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In the last few years there has been more research around sexual function during the menopause transition in areas such as low libido or pain during intercourse, but very little specifically focused on how important sex is to women during this time, says Holly N. Thomas, MD, assistant professor of medicine at the University of Pittsburgh in Pennsylvania. Dr. Thomas is the lead author of research presented on the topic of the importance of sex in women as they age at the 2020 Virtual Annual Meeting of The North American Menopause Society (NAMS), which opened on September 28, 2020.

We were interested in looking at how womens ratings of how important sex was to them changes or stays the same as they move through the menopausal transition, says Thomas.

To find out the answer, investigators studied a total of 3,257 women from The Study of Womens Health Across the Nation (SWAN), all of whom completed 14 evaluations over 15 years. Visits included interviews, questionnaires, blood draws, and biometric measures such as body mass index (BMI), blood pressure levels, hormone levels, and depression symptoms.

RELATED: 10 Symptoms of Menopause and Perimenopause

Women were asked to rate how important sex was to them with the choices of not at all, not very, moderately, quite, or extremely.

Rather than look at averages of the women over time, investigators looked at trajectories within the cohort. This analysis technique allowed us to see if there are unique pathways that women can follow, explains Thomas.

If you just looked at averages of the group as a whole, it would look like how important sex is to women would go down for everyone, but what we actually found three distinct pathways women commonly follow when it comes to how much they value sex as they get older, she says.

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For the largest group, about 45 percent of the women, sex did become less important to them as they went through their forties and fifties and early sixties, says Thomas. For 27 percent of the women, sex remained highly important to them throughout midlife, and for 28 percent of the women sex was not very important to them throughout the whole duration of midlife, from forties to sixties.

Its important to recognize not all women are going to follow the same pathway when it comes to sex at midlife, each woman has her own unique experience, says Thomas.

There were a few trends that Thomas and her team noticed.

These results show that its not necessarily true that sex becomes less important to all women at midlife and that its just an inevitable fact of aging, says Thomas.

RELATED: Menopause and Depression Is Strongly Linked

My takeaway was that we need to be more routinely asking women in midlife about their sexual function and whether there are barriers such as having pain during intercourse or if theyre having problems with low sexual desire thats bothering them, says Stephanie Faubion, MD, director of the Mayo Clinic Center for Womens Health in Rochester, Minnesota, and medical director of NAMS.

Sexual function is usually under addressed in women in general but certainly in women beyond menopause, adds Dr. Faubion.

RELATED:Sex Drug for Women Stirs Up Controversy in Medical Community

In general, women who have a good sex life before menopause have a good sex life after menopause, she says. This research indicates that if sex is important to a woman before menopause, its important after.

RELATED: Sexual Dysfunction in Some Women Can Occur Years Before Menopause, Study Says

Keep in mind that sex doesnt look the same with aging, says Faubion. We have to modify our expectations about sexual functioning as we get older. Sex may not be always be penis and vagina sex; I have that conversation often with my patients, she says.

As peoples bodies and health changes, including medical illnesses that can be experienced by both men and women, we may need to modify what we are doing, but nonetheless, sexual intimacy remains important to all people for as long as they live, says Faubion.

RELATED: What Is the Role of Intimacy and Sex in Overall Health?

About 30 percent or so of women in the United States report low libido or sex drive, and about 10 percent report being bothered or distressed by it, Brooke Faught, doctor of nursing practice and board-certified women's healthcare nurse practitioner, who is clinical director of the Womens Institute for Sexual Health in Nashville, Tennessee. Dr. Faught presented on sexual health, libido, and testosterone at the NAMS 2020 conference.

Having a low sex drive isnt automatically a reason for treatment; hypoactive sexual desire disorder (HSDD) is when women have a low libido and are bothered or distressed by it. If the patient isnt directly impacted or bothered by it and its not impacting their daily function, its not a true diagnosable condition, says Faught.

RELATED: The Facts About Sexual Desire Disorder (Low Libido) In Women and Men

Even when they are bothered by a lack of desire, many women put up with it rather than seek treatment; they think its a normal part of aging or something they should just deal with, she says.

One barrier that stands in the way of treating HSDD is the lack of an U.S. Food and Drug Administration (FDA)approved testosterone for women with HSDD, even though there is quite a bit of published research on how and when to use it, says Faught.

Faubion agrees, saying Testosterone is fairly well studied for sexual health in women and is effective in almost all areas of sexual function.

RELATED: Women Need Testosterone Formulation for Low Libido

The barrier that exists isnt lack of science or lack of interest, its the FDA, says Faught. The FDA has asked for more long-term data for using testosterone in hypoactive sexual desire disorder (HSDD) in women, potentially up to five years [worth], she says.

A study that would fulfill the FDAs request seems to be cost prohibitive for pharmaceutical companies, says Faught. I dont know of any specific product that is on the cusp of getting approval or seeking approval, which is unfortunate and frustrating, she adds.

There are options and guidance for how to use testosterone products for HSDD, says Faught. In 2018, the International Society for the Study of Womens Sexual Health (ISSWSH) published a process of care (POC) for the diagnosis and management of hypoactive sexual desire disorder (HSDD) in pre- and postmenopausal women, including guidelines for prescribing testosterone in postmenopausal women with HSDD.

A global consensus statement that was endorsed by several international medical societies including The International Menopause Society, The Endocrine Society, and the NAMS was published in The Journal of Clinical Endocrinology & Metabolism in October 2019. The statements purpose is to provide clear guidance on which women may benefit from testosterone therapy, as well as any potential risks.

The issue is that treating off-label can carry additional risk and expense for patients, says Faught. If I prescribe a testosterone product thats intended for men, I can prescribe it at a lower dose as is necessary, but because it isnt FDA approved for this use, usually insurance wont cover it. That could mean a cost of anywhere from $300 to $500, she says.

Compounding testosterone, a process where a pharmacist specifically makes the product from scratch may be cheaper, but then there is increased potential for human error as well as a lack of regulations, says Faught.

Probably the main reason there is no FDA-approved testosterone product for HSDD is that theres a lack of long-term safety data, says Faubion. For example, we dont know breast cancer risk, we dont know cardiovascular risk, she says.

The cardiovascular risk appears to be less of concern for women than it is for men taking testosterone, but the bigger question is breast cancer risk over time, says Faubion. This is because testosterone converts to estrogen inside the body, and so there is a question on whether that increases breast cancer risk, she says.

Ive used it in my practice and its effective for women, says Faubion. Yes, we still have questions about long-term safety and long-term efficacy, but for short-term efficacy and short-term safety, we have pretty convincing data; I think ultimately it probably will be approved for use in women.

RELATED:Menopause and Sleep News: NAMS 2020 Addresses 5 Key Issues;

Hot Flash Treatment News: 4 Takeaways From NAMS 2020

Read more:
Sex Life, Sex Drive, and Menopause: News from NAMS 2020 - Everyday Health

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Competitive Landscape

Competitor analysis is one of the best sections of the report that compares the progress of leading players based on crucial parameters, including market share, new developments, global reach, local competition, price, and production. From the nature of competition to future changes in the vendor landscape, the report provides in-depth analysis of the competition in the global Testosterone Replacement Therapy market.

