tissue May Produce Enzymes Crucial To Androgens.

HealthDay (10/22, Mozes) reported a presentation at the American Society for Reproductive Medicine (ASRM) annual meeting showing for the first time that enzymes “crucial to the production of” androgens “are active in penile tissue.” In addition, “that there are receptors in penile tissue.” Researchers believe that “these tissues could somehow be major components in the overall male hormone production process.”

Researchers Identify Symptoms Linked To “Male Menopause.”

AFP (6/17) reports that, according to a study published June 16 in the New England Journal of Medicine, “researchers have identified the symptoms linked to ‘male menopause,’ which results from low testosterone production in aging men.” But, “unlike female menopause, which affects all women and usually begins in the 40s and onward, male menopause only affects two percent of elderly men and is often linked to poor general health and obesity.”

“Some doctors have for years believed in a male menopause — termed late-onset hypogonadism — and have prescribed treatments such as hormone patches, gels, and injections,” the UK’s Daily Mail (6/17, Derbyshire) reports. Currently, “around 20,000 men are currently receiving such therapy, and there are claims that hundreds of thousands more could benefit.” However, the new study that “measured the testosterone levels of 3,369 men aged 40 to 79 from across Europe” reveals that the numbers of men who can benefit from testosterone therapy is small.

The UK’s Press Association (6/17) reports that “only nine of 32 candidate male menopause symptoms were associated in any way with low testosterone levels. Of these, the most important were three sexual symptoms: fewer morning erections, fewer sexual thoughts — reflecting a reduced sex drive — and impotence.” But, “for a true diagnosis of late-onset hypogonadism, all three sexual symptoms had to be present together with testosterone readings below a threshold limit of 11 nanomoles per litre of blood, the researchers concluded.”

In addition, the Time (6/16, Song) “Wellness” blog reported, “researchers identified six other symptoms that appeared more frequently as testosterone declined: three physical symptoms (an inability to engage in vigorous activity, such as running, lifting heavy objects or playing strenuous sports; an inability to walk more than 1 km; and an inability to bend, kneel or stoop), and three psychological symptoms (loss of energy, sadness and fatigue). But they were only weakly associated with testosterone, and overall, the researchers found, individual symptoms of andropause appeared frequently in men who didn’t have it.”

Nearly 90% Of Men Who Undergo RT For Prostate Cancer Will Eventually Develop Anejaculation.

Medscape (6/10, Stein) reported, “Nearly 90% of men who undergo radiation therapy (RT) for prostate cancer will eventually develop anejaculation,” researchers at the Memorial Sloan-Kettering Cancer Center explained during the American Urological Association 2010 Annual Scientific Meeting. After 364 “patients completed the widely validated International Index of Erectile Function…questionnaire at follow-up visits, starting with the first posttreatment visit,” investigators found that “overall, 72% of men lost their ability to ejaculate in an antegrade fashion after prostate RT by their last visit.” At one year, “a total of 16% reported anejaculation…69% at three years, and 89% at five years.”

ED Sufferers More Likely To Have High Coronary Artery Calcium Score.

Medscape (6/7, Stein) reported, “Men with erectile dysfunction (ED) are more likely to have a high coronary artery calcium score (CACS) than men without ED…according to the results of a study released…at the American Urological Association (AUA) 2010 Annual Scientific Meeting.” Before reaching that conclusion, researchers at the Mount Sinai School of Medicine “evaluated 1,119 consecutively enrolled men in the ongoing Law Enforcement Cardiac Screening Program,” all of whom “were evaluated with a dedicated cardiac computed tomography scan to determine CACS.” In short, “patients with ED had a 54% greater likelihood of having a high-risk CACS than men without ED (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.12- 2.11).”

Waning Sexual Desire May Be Early Sign Of Erectile Dysfunction.

WebMD (6/3, Laino) reported, “Waning sexual desire may be an early sign of erectile dysfunction (ED),” researchers at the New England Research Institutes found after studying “more than 800 men.” In fact, “those who reported fewer sexual thoughts and desires were more likely to develop ED by nine years later than those who had more sexual fantasies and feelings.” AUA spokesman “Ira Sharlip, MD, a urologist at the University of California-San Francisco, tells WebMD that at first glance, ‘it seems intuitive that you won’t get an erection if you don’t get very excited.’ But, the fact that there’s such a long lag time between waning sexual desire and development of ED may help doctors to identify men at risk for loss of sexual function earlier, he says.”

