Hypogonadotropic hypogonadism (HH) represents a relatively rare cause of nonobstructive azoospermia (NOA), but its knowledge is crucial for the clinical andrologists, as it represents a condition that can be corrected with medical therapy in 3 quarters of cases. There are forms of congenital HH, whether or not associated with an absent sense of smell (anosmic HH or Kallmann syndrome, and normosmic HH, respectively), and forms of acquired HH. In congenital HH, complete absence of pubertal development is characteristic. On the other hand, if the deficit occurs after the time of pubertal development, as in acquired HH patients, infertility and typical symptoms of late-onset hypogonadism are the main reasons for seeking medical assistance. Gonadotropin-releasing hormone (GnRH) or gonadotropin replacement therapy is the mainstay of drug therapy and offers excellent results, although a small but significant proportion of patients do not achieve sufficient responses.
Humans ; Hypogonadism/drug therapy* ; Male ; Azoospermia/drug therapy* ; Gonadotropin-Releasing Hormone/therapeutic use* ; Kallmann Syndrome/drug therapy* ; Hormone Replacement Therapy

Testosterone affects several organs in the body and is very important for male well-being. Aging men with late-onset hypogonadism (LOH) experience physiologic, psychiatric, and sexual symptoms related to a decline in the serum concentration of testosterone with age. However, it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms. Therefore, it is difficult to diagnose and treat patients with LOH. In addition, the symptoms, response to testosterone replacement therapy (TRT), and medical insurance coverage differ among ethnicities and countries. The evaluation of testosterone is essential for the diagnosis and treatment of LOH. The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity. A low number of glutamine repeats is indicative of high androgenic activity, and the number shows ethnicity-related differences (fewer in African American than in Caucasian people and more in East Asian people). The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration. The Aging Male Symptoms scale is widely used to evaluate the symptoms. The normal range of total testosterone concentration varies around the world; therefore, clinicians should follow the guidelines of their regional academic society. The principal treatment for LOH is TRT. There are many types of TRT and other treatment strategies are also available. Thus, physicians should treat LOH according to each patient's situation, considering related disorders, such as diabetes, osteoporosis, metabolic syndrome, and depression.
Humans ; Male ; Hypogonadism/drug therapy* ; Testosterone/blood* ; Hormone Replacement Therapy/methods* ; Japan ; Age of Onset ; Aging ; Aged ; Androgens/therapeutic use*

As the social pressure is increasing,the incidence of depression is growing.Testosterone is synthesized and secreted through the hypothalamic-pituitary-gonadal axis,which plays a regulatory role in men's mental health.Studies have shown that low testosterone levels,clinical hypogonadism,and androgen deprivation therapy-induced testosterone deficiency are significantly associated with male depression,while there are still many uncertainties about the mechanism of their effects.Given that low testosterone levels may serve as a characteristic biomarker of male depression risk,testosterone replacement therapy may have a good therapeutic effect on male depression.This article focuses on assessing the role of testosterone levels and related clinical therapies in mood regulation in men.
Humans ; Testosterone/physiology* ; Male ; Depression/etiology* ; Hormone Replacement Therapy

INTRODUCTION: Rehabilitation medicine in a tertiary care hospital involves attending to many patients affected by intensive care unit (ICU)-associated weakness (ICU-AW) and hospital-associated deconditioning (HAD). These conditions contribute to poor long-term functional outcomes and increased mortality. We explored the role of short-term adjunctive androgen therapy in this group of patients in improving the rehabilitative outcomes. METHODS: This was a retrospective analysis of five patients with either ICU-AW or HAD who were given testosterone replacement therapy (TRT) or oxandrolone for a total of 2 weeks during the period from April to November 2020 was undertaken. During the 2-week trial period, the subjects underwent standard rehabilitation therapy. RESULTS: Grip strength was used as the primary outcome measure, and the mean improvement was 4.2 kg (+24.9%), which is encouraging in a 2-week timeframe. This was matched with good functional recovery in terms of distance ambulated and less assistance needed for ambulation. Sex hormone analysis was also done before initiation of TRT, and it showed that four out of five of the subjects were biochemically hypogonadal. None of the subjects dropped out or experienced any significant adverse events over the 2-week trial period. All the subjects except one improved to full independence at 3 months post-discharge. CONCLUSION TRT has the potential to be used as a useful adjunct to standard rehabilitation in enhancing functional recovery in critically ill patients. A multidisciplinary approach would ensure that suitable patients benefit from optimal nutrition, optimal rehabilitation and synergistic testosterone therapy in a clinically sound and resource-efficient fashion.
Humans ; Testosterone/therapeutic use* ; Retrospective Studies ; Male ; Hormone Replacement Therapy/methods* ; Intensive Care Units ; Singapore ; Middle Aged ; Muscle Weakness/drug therapy* ; Aged ; Hospitals, General ; Hand Strength ; Androgens/therapeutic use* ; Treatment Outcome ; Critical Illness/rehabilitation* ; Female ; Recovery of Function