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TOC

1 Study Coverage1.1 Testosterone Replacement Therapy Product Introduction1.2 Market by Type1.2.1 Global Testosterone Replacement Therapy Market Size Growth Rate by Type1.2.2 Gels1.2.3 Injections1.2.4 Patches1.2.5 Other1.3 Market by Application1.3.1 Global Testosterone Replacement Therapy Market Size Growth Rate by Application1.3.2 Hospitals1.3.3 Clinics1.3.4 Others1.4 Study Objectives1.5 Years Considered 2 Executive Summary2.1 Global Testosterone Replacement Therapy Market Size Estimates and Forecasts2.1.1 Global Testosterone Replacement Therapy Revenue 2015-20262.1.2 Global Testosterone Replacement Therapy Sales 2015-20262.2 Testosterone Replacement Therapy Market Size by Region: 2020 Versus 20262.3 Testosterone Replacement Therapy Sales by Region (2015-2026)2.3.1 Global Testosterone Replacement Therapy Sales by Region: 2015-20202.3.2 Global Testosterone Replacement Therapy Sales Forecast by Region (2021-2026)2.3.3 Global Testosterone Replacement Therapy Sales Market Share by Region (2015-2026)2.4 Testosterone Replacement Therapy Market Estimates and Projections by Region (2021-2026)2.4.1 Global Testosterone Replacement Therapy Revenue by Region: 2015-20202.4.2 Global Testosterone Replacement Therapy Revenue Forecast by Region (2021-2026)2.4.3 Global Testosterone Replacement Therapy Revenue Market Share by Region (2015-2026) 3 Global Testosterone Replacement Therapy by Manufacturers3.1 Global Top Testosterone Replacement Therapy Manufacturers by Sales3.1.1 Global Testosterone Replacement Therapy Sales by Manufacturer (2015-2020)3.1.2 Global Testosterone Replacement Therapy Sales Market Share by Manufacturer (2015-2019)3.2 Global Top Testosterone Replacement Therapy Manufacturers by Revenue3.2.1 Global Testosterone Replacement Therapy Revenue by Manufacturer (2015-2020)3.2.2 Global Testosterone Replacement Therapy Revenue Share by Manufacturer (2015-2020)3.3 Global Testosterone Replacement Therapy Price by Manufacturer (2015-2020)3.4 Competitive Landscape3.4.1 Key Testosterone Replacement Therapy Manufacturers Covered: Ranking by Revenue3.4.2 Global Testosterone Replacement Therapy Market Concentration Ratio (CR5 and HHI) & (2015-2020)3.4.3 Global Testosterone Replacement Therapy Market Share by Company Type (Tier 1, Tier 2 and Tier 3)3.5 Global Testosterone Replacement Therapy Manufacturing Base Distribution, Product Type3.5.1 Testosterone Replacement Therapy Manufacturers Manufacturing Base Distribution, Headquarters3.5.2 Manufacturers Testosterone Replacement Therapy Product Type3.5.3 Date of International Manufacturers Enter into Testosterone Replacement Therapy Market3.6 Manufacturers Mergers & Acquisitions, Expansion Plans 4 Company Profiles4.1 AbbVie4.1.1 AbbVie Corporation Information4.1.2 AbbVie Description, Business Overview4.1.3 AbbVie Testosterone Replacement Therapy Products Offered4.1.4 AbbVie Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.1.5 AbbVie Testosterone Replacement Therapy Revenue by Product4.1.6 AbbVie Testosterone Replacement Therapy Revenue by Application4.1.7 AbbVie Testosterone Replacement Therapy Revenue by Geographic Area4.1.8 AbbVie Testosterone Replacement Therapy Revenue by Sales Channel4.1.9 AbbVie Recent Development4.2 Endo International4.2.1 Endo International Corporation Information4.2.2 Endo International Description, Business Overview4.2.3 Endo International Testosterone Replacement Therapy Products Offered4.2.4 Endo International Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.2.5 Endo International Testosterone Replacement Therapy Revenue by Product4.2.6 Endo International Testosterone Replacement Therapy Revenue by Application4.2.7 Endo International Testosterone Replacement Therapy Revenue by Geographic Area4.2.8 Endo International Testosterone Replacement Therapy Revenue by Sales Channel4.2.9 Endo International Recent Development4.3 Eli lilly4.3.1 Eli lilly Corporation Information4.3.2 Eli lilly Description, Business Overview4.3.3 Eli lilly Testosterone Replacement Therapy Products Offered4.3.4 Eli lilly Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.3.5 Eli lilly Testosterone Replacement Therapy Revenue by Product4.3.6 Eli lilly Testosterone Replacement Therapy Revenue by Application4.3.7 Eli lilly Testosterone Replacement Therapy Revenue by Geographic Area4.3.8 Eli lilly Testosterone Replacement Therapy Revenue by Sales Channel4.3.9 Eli lilly Recent Development4.4 Pfizer4.4.1 Pfizer Corporation Information4.4.2 Pfizer Description, Business Overview4.4.3 Pfizer Testosterone Replacement Therapy Products Offered4.4.4 Pfizer Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.4.5 Pfizer Testosterone Replacement Therapy Revenue by Product4.4.6 Pfizer Testosterone Replacement Therapy Revenue by Application4.4.7 Pfizer Testosterone Replacement Therapy Revenue by Geographic Area4.4.8 Pfizer Testosterone Replacement Therapy Revenue by Sales Channel4.4.9 Pfizer Recent Development4.5 Actavis (Allergan)4.5.1 Actavis (Allergan) Corporation Information4.5.2 Actavis (Allergan) Description, Business Overview4.5.3 Actavis (Allergan) Testosterone Replacement Therapy Products Offered4.5.4 Actavis (Allergan) Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.5.5 Actavis (Allergan) Testosterone Replacement Therapy Revenue by Product4.5.6 Actavis (Allergan) Testosterone Replacement Therapy Revenue by Application4.5.7 Actavis (Allergan) Testosterone Replacement Therapy Revenue by Geographic Area4.5.8 Actavis (Allergan) Testosterone Replacement Therapy Revenue by Sales Channel4.5.9 Actavis (Allergan) Recent Development4.6 Bayer4.6.1 Bayer Corporation Information4.6.2 Bayer Description, Business Overview4.6.3 Bayer Testosterone Replacement Therapy Products Offered4.6.4 Bayer Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.6.5 Bayer Testosterone Replacement Therapy Revenue by Product4.6.6 Bayer Testosterone Replacement Therapy Revenue by Application4.6.7 Bayer Testosterone Replacement Therapy Revenue by Geographic Area4.6.8 Bayer Recent Development4.7 Novartis4.7.1 Novartis Corporation Information4.7.2 Novartis Description, Business Overview4.7.3 Novartis Testosterone Replacement Therapy Products Offered4.7.4 Novartis Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.7.5 Novartis Testosterone Replacement Therapy Revenue by Product4.7.6 Novartis Testosterone Replacement Therapy Revenue by Application4.7.7 Novartis Testosterone Replacement Therapy Revenue by Geographic Area4.7.8 Novartis Recent Development4.8 Teva4.8.1 Teva Corporation Information4.8.2 Teva Description, Business Overview4.8.3 Teva Testosterone Replacement Therapy Products Offered4.8.4 Teva Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.8.5 Teva Testosterone Replacement Therapy Revenue by Product4.8.6 Teva Testosterone Replacement Therapy Revenue by Application4.8.7 Teva Testosterone Replacement Therapy Revenue by Geographic Area4.8.8 Teva Recent Development4.9 Mylan4.9.1 Mylan Corporation Information4.9.2 Mylan Description, Business Overview4.9.3 Mylan Testosterone Replacement Therapy Products Offered4.9.4 Mylan Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.9.5 Mylan Testosterone Replacement Therapy Revenue by Product4.9.6 Mylan Testosterone Replacement Therapy Revenue by Application4.9.7 