Erectile Dysfunction May Be Early Warning Sign Of Heart Disease.

WebMD (5/21, Mann) reported, “Erectile dysfunction is an early warning sign of heart disease and may provide a window of opportunity to stave off heart attacks and strokes,” according to a paper in the International Journal of Clinical Practice. “In fact, erectile dysfunction will be a harbinger of heart disease in about two-thirds of men,” a link that is “more pronounced in otherwise healthy men aged 40 to 69 than in older men.” Yet, “by treating erectile dysfunction, we can save a love life, but we can also use erectile dysfunction as a means of saving a life,” Graham Jackson, MD, a cardiologist at London Bridge Hospital in London, explained.

Men With ED, Low Testosterone Face Increased Risk Of Dying From Cardiovascular Disease.

MedPage Today (4/28, Smith) reported, “Men with erectile dysfunction and low testosterone have an increased risk of dying from cardiovascular disease,” Italian researchers found. “In a prospective cohort study of men with erectile dysfunction, those whose serum testosterone was below a threshold of 230 nanograms per deciliter and who suffered a major adverse cardiovascular event were seven times more likely to die as a result than those with the highest testosterone levels.” Investigators pointed out, however, that “low testosterone itself did not increase the risk of any cardiac event.”

Alfuzosin Improves Ejaculatory Dysfunction In Sexually Active Men With LUTS Suggestive Of BPH.

Medscape (4/20, Stein) reported, “Alfuzosin (Uroxatral, Sanofi Aventis), a uroselective alpha-1-adrenergic receptor blocker, ameliorates ejaculatory dysfunction in sexually active men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hypertrophy (BPH).” In fact, “alfuzosin 10 mg once daily given for six months in sexually active men with LUTS due to BPH significantly improves LUTS and bother due to LUTS, and is well tolerated from a cardiovascular and sexual standpoint,” researchers in Ireland explained.

Sexual Problems May Remain Constant, Severe In Cancer Patients.

The Time (4/2, O’Callaghan) “Wellness” blog reported that, according to research appearing in the journal Psycho-Oncology, “sexual problems commonly do not resolve in the first two years of disease-free survival” in cancer patients, “but may remain constant and relatively severe.” Researchers found that “the vast majority of patients said that sexual intimacy was less important than basic survival, but that it was still a critical component of quality of life.” There were “varying concerns about the way in which treatment interfered with intimacy,” based on “different types of cancer.” Overall, however, “most groups found that fatigue, hair loss, body image, and discomfort limited sexual enjoyment.”

ED May Predict All-Cause Mortality, Cardiovascular Events In Certain Men.

Medscape (3/19, MacReady) reported, “Erectile dysfunction (ED) is a robust predictor of all-cause mortality and cardiovascular events in men with cardiovascular disease or those with risk factors,” researchers in Germany found after studying 1,519 men from 13 countries. “All-cause mortality occurred in 11.3% of the men with ED at baseline vs. 5.6% of the men with no or mild ED at baseline.” In addition, the “composite primary outcome of cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure occurred in 16.2% of the men with ED vs. 10.3% of the men with no or mild ED.”

New research links RLS to erectile dysfunction.

Bloomberg News (1/1, Bennett) reported, “Erection problems are more common among men with a disorder that causes sufferers to have an irresistible urge to move their legs than those without the condition,” according to a new Harvard paper in Sleep.

In fact, those experiencing restless leg syndrome “15 or more times per month have almost a two-fold higher risk of also having” erectile dysfunction (ED) “than men without RLS,” Medscape (1/1, Anderson) reported. Investigators are partly attributing the association to “the fact that both conditions are associated with dopamine function and with sleep disorders.”

The “dopamine hypothesis,” MedPage Today (1/1, Bankhead) reported, “has been supported by studies showing that RLS symptoms improve with administration of L-dopa or a dopamine agonist and worsen with administration of dopamine antagonists that cross the blood-brain barrier.” As to what sparked the researchers’ interest in the ED connection, the authors previously uncovered “an association between erectile dysfunction and Parkinson’s disease, another condition involving dopamine hypofunction in the CNS.”