To evaluate the efficacy and safety of Kuntai Capsules in the treatment of perimenopausal syndrome. Systematic reviews on Kuntai Capsules in the treatment of perimenopausal syndrome were retrieved from Chinese and English databases from database establishment to August 31, 2020. AMSTER-2 scale, GRADE scale and ROBIS tools were used respectively to evaluate the methodological quality, evidence quality level and bias risk of the finally included systematic reviews. A total of 6 systematic reviews with 28 outcome indicators were included. The results of AMSTER-2 methodological quality assessment showed that one of the six systematic reviews was of low quality, and the other five were of extremely low quality. GRADE scale showed that 28 clinical outcome indicators were evaluated, three of which were intermediate-level ones, and the rest were low-level or very low-level ones. Two evidences of the three intermediate evidences were total efficiency, and the other intermediate evidence was Kupperman score. ROBIS bias risk assessment showed all the included studies were of high risk. The results showed that, Kuntai Capsules were effective in the treatment of perimenopausal symptoms, such as hot flashes and sweating. The improvement of E_2 level was not as good as that in the menopause hormone therapy group, but the incidence of adverse reactions was lower than that in the menopause hormone therapy group. However, the quality of evidence needs to be improved due to the low quality of methodology and high risk of bias. It is suggested that systematic review and reasonable design should be carried out in the future, and attention should be paid to the registration of research schemes. In addition, the research reports shall be prepared according to PRISMA statement.
Drugs, Chinese Herbal ; Female ; Hormone Replacement Therapy ; Humans ; Perimenopause ; Syndrome ; Systematic Reviews as Topic

Cardiovascular Diseases/prevention & control* ; Female ; Hormone Replacement Therapy ; Humans ; Menopause

A 44-year-old woman was transferred to the ICU of the First Affiliated Hospital of Jinan University for 2 days of persistent epigastric pain and 7 hours of unconsciousness. Her admission diagnosis was severe acute necrotizing pancreatitis (hypertriglyceridemia type) with multiple organ dysfunctions. The results of CT revealed a small area of necrotizing pancreatitis, which was not consistent with the severe clinical manifestations. Considering lack of hair and history of postpartum hemorrhage, hormone examination was carried out. According to the results of the examination, she was further diagnosed as Sheehan's syndrome and pituitary crisis. After hormone replacement therapy, her condition improved rapidly.
Acute Disease ; Adult ; Female ; Hormone Replacement Therapy/methods* ; Humans ; Hypopituitarism/drug therapy* ; Pancreatitis, Acute Necrotizing/diagnostic imaging* ; Tomography, X-Ray Computed/methods*

Consensus ; Growth Disorders ; diagnosis ; drug therapy ; Hormone Replacement Therapy ; Human Growth Hormone ; administration & dosage ; deficiency ; therapeutic use ; Humans ; Practice Guidelines as Topic

OBJECTIVES: The effects of hormone replacement therapy on the survival rate of female lung cancer patients are still controversial. The Meta-analysis aims to systematically evaluate the effect of hormone replacement therapy on the survival rate of female lung cancer patients. METHODS: Retrospective studies regarding the effect of hormone replacement therapy on female lung cancer patients' survival rate were searched from the database of Embase, Cochrane, Pubmed, CNKI, Wanfang, and Weipu. The Meta-analysis was conducted with Stata 12.0 software. test was used to analyze the heterogeneity among included studies. The analysis was conducted by randomized model. Egger's test and Begg's test were used to assess the publication bias. RESULTS: Five retrospective studies were included, involving 2 582 female patients with lung cancer. There were 1 054 cases of female lung cancer with hormone replacement therapy and 1 528 cases of female lung cancer without hormone replacement therapy. No publication bias was observed among these studies. The sensitivity analysis result showed that the overall results were stable. Meta-analysis showed that compared with patients without hormone replacement therapy, patients with hormone replacement therapy had an increased survival time for 5 years (ES=0.346; 95% CI 0.216 to 0.476; <0.001). CONCLUSIONS Hormone replacement therapy improves 5-year survival in female lung cancer patients. Female lung cancer patients with menopausal syndrome can use hormone replacement therapy properly under their doctors' suggestion.
Female ; Hormone Replacement Therapy ; Humans ; Lung Neoplasms ; drug therapy ; Retrospective Studies ; Survival Rate

Objective: This study evaluated the knowledge, attitude and practice of Filipino gynecologists towards hormonal therapy for menopausal symptoms. Methods: This was a cross-sectional study carried out among practicing Filipino gynecologists in different regions of the Philippines from April to October 2018. A self-administered questionnaire was used to identify the current knowledge, attitude and practice of gynecologists regarding the use of hormonal replacement therapy. Results: There were 369 respondents included in the study. Our findings indicate that the most common indication for MHT are vasomotor symptoms and vaginal dryness. Almost all Filipino gynecologists participating in this study were aware that MHT will improve vasomotor and urogenital symptoms, sexual dysfunction and mood. Majority of them correctly agreed that MHT will decrease the risk of osteoporosis and coronary artery disease. On the other hand, at least half of the respondents falsely believed that MHT can decrease the risk for cognitive dysfunction, cerebrovascular disease, Parkinson’s disease and vascular thrombosis. Only 68% of the respondents agreed that they have adequate knowledge about the treatment options for postmenopausal symptoms and as much as 32% of them are still not confident with their knowledge. Majority (65%) of Filipino gynecologists do not routinely recommend or offer the use of MHT to every postmenopausal woman. Conclusion The knowledge and attitude of gynecologists on hormonal therapy play an important role in the decision making of a woman during her climacteric period. Basic knowledge on menopausal symptoms and indications for hormonal therapy are known to the respondents but these knowledge do not translate to practice.
Hormone Replacement Therapy ; Menopause ; Postmenopause