Mylan Testosterone Replacement Therapy Revenue by Geographic Area4.9.8 Mylan Recent Development4.10 Upsher-Smith4.10.1 Upsher-Smith Corporation Information4.10.2 Upsher-Smith Description, Business Overview4.10.3 Upsher-Smith Testosterone Replacement Therapy Products Offered4.10.4 Upsher-Smith Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.10.5 Upsher-Smith Testosterone Replacement Therapy Revenue by Product4.10.6 Upsher-Smith Testosterone Replacement Therapy Revenue by Application4.10.7 Upsher-Smith Testosterone Replacement Therapy Revenue by Geographic Area4.10.8 Upsher-Smith Recent Development4.11 Ferring Pharmaceuticals4.11.1 Ferring Pharmaceuticals Corporation Information4.11.2 Ferring Pharmaceuticals Description, Business Overview4.11.3 Ferring Pharmaceuticals Testosterone Replacement Therapy Products Offered4.11.4 Ferring Pharmaceuticals Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.11.5 Ferring Pharmaceuticals Testosterone Replacement Therapy Revenue by Product4.11.6 Ferring Pharmaceuticals Testosterone Replacement Therapy Revenue by Application4.11.7 Ferring Pharmaceuticals Testosterone Replacement Therapy Revenue by Geographic Area4.11.8 Ferring Pharmaceuticals Recent Development4.12 Kyowa Kirin4.12.1 Kyowa Kirin Corporation Information4.12.2 Kyowa Kirin Description, Business Overview4.12.3 Kyowa Kirin Testosterone Replacement Therapy Products Offered4.12.4 Kyowa Kirin Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.12.5 Kyowa Kirin Testosterone Replacement Therapy Revenue by Product4.12.6 Kyowa Kirin Testosterone Replacement Therapy Revenue by Application4.12.7 Kyowa Kirin Testosterone Replacement Therapy Revenue by Geographic Area4.12.8 Kyowa Kirin Recent Development4.13 Acerus Pharmaceuticals4.13.1 Acerus Pharmaceuticals Corporation Information4.13.2 Acerus Pharmaceuticals Description, Business Overview4.13.3 Acerus Pharmaceuticals Testosterone Replacement Therapy Products Offered4.13.4 Acerus Pharmaceuticals Testosterone Replacement Therapy Sales, Revenue and Gross Margin (2015-2020)4.13.5 Acerus Pharmaceuticals Testosterone Replacement Therapy Revenue by Product4.13.6 Acerus Pharmaceuticals Testosterone Replacement Therapy Revenue by Application4.13.7 Acerus Pharmaceuticals Testosterone Replacement Therapy Revenue by Geographic Area4.13.8 Acerus Pharmaceuticals Recent Development 5 Breakdown Data by Type5.1 Global Testosterone Replacement Therapy Sales by Type (2015-2026)5.1.1 Global Testosterone Replacement Therapy Sales by Type (2015-2020)5.1.2 Global Testosterone Replacement Therapy Sales Forecast by Type (2021-2026)5.1.3 Global Testosterone Replacement Therapy Sales Market Share by Type (2015-2026)5.2 Global Testosterone Replacement Therapy Revenue Forecast by Type (2015-2026)5.2.1 Global Testosterone Replacement Therapy Revenue by Type (2015-2020)5.2.2 Global Testosterone Replacement Therapy Revenue Forecast by Type (2021-2026)5.2.3 Global Testosterone Replacement Therapy Revenue Market Share by Type (2015-2026)5.3 Testosterone Replacement Therapy Average Selling Price (ASP) by Type (2015-2026) 6 Breakdown Data by Application6.1 Global Testosterone Replacement Therapy Sales by Application (2015-2026)6.1.1 Global Testosterone Replacement Therapy Sales by Application (2015-2020)6.1.2 Global Testosterone Replacement Therapy Sales Forecast by Application (2021-2026)6.1.3 Global Testosterone Replacement Therapy Sales Market Share by Application (2015-2026)6.2 Global Testosterone Replacement Therapy Revenue Forecast by Application (2015-2026)6.2.1 Global Testosterone Replacement Therapy Revenue by Application (2015-2020)6.2.2 Global Testosterone Replacement Therapy Revenue Forecast by Application (2021-2026)6.2.3 Global Testosterone Replacement Therapy Revenue Market Share by Application (2015-2026)6.3 Testosterone Replacement Therapy Average Selling Price (ASP) by Application (2015-2026) 7 North America7.1 North America Testosterone Replacement Therapy Market Size YoY Growth 2015-20267.2 North America Testosterone Replacement Therapy Market Facts & Figures by Country7.2.1 North America Testosterone Replacement Therapy Sales by Country (2015-2026)7.2.2 North America Testosterone Replacement Therapy Revenue by Country (2015-2026)7.3 North America Testosterone Replacement Therapy Sales by Type7.4 North America Testosterone Replacement Therapy Sales by Application 8 Asia-Pacific8.1 Asia-Pacific Testosterone Replacement Therapy Market Size YoY Growth 2015-20268.2 Asia-Pacific Testosterone Replacement Therapy Market Facts & Figures by Region8.2.1 Asia-Pacific Testosterone Replacement Therapy Sales by Region (2015-2026)8.2.2 Asia-Pacific Testosterone Replacement Therapy Revenue by Region (2015-2026)8.3 Asia-Pacific Testosterone Replacement Therapy Sales by Type8.4 Asia-Pacific Testosterone Replacement Therapy Sales by Application 9 Europe9.1 Europe Testosterone Replacement Therapy Market Size YoY Growth 2015-20269.2 Europe Testosterone Replacement Therapy Market Facts & Figures by Country9.2.1 Europe Testosterone Replacement Therapy Sales by Country (2015-2026)9.2.2 Europe Testosterone Replacement Therapy Revenue by Country (2015-2026)9.3 Europe Testosterone Replacement Therapy Sales by Type9.4 Europe Testosterone Replacement Therapy Sales by Application 10 Latin America10.1 Latin America Testosterone Replacement Therapy Market Size YoY Growth 2015-202610.2 Latin America Testosterone Replacement Therapy Market Facts & Figures by Country10.2.1 Latin America Testosterone Replacement Therapy Sales by Country (2015-2026)10.2.2 Latin America Testosterone Replacement Therapy Revenue by Country (2015-2026)10.3 Latin America Testosterone Replacement Therapy Sales by Type10.4 Latin America Testosterone Replacement Therapy Sales by Application 11 Middle East and Africa11.1 Middle East and Africa Testosterone Replacement Therapy Market Size YoY Growth 2015-202611.2 Middle East and Africa Testosterone Replacement Therapy Market Facts & Figures by Country11.2.1 Middle East and Africa Testosterone Replacement Therapy Sales by Country (2015-2026)11.2.2 Middle East and Africa Testosterone Replacement Therapy Revenue by Country (2015-2026)11.3 Middle East and Africa Testosterone Replacement Therapy Sales by Type11.4 Middle East and Africa Testosterone Replacement Therapy Sales by Application 12 Supply Chain and Sales Channel Analysis12.1 Testosterone Replacement Therapy Supply Chain Analysis12.2 Testosterone Replacement Therapy Key Raw Materials and Upstream Suppliers12.3 Testosterone Replacement Therapy Clients Analysis12.4 Testosterone Replacement Therapy Sales Channel and Sales Model Analysis12.4.1 Testosterone Replacement Therapy Distribution Channel Analysis: Indirect Sales VS Direct Sales12.4.2 Testosterone Replacement Therapy Distribution Channel Analysis: Online Sales VS Offline Sales12.4.3 Testosterone Replacement Therapy Distributors 13 Market Dynamics13.1 Testosterone Replacement Therapy Market Drivers13.2 Testosterone Replacement Therapy Market Opportunities13.3 Testosterone Replacement Therapy Market Challenges13.4 Testosterone Replacement Therapy Market Restraints13.5 Porters Five Forces Analysis 14 Research Findings and Conclusion 15 Appendix15.1 Research Methodology15.1.1 Methodology/Research Approach15.1.2 Data Source15.2 Author Details15.3 Disclaimer