Sexual function decline may stabilize two years after EBRT for prostate cancer.

MedWire (12/15, Guy) reported that, according to a paper in the International Journal of Radiation Oncology Biology Physics, “men treated with external beam radiotherapy (EBRT) for prostate cancer experience a decline in sexual function for two years after treatment at which point it stabilizes.” That assertion is based on a questionnaire that was distributed to 143 patients. “Of the 94.0 percent of patients who reported their status at baseline, 74.1 percent were potent,” explained University of California-Sacramento investigators. “At one year after treatment, 74.4 percent of those men remained potent, and after two years, 70.4 percent were still potent.” Although “this represented a statistically significant decline in potency,” after “the two-year point, no further significant change was observed.”

Spray-on anesthetic helps delay ejaculation.

Bloomberg News (11/20, Matsuyama) reports, “A spray-on treatment for premature ejaculation may prolong sexual intercourse by as much as five times.” In fact, the drug, known as PSD502, “delayed orgasm by an average of 108 seconds” after one month of treatment, according to a 256-patient trial conducted in Canada, Poland, and the US.  The work may benefit the estimated “one in three US men ages 18 to 59” who have dealt with the problem at one time or another, according to the Los Angeles Times (11/19, Maugh) “Booster Shots” blog. That’s “about twice as many as those who suffer from erectile dysfunction.” Indeed, “some antidepressant-like drugs, such as dapoxetine, have been approved in a few countries to treat the condition, but the Food and Drug Administration rejected it because of long-term side effects.” And while “some physicians prescribe anesthetic creams like EMLA cream…off-label,” they “require 45 minutes to work.”  Now, researchers at the University of California-San Francisco may have stumbled upon a solution. According to WebMD (11/19, DeNoon), the spray “contains the anesthetics lidocaine and prilocaine,” but it “doesn’t deaden feeling, thanks to an ingredient in the spray that allows it to rapidly penetrate the skin.” What’s more, it “seems safe for men’s female sex partners,” as “only about 0.5 percent of female partners report decreased feeling in the vagina.”  In light of those findings, HealthDay (11/19, Preidt) pointed out, “Sciele Pharma plans to seek US Food and Drug Administration approval of the spray.” Reuters (11/20), the UK’s Telegraph (11/19), and the UK’s Press Association (11/19) also covered the story.

Avanafil reaches goal in late-stage study as ED treatment.

The AP (11/19) reports that Vivus Inc. “said its erectile dysfunction drug candidate avanafil reached its key goal in a late-stage clinical study.” The first of four late-stage studies on the drug found that “men who took avanafil experienced a greater improvement in their erectile dysfunction symptoms than patients who took a placebo.” Vivus will seek FDA “approval in late 2010 or early 2011.”
Bloomberg News (11/19, Waters) also reports that avanafil “helped men in a study achieve erections in 30 minutes.” In addition, “the most-common side effects were headaches, experienced by seven percent of the men, facial flushing, experienced by 4.6 percent and nasal congestion, experienced by 2.3 percent.”
Reuters (11/19) points out that in the 646-patient trial, about three-quarters of patients taking either a 100 mg or a 200 mg dose of the drug had erections sufficient for intercourse, and fifty-seven percent experienced “successful intercourse,” compared with 27 percent of placebo patients. Dow Jones Newswire (11/19, Stynes), the Indianapolis Business Journal (11/18), and the Indianapolis Star (11/18) also covered the study.

Atorvastatin said to improve sildenafil response in men with high cholesterol, ED.

MedWire (10/29, Albert) reported, “Atorvastatin therapy improves the response to sildenafil of men with erectile dysfunction (ED) and hypercholesterolemia,” according to a study appearing in the International Journal of Impotence Research. Researchers in Iran “investigated whether addition of atorvastatin therapy to sildenafil treatment would improve erectile function in 131 men, aged 62.9 years on average, with ED and high cholesterol who were previously unresponsive to sildenafil.” They found that subjects “taking atorvastatin had significantly greater improvements in [International Index of Erectile Function (IIEF-5)] score by week six than those taking placebo. By the end of the study, the average IIEF-5 score was 13.9 for patients in the atorvastatin group and 10.5 for those in the placebo group.”

Researchers testing stent for treatment of ED.

HeartWire (10/2, Wood) reported that, according to researchers at the Transcatheter Cardiovascular Therapeutics conference, “nine hospitals in the US” are “testing the use of a zotarolimus-eluting stent for the treatment of erectile dysfunction” in a study of “50 men who’ve failed treatment with phosphodiesterase-5 (PDE-5) inhibitors and have angiographic evidence of internal pudendal artery disease amenable to percutaneous treatment.” In a pilot study, researchers “correlated angiographic evidence of coronary disease with pudendal arterial disease.” Ten participants “undergoing coronary angiography for CAD symptoms who also reported a poor response to PDE-5 inhibitors underwent a pelvic angiogram as well.” The study showed that “stenosis in the coronary arteries typically mirrored that of the pudendal artery, which ranged from a mean of 52 percent in the right internal pudendal artery to 60 percent in the left.

“Scientists say Brazilian spider may inspire new treatments for erectile dysfunction.

WebMD (9/24, Hitti) reported, “The venom of a Brazilian spider may inspire new drugs to treat erectile dysfunction (ED).” Bites from the Phoneutria nigriventer “are intensely painful and ‘can cause priapism, a potentially harmful and painful erection that can last for many hours and lead to impotence.'” Speaking before a medical conference, researchers from Brazil and the Medical College of Georgia explained that they were able to “purify a toxin from [the] spider’s venom.” After testing it on rodents, they discovered “that the toxin causes a chemical chain reaction that sets the stage for better blood flow in penile tissue — and that could help treat ED.”

Most men use erectile aids after localized prostate cancer, study finds.

MedWire (7/20, Davenport) reported that, according to a study published in the August issue of the Journal of Urology, “over half of men treated for localized prostate cancer use erectile aids for dysfunction, particularly those who have undergone radical prostatectomy or have significant comorbidity, US researchers have found.” Noting that such treatments are “associated with significant reductions in erectile function,” researchers from the University of California-Los Angeles examined “425 patients not using erectile aids at baseline. Of these, 275 were treated with radical prostatectomy, 70 with external beam radiotherapy (EBRT), and 80 with brachytherapy. … In all, 56 percent of patients used an erectile aid during the post-treatment period.” The investigators found that “men who used an erectile aid were more likely to be younger, employed, and choose radical prostatectomy rather than radiation therapy, compared with other men.”

Study indicates lower testosterone levels, diminished ratings for sexual quality of life may correlate with increased BMI.

HealthDay (3/3/09, Preidt) reported that, according to a study to appear in the Journal of Clinical Endocrinology & Metabolism, “the more obese a man” is, “the greater his hormonal changes, and the worse his sex life.” In an Endocrine Society news release, study lead author Ahmad Hammoud, MD, of the University of Utah, explained that “obesity was biologically associated with an unsatisfying sex life,” but this could “be reversible.” For the study, the researchers “checked the weight, body mass index (BMI), and reproductive hormone levels of 64 obese men at the start of the study and again two years later, after some of them had what’s known as Roux-en-Y gastric bypass surgery.” The team found that “lower testosterone levels and diminished ratings for sexual quality of life were correlated with increased BMI,” but participants “who lost weight through bariatric surgery experienced a reduction in estradiol [hormone] levels, an increase in testosterone levels, and an increase in ratings of sexual quality of life.

Study suggests hydrogen sulfide may contribute to erections.

WebMD (3/2/09, Hoffman) reported that, according to a study published in the early online edition of the Proceedings of the National Academy of Sciences, hydrogen sulfide, a gas that “is present in raw natural gas and in the odor of rotting eggs,” may “someday become the target of new drugs for erectile dysfunction.” For the study, researchers from the University of Naples in Italy examined “penile tissue samples obtained from humans,” and discovered that “the same enzymes that produce hydrogen sulfide in animals were present and functional in human tissue.” In animal experiments, “injecting hydrogen sulfide opened blood vessels and improved erections.” The team “concluded that hydrogen sulfide” may “likely contribute to erections in men, just as in animal studies.” The authors said that “greater understanding of hydrogen sulfide’s separate chemical pathway could eventually lead to new treatments for erectile dysfunction

ED may become less of a predictor of CV disease risk as men age, analysis indicates.