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Testosterone Replacement Therapy Market size was US$ 1665.5 million and it is expected to reach US$ 1238.2 million by the end of 2026, with a CAGR of...

Contrary to prior understanding, many hormones related to spermatogenesis take longer to recover than previously thought, and up to 3 years in some cases after anabolic steroid misuse, according to a fertility expert speaking at the Royal Society of Medicine webinar series.

Dr Channa Jayasena, consultant in reproductive endocrinology and andrology at Imperial College and Hammersmith Hospital, London, gave a talk on male hypogonadism that he admitted might seem provocative to some people but addresses issues that extend current knowledge. The three key issues discussed were: how quickly can men recover fertility after androgen use; how to assist azoospermic men with Klinefelter syndrome (or XXY) father children; and whether testosterone therapy affects progression to diabetes in obese men.

Dr Jayasena spoke at last weeks 3-day webinar held by the Royal Society of Medicine, Endocrinology and Diabetes section, entitled, EDN50:What's new in endocrinology and diabetes 2020?

He began by asking how quicky do men who take anabolic steroids recover fertility? "This has never been studied to much extent."

Self-confessed steroid user and reality television star, Spencer Matthews, said in a tabloid newspaper article that the UK is in the grips of an epidemic of anabolic steroid use, Dr Jayasena remarked. "I see men who take anabolic steroids but then they want a baby and want to know whats next?"

The nearest data to understanding recovery from anabolic steroids comes from studies of the male pill, said the andrologist. This involves giving a high level of progesterone to suppress luteinising hormone and follicle stimulating hormone (in effect the male pill), and then giving the men testosterone replacement. A Lancet paper (Liu at al 2006) involving this regimen looked at the time from stopping the male pill to recovery of sperm. It shows that, by 12 months, all participants had recovered some sperm function, with 80% recovering to the pre-treatment semen level, explained Dr Jayasena. "This has long been presumed to be the measure of recovery. However, this does not resonate with reality and the observation that actually there are many people who dont recover within this time frame and take a lot longer, some with azoospermia[semen containing no sperm]," he pointed out.

Another cross-sectional observational study looked at 41 current users of anabolic steroids, 31 recent ( 3 months since last use), and 21 healthy eugonadal men. All were 18-55 years, exercising at least three times a week. "The critical strength of this study is that these men were all clinically indistinct," Dr Jayasena remarked. "This matching of baseline characteristics is critical for interpretation of the data. Due to recruitment issues, weve never had such a good look at recovery in this way before."

The study looked at the reproductive endocrine profiles including the levels of luteinising hormone, follicle stimulating hormone, and testosterone. In current users, the former two were suppressed and the testosterone level was high, as expected, displaying a hypogonadatropic profile. "Past users and non-users have very similar profiles, suggesting reversible luteinising hormone and follicle stimulating hormone suppression," said Dr Jayasena, adding, "this is really interesting and looking at acne, gynaecomastia, hair loss and smaller testicles all classical features of androgen abuse - appear to persist in many of the men who are past users. Its important we counsel these men that we, the clinicians, are not really clear about how long these side effects will persist."

Results also showed low HDL cholesterol and high triglycerides in users, but not in non-users or past users, and cardiac hypertrophy in users but not past users. "The latter finding is encouraging," Dr Jayasena pointed out.

Regarding fertility, the study by Shankara-Naranya found that when comparing non-users to users of anabolic steroids, it took a mean of 10.7 months for users to recover their luteinising hormone levels to the mean luteinising hormone of a non-user. "But recovery time is highly variable. Luteinising hormone (and testosterone by inference), and sperm concentration seem to recover within a year, with a mean of 10 months, but all the other hormones that are important for spermatogenesis take much longer to recover so follicle stimulating hormone was 20 months, inhibin B was 32 months, sperm motility was 38 months, up to 3 years to recover. This is critical and we didnt know this," reported Dr Jaysena.

"In answer to what is the prognosis for recovery in men after androgen misuse? The endocrine system mostly recovers in the first year but sperm take much longer to recover," he concluded.

Along with Downs syndrome, Klinefelter is the most common chromosomal disorder in men, affecting 1 in 500 men. A total of 90% of those with Klinefelter syndrome are azoospermic, and it has long been assumed to be incompatible with fatherhood.

"Things have changed, and Id like to ask what is the chance of fatherhood for a man with XXY undergoing microdissection testicular sperm extraction (mTESE)?" said Dr Jayasena. "This can be done by dissecting open a testicle and looking for an engorged seminiferous tubule that is likely to be full of sperm," he explained. "If this is confirmed, after some processing, the sperm can be used in intracytoplasmicsperm injection (ICSI)."

It has been known that it was possible for patients with Klinefelter syndrome to father children for the past 20 years, but, asked Dr Jayasena, how successful is it? "Its still an embryonic field," he noted. Referring to a meta-analysis of 37 studies, Dr Jayasena said 40% of men with Klinefelters syndrome had sperm retrieved, and of these 40%, an average of nearly 50% of men had live births after ICSI. But some studies reported 10% and others 90%.

In conclusion, the chances of fatherhood in XXY men undergoing mTESE, is around 20% but a large randomised controlled trial (RCT) is needed to confirm this, said Dr Jayasena.

Finally, the researcher moved on to the third topic of whether testosterone therapy improves the effectiveness of weight loss in men over 50 years with type 2 diabetes. Referring to outcomes of the largest, as yet unpublished, testosterone trial ever, in more than 1000 men by Dr Gary Wittert, from the University of Adelaide, Dr Jayasena described the study.

Most importantly, they did not select men with hypogonadism these results are not valid for hypogonadism because not all men had hypogonadism, explained Dr Jayasena. Two-hour plasma glucose was 7.8 to 15 mmol/l. The men were randomised to Weight Watchers weight loss programme plus placebo versus the same weight loss programme plus testosterone. They also excluded men with high cardiovascular risk, due to a Food and Drug Administration [FDA] unproven concern about cardiovascular risk. "Testosterone may be dangerous in some of these men (59-75 years and obese) in real life," he pointed out.

The paper is currently in review but some preliminary findings were presented at a conference earlier this year. Dr Jayasena says: "If testosterone improves the prevention of type 2 diabetes during weight loss in men without hypogonadism, then that would challenge our understanding of how it works. However, testosterone is still not a treatment to prevent type 2 diabetes,"

To answer the question definitively, said Dr Jayasena, confirmatory data, mechanistic data, and safety data are needed.

COI: Dr Jayasena received an honorarium for speaking during a debate organised by the Society for Endocrinology and sponsored by Besins Healthcare. He has an investigator-led grant by Logixx Pharma Ltd.

Presented at the Royal Society of Medicine, Endocrinology and Diabetes section, entitled, EDN50: What's new in endocrinology and diabetes 2020? , Day 3. September 23, 2020

Read this article:
Sperm Take Up to 3 Years to Recover After Anabolic Steroids - Medscape

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Testosterone Replacement Therapy Market Segmentation, By Type

Testosterone Replacement Therapy Market Segmentation, By Applications

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The market is geographically spread across several key geographic regions and the report includes regional analysis as well as production, consumption, revenue and market share in these regions for the 2020-2027 forecast period. Regions include North America, Latin America, Europe, Asia Pacific, the Middle East, and Africa.

Radical Coverage of the Testosterone Replacement Therapy Market:

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Testosterone Replacement Therapy Market Potential Growth, Size, Share, Demand and Analysis of Key Players Research Forecasts to 2027 - The Daily...

TheTestosterone Replacement Therapy Marketresearch report thoroughly explains each and every aspect related to the Global Testosterone Replacement Therapy Market, which facilitates the reports reader to study and evaluate the upcoming market trend and execute the analytical data to promote the business.

The Global Testosterone Replacement Therapy Market research report assembles data collected from different regulatory organizations to assess the growth of the segments. In addition, the study also appraises the global Testosterone Replacement Therapy market on the basis of topography. It reviews the macro- and microeconomic features influencing the growth of the Testosterone Replacement Therapy Market in each region. Various methodological tools are used to analyze the growth of the worldwide Testosterone Replacement Therapy market.

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Prominent Key Players Covered in the report:

AbbVie Inc., Bausch Health Companies Inc., Allergan, Amneal Pharmaceuticals LLC, Pfizer Inc., Endo International plc, Teva Pharmaceutical Industries Ltd., Perrigo Company plc, Cipla Inc., Lupin, Novartis AG, Sun Pharmaceuticals Industries Ltd., Hikma Pharmaceuticals PLC, among others.

Major Regions as Follows:

A complete value chain of the global Testosterone Replacement Therapy market is presented in the research report. It is associated with the review of the downstream and upstream components of the Testosterone Replacement Therapy Market. The market is bifurcated on the basis of the categories of products and customer application segments. The market analysis demonstrates the expansion of each segment of the global Testosterone Replacement Therapy market. The research report assists the user in taking a decisive step that will be a milestone in developing and expanding their businesses in the global Testosterone Replacement Therapy market.

The Objectives of the Testosterone Replacement Therapy Market Report:

How Does This Market Insights Help?

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Market Dynamics:The Testosterone Replacement Therapy report also demonstrates the scope of the various commercial possibilities over the coming years and the positive revenue forecasts in the years ahead. It also studies the key markets and mentions the various regions i.e. the geographical spread of the industry.

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TABLE OF CONTENTS

Part 01:Executive Summary

Part 02:Scope of the Report

Part 03:Research Methodology

Part 04:Market Landscape

Part 05:Pipeline Analysis

Part 06:Market Sizing

Market Definition

Market Sizing

Market Size And Forecast

Part 07:Five Forces Analysis

Bargaining Power Of Buyers

Bargaining Power Of Suppliers

Threat Of New Entrants

Threat Of Substitutes

Threat Of Rivalry

Market Condition

Part 08:Market Segmentation

Segmentation

Comparison

Market Opportunity

Part 09:Customer Landscape

Part 10:Regional Landscape

Part 11:Decision Framework

Part 12:Drivers and Challenges

Part 13:Market Trends

Part 14:Vendor Landscape

Part 15:Vendor Analysis

Vendors Covered

Vendor Classification

Market Positioning Of Vendors

Part 16:Appendix

In conclusion, the Testosterone Replacement Therapy Market report is a reliable source for accessing the research data that is projected to exponentially accelerate your business. The report provides information such as economic scenarios, benefits, limits, trends, market growth rates, and figures. SWOT analysis is also incorporated in the report along with speculation attainability investigation and venture return investigation.

COVID-19 Impact Analysis:

The report seeks to track the evolution of the market growth pathways and publish a medical crisis in an exclusive section publishing an analysis of the impact of COVID-19 on the Testosterone Replacement Therapy market. The new analysis on COVID-19 pandemic provides a clear assessment of the impact on the Testosterone Replacement Therapy market and the expected volatility of the market during the forecast period. Various factors that can affect the general dynamics of the Testosterone Replacement Therapy market during the forecast period (2020-2026), including current trends, growth opportunities, limiting factors, etc., are discussed in detail in this market research.

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Massive Growth Of Testosterone Replacement Therapy Market Size Strong Revenue and Competitive Outlook - The Daily Chronicle

Testosterone is what separates the men from the boys literally. This sex hormone is naturally produced by the body and plays a big role in the development of male characteristics, although, women produce it too, just in smaller amounts (well talk more about testosterone in a minute). And low testosterone, especially in men, is associated with chronic health issues and even premature death. (1)

Now youre probably wondering what are 8 foods that kill testosterone (since that is the title of this article). But we want to make one thing clear, there likely isnt a single food that will kill testosterone levels. However, its a no-brainer that a low-quality diet will affect health, and therefore lower test levels.

Although, there are some foods that may not be the worst, but that studies have shown to be associated with lower testosterone levels.

So, weve provided those studies below, but take them with a grain of salt regarding the extent to which they show certain foods to negatively affect test levels. Moderation is usually key as with a lot of things and we realize that. We also suggest getting your test levels checked if you suspect that you have low levels, then possibly change/improve your diet if you believe your nutritional habits may not be as healthy and balanced as it could be.

Alright, lets get into these 8 foods that kill testosterone (potentially).

Theres no debate here. Delectable treats, sugar drinks, junk foods, fast foods, highly-processed low-quality meats, and anything in between tend to make up a concerning portion of the typical American diet.

These foods are loaded with calories, simple sugars, saturated fat, sodium, and low-quality protein that, when consumed in excessive amounts over a prolonged period, are not conducive to good health.