Medscape (2/10/09, Stiles) reported that “as men age, their risk of developing erectile dysfunction (ED) rises but the power of ED as a predictor of cardiovascular disease declines, according to an analysis in which the adjusted risk of CV disease was strikingly high for men with ED in their 40s and negligible for men 70 or older.” In the February issue of the Mayo Clinic Proceedings, study authors write that the “long interval between ED diagnosis and CV events among the men who were youngest at baseline in the…study ‘raises the possibility of a window of curability, whereby the progression of cardiac disease might be slowed or halted by some form of medical intervention.'” After analyzing 1402 white men aged 40 to 79, researchers found that “the risk of [coronary artery disease (CAD)] events was highly dependent on age. It declined with ED at increasing ages by decade, from a hazard ratio of 2.1 for men in their 40s to 0.6 for men 70 and older after adjustment for the same characteristics.

ED may indicate increased heart disease risk, research suggests.

UPI (2/4/09) reports that a study from the Mayo Clinic suggests that “men who experience erectile dysfunction between the ages of 40 and 49 are twice as likely to develop heart disease.” In the study, published in the Mayo Clinic Proceedings, “men with erectile dysfunction [had] an 80 percent higher risk of heart disease.” For the study, researchers “identified 1,402 men…in 1996 who didn’t have heart disease. Every two years for 10 years, the men were assessed for urological and sexual health.” They found that “baseline prevalence of erectile dysfunction in study participants was: 2.4 percent in men aged 40-49; 5.6 percent in men aged 50-59; 17 percent in men aged 60-69 and 38.8 percent in men 70 years and older.”

“The end result suggests that erectile dysfunction for middle-aged men could be a red flag for heart disease down the road,” Minnesota’s KTTC-TV (2/4, Hrapsky) notes on its website. Mayo Epidemiologist Dr. Jennifer St. Sauver explained, “We found that men who had erectile dysfunction at baseline were more likely to develop coronary heart disease later on.” She added that “Mayo’s study is the third large study to find that ED could forecast future heart illness in middle-aged men.

Physical activity may revitalize a man’s sex drive, study suggests.

The U.K.’s Daily Mail (1/15/09, Derbyshire) reported that, according to a study published in the journal European Urology, “regular bouts of gentle weeding, digging, and mowing can revitalize a man’s flagging sex drive.”  In the study of “674 men aged 45 to 60,” researchers found that “just 30 minutes of gardening, five days a week, is enough to reduce the risk of impotence by around 38 percent.”  They also found that “other forms of moderate exercise, such as dancing, cycling, or jogging, can also act as ‘natural Viagra.'”  They wrote that “erectile function can be maintained even by low, regular physical activity.  Energy expenditure of as little as 1,000 kilocalories a week reduces the risk.

Study suggests sildenafil may help protect hearts.

HealthDay (1/5/09) reported, “Tests in mouse hearts show that sildenafil, the key ingredient in Viagra, may shield hearts from damage caused by high blood pressure,” according to a study published online in the Journal of Clinical Investigation.  David Kass, M.D., a cardiologist and professor of medicine at the Johns Hopkins University School of Medicine, and colleagues, induced “high blood pressure in…mice” for one week.  The researchers “found that the hearts engineered to lack RGS2, or regulator of G-protein signaling 2, expanded in weight by 90 percent, and almost half of the experiment animals died of heart failure.”  But, in the rodents “with RGS2, the dangerous muscle expansion, known as hypertrophy, was delayed, growing by only 30 percent…and none of those mice died.”

CTV (1/6/09) adds that, “in a second phase of the study, the researchers gave Viagra to the mice with RGS2, and found that these mice had greater protection against…hypertrophy.”  Notably, “the hearts of these mice had stronger contractions and produced significantly fewer stress-related enzymes, compared to untreated mice.”  The authors pointed out that “Viagra had no effect on mice that lacked RGS2.”  The Baltimore Examiner (1/6, Michael) also covers the story.

ED pills may lead to dangerous side effects if combined with common medicines, consumer group says.