Its well known that consuming a lot of refined carbohydrates and saturated fats is associated with obesity, Type 2 diabetes/reduced insulin sensitivity, high cholesterol/blood pressure, and other common health concerns. But having chronic health issues tends to throw the body out of homeostasis and so its easy to see how testosterone levels are affected.

In fact, one scientific review from 2018 found that individuals who prefer Western-style foods and eat out a lot are more likely to have more visceral fat, less muscle mass, low serum total T levels, and a higher chance of developing hypogonadism (lack of testosterone production) (2).

While its not necessarily a sin to have dessert, pizza, ice cream, and all of the mouth-watering options that have become a part of our daily or weekly diet, these foods are likely to contribute to lower test and over time, bad health.

Related: 5 High-Carb Foods To Avoid And Their Healthy Alternatives and Carb Cycling Calculator

Who doesnt like to enjoy an alcoholic beverage every now and then? Well, its likely not an issue unless youre consuming it on a regular basis. And actually, moderate wine consumption, more specifically red wine, can be beneficial for your health. Research has shown that wine can provide disease-fighting antioxidants (polyphenols) that can reduce oxidative stress and inflammation, causes of death.

But it can even widen blood vessels, therefore, improving high blood pressure, cholesterol (also increases HDL cholesterol), and preventing heart disease. Plus, it has shown to have beneficial properties for supporting health overall (3, 4).

However, too much alcohol is a bad thing and one of the top causes of mortality in the world. Overconsumption over a prolonged period can negatively overall health that will consequently affect hormone levels.

According to health.gov, women can safely have up to one drink per day while men can safely have up to two drinks per day. But it really depends on the type of alcoholic beverage since they do vary in alcohol content. So, youll want to check health.gov or any authority link to determine an appropriate amount for you (5).

Now as far as alcohols effects on testosterone, research is mixed. So much so in fact, that according to one study, acute alcoholic intoxication was shown to increase testosterone in women, and decrease levels in men. And this seems to be the case in other studies as well, implying that gender and sexual maturity could be a factor (6, 7).

But more studies need to be carried out to better investigate the relationship between varying alcoholic doses and lowered testosterone levels.

While studies in humans are limited, the possibility of soy lowering testosterone levels has always been a concern.

Common soy food products include soy, tempeh, soy milk, soy protein drinks. These foods are known to contain phytoestrogens that have been associated with having estrogenic effects in the body, therefore causing reduced testosterone levels in men especially (8).

In one study of thirty-five men, individuals who consumed both low and high-isoflavone soy isolate protein for 57 days experienced decreased DHT and DHT/testosterone with minor effects on other hormones (9).

However, in contrast, one review of studies determined no negative effects on testosterone levels in men (10).

Therefore, more studies are needed for conclusive evidence on the potential effects of soy on testosterone levels. But its important to note that some research has suggested that soy could potentially have less than desirable effects in the body without altering hormones and that theyll go away when you stop consuming it.

If you suspect that soy is having certain effects on your body, you might want to switch to something else or get medical advice.

But if its working for you, theres no need to stop eating soy, especially since it has a big role in the typical vegan diet.

Not all foods with the name vegetable are good for you apparently. Vegetable oils such as canola, peanut, corn, and soybean could contribute to lower testosterone. But its important to note that these oils contain polyunsaturated fats that are liquid at room temperature unlike saturated fats, and are typically deemed good for heart, brain, and other improvements in health (11).

However, like several of the options on our list of foods that kill testosterone (potentially), healthy doesnt necessarily mean a certain food wont mess with testosterone levels.

In some studies, consuming polyunsaturated fats on a frequent basis resulted in decreased testosterone levels. Although, more studies are needed to come to a better conclusion on the potentially negative effects of polyunsaturated fats where it relates to T levels due to relatively smaller sample sizes tested (12, 13).

We should also mention that because oil is high-calorie by nature, consuming too much of it could contribute to weight/fat gain that compromises fat in itself. Moderation is key once again.

Nuts also contain polyunsaturated fats like vegetable oils, and although several varieties contain beneficial nutrients, consuming certain nuts in higher amounts can increase levels of sex hormone-binding globulin (SHBG), a protein that binds to testosterone. That may sound like a good thing but SHBG is linked to lower free testosterone levels (14).

Almonds and walnuts may be culprits but there needs to be more research to learn which nuts may have the most negative effects on testosterone levels.

Flaxseed is a nutritional food that provides good fats (Omega-3s), fiber, that supports good digestion, and nutrients to support overall good health. Not to mention, it contains lignans that may help to reduce cancer and other health factors (15, 16, 17).

But you know the drill it has been associated with a decrease in testosterone levels.

And actually, both lignans and Omega-3 fatty acids contained in flaxseed may cause a reduction in T levels. Lignans cause testosterone excretion after binding to it in the body and in a study of 78 women with PCOS (Polycystic Ovarian Syndrome), who took 3g/d Omega-3s for eight weeks,testosterone concentration was significantly lower. (18, 19).

Theres also a study where men with prostate cancer experienced a significant reduction in serum and total testosterone levels after taking 30g/day of flaxseed and eating a lower-fat diet (20).

There are a few other studies that saw similar results.

Read: Healthy Fats The 7 Functional Fatty Foods You Can Eat For Fat Loss

Mint? Were not saying you have to throw your dinner mints and gum in the trash if you want gains.

But according to research, mint may be one of those foods that kill testosterone.

A study found that high levels of spearmint has an adverse effect on fertility in adult male rats, not to mention, there are a few studies on rats that found the same effects (21, 22, 23).

Another study found involving 42 women with PCOS found that the group who drank spearmint tea over 30 days experienced a significant reduction in testosterone (24).

Theres isnt much research in men but these are interesting studies.

Licorice root is used in food products such as candies, tobacco products, and other food items. Today its used to treat a variety of ailments such as digestive issues, menopause, and viral infections.

One study showed a 26% decrease in mean testosterone in 25 healthy adult men in just a week after consuming 7g/d. And there was a similar result in a study of women who took 3.5g/d and saw a decrease of 32% following a menstrual cycle (25, 26).

Related: 7 Ways To Boost Your Testosterone Naturally also check our top pick for Best Testosterone Boosters.

We hope our list of 8 foods that kill testosterone gave you some insight into nutritional choices that may be worth limiting. There are some interesting studies that have found negative associations between some foods and lower testosterone levels. But well admit that for many of these foods, there needs to be more research to come to any definitive conclusions.

Our best piece of advice is to use your best judgment, keep track of your nutritional choices, and if youre concerned about your testosterone levels, have them checked.

1. Mederos, Michael A.; Bernie, Aaron M.; Scovell, Jason M.; Ramasamy, Ranjith (2015).Can Serum Testosterone Be Used as a Marker of Overall Health?.Reviews in Urology.17 (4): 226230.ISSN1523-6161.PMC4735669.PMID26839520.

2. Hu, Tzu-Yu; Chen, Yi Chun; Lin, Pei; Shih, Chun-Kuang; Bai, Chyi-Huey; Yuan, Kuo-Ching; Lee, Shin-Yng; Chang, Jung-Su (2018-11-16).Testosterone-Associated Dietary Pattern Predicts Low Testosterone Levels and Hypogonadism.Nutrients.10(11).doi:10.3390/nu10111786.ISSN2072-6643.PMC6266690.PMID30453566.

3. Copetti, Cristiane; Franco, Fernanda Wouters; Machado, Eduarda da Rosa; Soquetta, Marcela Bromberger; Quatrin, Andria; Ramos, Vitor de Miranda; Moreira, Jos Cludio Fonseca; Emanuelli, Tatiana; Sautter, Cludia Kaehler; Penna, Neidi Garcia (2018-03-01).Acute Consumption of Bordo Grape Juice and Wine Improves Serum Antioxidant Status in Healthy Individuals and Inhibits Reactive Oxygen Species Production in HumanNeuron-Like Cells.Journal of Nutrition and Metabolism.2018.doi:10.1155/2018/4384012.ISSN2090-0724.PMC5852837.PMID29686894

4. Pavlidou, Eleni; Mantzorou, Maria; Fasoulas, Aristeidis; Tryfonos, Christina; Petridis, Dimitris; Giaginis, Constantinos (2018-08-08).Wine: An Aspiring Agent in Promoting Longevity and Preventing Chronic Diseases.Diseases.6(3).doi:10.3390/diseases6030073.ISSN2079-9721.PMC6165230.PMID30096779

5.Appendix 9. Alcohol 2015-2020 Dietary Guidelines | health.gov.health.gov. Retrieved2020-10-01.

6. Frias, J.; Torres, J. M.; Miranda, M. T.; Ruiz, E.; Ortega, E. (2002-03).Effects of acute alcohol intoxication on pituitary-gonadal axis hormones, pituitary-adrenal axis hormones, beta-endorphin and prolactin in human adults of both sexes.Alcohol and Alcoholism (Oxford, Oxfordshire).37 (2): 169173. doi:10.1093/alcalc/37.2.169.ISSN0735-0414.PMID11912073.

7. German, J. B.; Walzem, R. L. (2000).The health benefits of wine.Annual Review of Nutrition.20: 561593. doi:10.1146/annurev.nutr.20.1.561.ISSN0199-9885.PMID10940346.

8. Jargin, Sergei V. (2014-12-15).Soy and phytoestrogens: possible side effects.GMS German Medical Science.12.doi:10.3205/000203.ISSN1612-3174.PMC4270274.PMID25587246.

9. Dillingham, Barbara L.; McVeigh, Brianne L.; Lampe, Johanna W.; Duncan, Alison M. (2005-03).Soy protein isolates of varying isoflavone content exert minor effects on serum reproductive hormones in healthy young men.The Journal of Nutrition.135 (3): 584591.doi:10.1093/jn/135.3.584.ISSN0022-3166.PMID15735098.

10. Hamilton-Reeves, Jill M.; Vazquez, Gabriela; Duval, Sue J.; Phipps, William R.; Kurzer, Mindy S.; Messina, Mark J. (2010-08).Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: results of a meta-analysis.Fertility and Sterility.94 (3): 9971007.doi:10.1016/j.fertnstert.2009.04.038.ISSN1556-5653.PMID19524224.

11. Publishing, Harvard Health.The truth about fats: the good, the bad, and the in-between.Harvard Health.Retrieved2020-10-01.

12. Nagata, C.; Takatsuka, N.; Kawakami, N.; Shimizu, H. (2000).Relationships between types of fat consumed and serum estrogen and androgen concentrations in Japanese men.Nutrition and Cancer.38 (2): 163167. doi:10.1207/S15327914NC382_4.ISSN0163-5581.PMID11525593.

13. Volek, J. S.; Kraemer, W. J.; Bush, J. A.; Incledon, T.; Boetes, M. (1997-01).Testosterone and cortisol in relationship to dietary nutrients and resistance exercise.Journal of Applied Physiology (Bethesda, Md.: 1985).82 (1): 4954.doi:10.1152/jappl.1997.82.1.49.ISSN8750-7587.PMID9029197.

14. Selby, C. (1990-11).Sex hormone binding globulin: origin, function and clinical significance.Annalsof Clinical Biochemistry. 27 ( Pt 6): 532541.doi:10.1177/000456329002700603.ISSN0004-5632.PMID2080856.

15. Selby, C. (1990-11).Sex hormone binding globulin: origin, function and clinical significance.Annalsof Clinical Biochemistry. 27 ( Pt 6): 532541.doi:10.1177/000456329002700603.ISSN0004-5632.PMID2080856.

16. Mason, Julie K.; Thompson, Lilian U. (2014-06).Flaxseed and its lignan and oil components: can they play a role in reducing the risk of and improving the treatment of breast cancer?.Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme.39 (6): 663678.doi:10.1139/apnm-2013-0420.ISSN1715-5320.PMID24869971.

17. Demark-Wahnefried, Wendy; Polascik, Thomas J.; George, Stephen L.; Switzer, Boyd R.; Madden, John F.; Ruffin, Mack T.; Snyder, Denise C.; Owzar, Kouros; Hars, Vera; Albala, David M.; Walther, Philip J. (2008-12). Flaxseed Supplementation (not Dietary Fat Restriction) Reduces Prostate Cancer Proliferation Rates in Men Presurgery.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.17 (12): 35773587.doi:10.1158/1055-9965.EPI-08-0008.ISSN1055-9965.PMC2703189.PMID19064574.

18. Adlercreutz, H.; Hckerstedt, K.; Bannwart, C.; Bloigu, S.; Hmlinen, E.; Fotsis, T.; Ollus, A. (1987).Effectof dietary components, including lignans and phytoestrogens, on enterohepatic circulation and liver metabolism of estrogens and on sex hormone binding globulin (SHBG).Journal of Steroid Biochemistry.27(46): 11351144. doi:10.1016/0022-4731(87)90200-7.ISSN0022-4731.PMID2826899.

19. Nadjarzadeh, Azadeh; Dehghani Firouzabadi, Razieh; Vaziri, Niloofar; Daneshbodi, Hoorieh; Lotfi, Mohammad Hassan; Mozaffari-Khosravi, Hassan (2013-8).The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial.Iranian Journal of Reproductive Medicine.11 (8): 665672.ISSN1680-6433.PMC3941370.PMID24639805.

20. Demark-Wahnefried, W.; Price, D. T.; Polascik, T. J.; Robertson, C. N.; Anderson, E. E.; Paulson, D. F.; Walther, P. J.; Gannon, M.; Vollmer, R. T. (2001-07).Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery: exploring the effects on hormonal levels, prostate-specific antigen, and histopathologic features.Urology.58 (1): 4752.doi:10.1016/s0090-4295(01)01014-7.ISSN1527-9995.

21. Demark-Wahnefried, W.; Price, D. T.; Polascik, T. J.; Robertson, C. N.; Anderson, E. E.; Paulson, D. F.; Walther, P. J.; Gannon, M.; Vollmer, R. T. (2001-07).Pilot study of dietary fat restriction and flaxseed supplementation in men with prostate cancer before surgery: exploring the effects on hormonal levels, prostate-specific antigen, and histopathologic features.Urology.58 (1): 4752.doi:10.1016/s0090-4295(01)01014-7.ISSN1527-9995.PMID11445478.