Bloomberg News (1/6/09, Larkin) reports, “Erectile dysfunction (ED) pills made by Pfizer Inc., Eli Lilly & Co., and Bayer AG may lead to dangerous side effects if combined with one of 56 common medicines,” Public Citizen said.  The organization has “posted a list online…of prescription drugs and herbal remedies to avoid when taking Pfizer’s Viagra (sildenafil citrate), Lilly’s Cialis (tadalafil), or Bayer’s Levitra (vardenafil HCl).  The 56 products range from treatments for high blood pressure and chest pain, to grapefruit juice and St. John’s wort.”  Bloomberg News notes that “some of the drug-interaction risks are already noted in the pills’ prescribing information.”  Sally Beatty, a Pfizer spokesperson, told Bloomberg that “Viagra has a proven safety profile that has been well established in extensive post-marketing studies and in more than 120 clinical trials.”  Beatty added, “Viagra’s product label accurately and responsibly reflects the safety profile of this important medicine.”  Spokespeople for Lilly and Bayer “weren’t immediately able to comment.”

Sexual effects from SSRIs may be more common than previously thought, researchers say.

The Boston Globe (12/15/08, Goldberg) reports that “sexual numbness, lack of libido,” and stalled arousal are “sexual symptoms [that] have long been known side effects of the popular Prozac (fluoxetine) class of antidepressants, but a growing body of research suggests that they are far more common than previously thought, perhaps affecting half or more of patients.”  The warnings that are currently “on the labels of selective serotonin reuptake inhibitors, or SSRIs, cite early studies in which the prevalence of sexual side effects was lower: four percent for Prozac, for example, and ranging from 0 to 28 percent for Paxil (paroxetine).”  However, “more recent studies, in which patients were more likely to be asked about specific sexual side effects and thus more likely to report them, suggest that the ballpark range of those affected by SSRIs is between 30 and 50 percent, said researchers including Dr. Richard Balon, a psychiatry professor at Wayne State University, who studies the symptoms.

Study suggests men who ride motorcycles may risk impotence, urinary problems.

Australia’s The Age (11/23/08, Benson) reported that a survey found that men who ride motorcycles “risk impotence and urinary problems because the engine vibration damages nerves in their penises.” For the survey, researchers looked at “more than 230 motorcyclists who ride for about three hours every weekend.” They “found that almost 70 percent had problems getting an erection or emptying their bladders.” In addition, researchers “in Japan, who published two studies on the dangers in the International Journal of Impotence Research, said most motorcycle seats put undue pressure on the area between the anus and the scrotum, cutting blood flow to the penis.” Furthermore, “vibrations from the engine also caused a decrease in two growth hormones in the bladder and prostate related to bladder relaxation.”

Anti-depressant drugs may cause ED, physician says.

In a column in the Salem (OR) News (11/22/08), Dr. Phillip Leveque wrote “I have had a few PTSD Veteran victims come in for MJ permits who informed me that one of their PTSD symptoms was ED, Erectile Dysfunction.” Dr. Leveque wrote that “I was not surprised to read in Peoples Pharmacy a medical/pharmacology news feature about this problem by Joe & Teresa Graedon.” The column discussed a patient that “had been taking Prozac (fluoxetine) for about five years and could not get a sexual climax. He was switched to Celexa (citalopram hydrobromide) which didn’t help either.” According to the column, anti-depressant drugs that may cause ED include “Celexa, Effexor (venlafaxine hydrochloride), Lexapro (escitalopram oxalate), Paxil (paroxetine hydrochloride), Prozac (fluoxetine Hcl) and Zoloft (sertraline Hcl).” Furthermore, “these drugs reduce libido (sex drive), decrease arousal, delay or block orgasm (climax) and cause E.D. Some described the effects as “genital anesthesia” or numbness and that the sex act produces little or no pleasure.”

Watermelon may produce effects in the body similar to that of Viagra, research indicates.

Natural News (11/16/08) reported, “New research suggests that watermelon may produce effects in the body similar to that of Viagra (sildenafil citrate), perhaps pointing the way to a natural remedy for men suffering from erectile dysfunction.”  Researchers found “that the flesh of watermelon contains higher levels of the amino acid citrulline than researchers had thought.  Until then, most of the citrulline was believed to reside in the inedible rind of the fruit.”  Furthermore, “the body converts citrulline into arginine, another amino acid that functions as a precursor to nitric oxide.  Nitric oxide, in turn, plays a critical role in the dilation of blood vessels and the process of penile erection.”

Androgens Play a Pivotal Role in Maintaining Penile Tissue Architecture and Erection: A Minireview  Monday, 29 September 2008

Androgens are essential for development, growth and maintenance of penile structure and regulate erectile physiology by multiple mechanisms. Here we provide a concise overview of the basic research findings pertaining to androgen modulation of erectile tissue architecture and physiology. A significant body of evidence exists pointing to a fundamental role of androgens in erectile physiology. Studies in animal models have provided fundamental knowledge on the role of androgens in modulating the tissue architecture and cellular, molecular and physiological mechanisms. Based on data from our laboratory and those reported by others, we believe that androgens play a pivotal role in maintaining the structure and function of the peripheral penile nerve network, the structural integrity of the corpora cavernosa, the tunica albuginea and the endothelium of the cavernous spaces. Further, androgens play an important role in regulating the differentiation of precursor cells into trabecular smooth muscle. In this review, we will focus our discussion to findings pertaining to the role of androgens in regulating penile tissue architectural elements in modulating penile function. This knowledge has a profound impact on the potential use of androgens in the clinical setting to treat patients with erectile dysfunction.  Written by: Traish AM, J Androl. 2008 Sep 18

Testosterone deficiency, metabolic syndrome may be concurrent, study suggest.

Medical News Today (6/16/08) reported, “Men with erectile dysfunction (ED) should be examined for testosterone deficiency and the metabolic syndrome, because these conditions commonly occur together,” according to a study presented during the Endocrine Society’s annual meeting. Researchers tracked “771 patients who sought treatment for ED,” who got “a comprehensive screening for low testosterone and indicators of the metabolic syndrome, a cluster of risk factors that increase the chances of developing heart and vascular disease and type 2 diabetes.” The researchers found that “18.3 percent of the men (141) had testosterone deficiency, which had previously been undetected,” compared to “about 12 percent” of the total “population of men age 45 and older.” Furthermore, “270 (35 percent) had type 1 or type 2 diabetes; in eight of the men, diabetes was a new diagnosis.” And, “[h]igh blood pressure was found in 239 men (31 percent), and 12 of these men had been unaware of it.”

Research indicates testosterone replacement for older men may not increase prostate cancer risk.

Medical News Today (6/16/08) reported, “Older men who receive testosterone replacement therapy because of low testosterone are no more likely to get prostate cancer than similarly aged men not receiving testosterone,” according to a study presented at the Endocrine Society’s annual meeting. Researchers followed “154 testosterone-deficient men with an average age of 56, who had one to three years of follow-up testing.” During the study, “11 men receiving testosterone had a biopsy, two of which showed a small cancerous tumor on one side of the prostate.” And, “

[o]

f the 12 men in the untreated group, five had prostate cancer,” four of which “were on both sides of the prostate and were high grade.” Thus, researchers determined that “there were no more prostate cancers in the group that received testosterone treatment”.
Topical testosterone gel is well tolerated in hypogonadal men with diabetes, metabolic syndrome, study suggests.

Topical testosterone gel is well tolerated in hypogonadal men with diabetes, metabolic syndrome, study suggests.

The Doctor’s Guide (3/30/08, Stein) reported “that transdermal testosterone replacement is well tolerated in hypogonadal men with type 2 diabetes or metabolic syndrome,” according to early data presented at the EAU Congress. To reach this conclusion, researchers examined data from the Testosterone Replacement in Hypogonadal Men With Either Metabolic Syndrome or Type 2 Diabetes (TIMES2) study. In the TIMES2 study, 221 men were randomly assigned to receive “3 g of 2 percent testosterone gel per day (60 mg testosterone) or placebo gel.” More than three-quarters “of the patients enrolled in the TIMES2 trial have metabolic syndrome, about two thirds have type 2 diabetes, and nearly half have both medical conditions.” An analysis of the preliminary safety data showed that the “adverse-event rate [was] 57 percent. Adverse events were usually mild.” In patients who “developed serious adverse events,” the events were “unrelated to the study drug. The most commonly reported serious adverse events were gastrointestinal disorders, cardiac disorders, and neoplasms.” As a result, the researchers said that the drug “was found to be well tolerated to date.”