22. Sampaio, Francisco J. B. (2004-07).Effects of peppermint teas on plasma testosterone, follicle-stimulating hormone, and luteinizing hormone levels and testicular tissue in rats.International Braz J Urol: Official Journal of the Brazilian Society of Urology.30 (4): 350351.ISSN1677-5538.PMID15679984.

23. Sadeghi Ataabadi, Mahmood; Alaee, Sanaz; Bagheri, Mohammad Jafar; Bahmanpoor, Soghra (2017-12).Roleof Essential Oil of Mentha Spicata (Spearmint) in Addressing Reverse Hormonal and Folliculogenesis Disturbances in a Polycystic Ovarian Syndrome in a Rat Model.Advanced Pharmaceutical Bulletin.7 (4): 651654. doi:10.15171/apb.2017.078.ISSN2228-5881.PMC5788221.PMID29399556.

24. Grant, Paul (2010-02).Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial.Phytotherapy research: PTR.24 (2): 186188. doi:10.1002/ptr.2900.ISSN1099-1573.PMID19585478.

25. Armanini, D.; Bonanni, G.; Mattarello, M. J.; Fiore, C.; Sartorato, P.; Palermo, M. (2003-09).Licoriceconsumption and serum testosterone in healthy man.Experimental and Clinical Endocrinology & Diabetes: Official Journal, German Society of Endocrinology [and] German Diabetes Association.111 (6): 341343. doi:10.1055/s-2003-42724.ISSN0947-7349.PMID14520600.

26. Armanini, Decio; Mattarello, Mee Jung; Fiore, Cristina; Bonanni, Guglielmo; Scaroni, Carla; Sartorato, Paola; Palermo, Mario (2004-10).Licorice reduces serum testosterone in healthy women.Steroids.69 (1112): 763766. doi:10.1016/j.steroids.2004.09.005.ISSN0039-128X.PMID15579328.

Written by Matthew Magnante.Medically reviewed by: Dr. Malik, DPT.

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8 Foods That Kill Testosterone (Potentially) Fitness Volt - FitnessVolt.com

MarketsandResearch.biz has carefully uploaded a smart research report titled Global Testosterone Cypionate Injection Market 2020 by Manufacturers, Type and Application, Forecast to 2025 to its immense online database. The report shares informative data figures and important insights associated with the market components. The report answers business challenges all the more rapidly and also saves a lot of time. The research presents an overview of the relevant market including analysis, latest market trends, and developments. The study covers an assortment of market factors, such as, drivers, opportunities, and restrictions. Authors estimate factors such as market size, market share, market segmentation, significant growth drivers, market competition, expected business up-downs, and key companies operating in the global Testosterone Cypionate Injection market. The past and current global market conditions are explained.

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Global Testosterone Cypionate Injection Market 2020 Analysis, Types, Applications, Forecast and COVID-19 Impact Analysis 2025 - The Daily Chronicle

When a man receives a diagnosis of prostate cancer, Dr. Charles Ryan has two immediate questions: Has it spread outside of the prostate and, if so, is it resistant to the hormonal therapy typically used to treat the disease?

When we talk about a patient with a life-threatening form of prostate cancer, thoseare typically patients who have both of those phenomena, said Ryan, director of the Division of Hematology, Oncology and Transplantation at the Masonic Cancer Center of the University of Minnesota in Minneapolis. The cancer spreads to the bone, and standard hormonal therapy stops being effective, so the cancer begins to grow despite the lowering of testosterone.

While those cancers, known as castration-resistant or hormone-resistant, represent the most advanced stage of the disease, the good news is that there are numerous ways to treat such cases, Ryan told CURE in an interview. In fact, he said, the number of treatments for prostate cancer has really exploded in the last four or five years, and its actually going to get even bigger in the next few.

Ryan: We can divide them into three or four categories. With hormonal therapy, the standard of care would be some form of ablation of the level of testosterone in the body (because testosterone fuels the cancer). We typically do this with injections that lower the level of testosterone by about 90%. The most commonly used drugs would be leuprolide (Lupron Depot), degarelix (Firmagon) and goserelin (Zoladex).

On top of that, we have targeted hormonal therapies that block the effect of testosterone even when the first line of therapies has failed. And thats where we have drugs like enzalutamide (Xtandi), abiraterone (Zytiga), apalutamide (Erleada) and darolutamide (Nubeqa).

Compared with some other cancers, we use relatively little chemotherapy, but we do have some very effective chemotherapies. Docetaxel can be used in advanced hormone-resistant disease or as an initial therapy for metastatic disease. And we have a drug called cabazitaxel, which is similar.

The new class of drugs that were using now is the PARP (poly-ADP ribose polymerase) inhibitors, which target the mechanism of DNA repair (making it harder for cancer cells to repair themselves when damaged; these are used in patients whose cancers are already deficient in this ability due to gene mutations). In addition, we have a cellular therapy called sipuleucel-T, which is used in castration-resistant, metastatic disease. Finally, we have a radioisotope called radium-223, which is used in disease that has spread to the bone, causing bone pain.

Treatment adherence has to do with whether the prescribed medication actually gets into the patient. Adherence for injected drugs is, of course, high; if a patient shows up and has the drug injected, adherence is almost 100%. But with oral drugs, we can lose adherence for a number of reasons. One is that a patient could take a bottle of pills home, put it in his medicine cabinet and never take it. Or, it could be that a patient starts to take a medication and because he doesnt feel so good, he stops taking it. We would want to hear about that, why he doesnt feel well and whether we could reduce the dose or give him a treatment break. As oncologists, thats our job.

But the reality is that all the research in the world that leads to the development of a new therapy isnt effective if we dont get it into the patient. So, its sort of a dialogue between the doctor and the patient about what can or cannot be administered and why. It may not be just one factor.

Unfortunately, a problem in this country is that patients sometimes bear a lot of the cost of their medication, so not being able to pay would be one (reason) for a patient not adhering to the treatment regimen. And that is something that I, as a doctor, would want to hear about, because we can think about patient assistance programs if they exist in your area, or we can think about ways we can reduce the dose to allow us to effectively deliver the drug, but perhaps on a slightly more cost-effective schedule.

The major driver of quality of life in advanced prostate cancer is the efficacy of the therapy, and this has been shown, for example, with chemotherapy. Many men might think, Well, chemotherapy is going to be associated with a very poor quality of life. But that didnt bear out in a study that was done many years ago, in which patients (newly diagnosed) with metastatic disease were treated with standard hormonal therapy with or without chemotherapy.

The patients who were on the chemotherapy had a slightly lower quality of life after about three months of treatment, but after 12 months of starting treatment, the patients who had received the chemotherapy had a better quality of life. And that was because 12 months after starting the treatment, the patients had already been done with the treatment for six months. They were less likely to have their cancer worsening, and better cancer control leads to better quality of life.

I would put clinical trials into one of two categories. The first would be optimization studies using therapies that exist, but maybe were testing them in an earlier disease population, or looking for a better outcome by giving it to a patient with a lower volume of disease.

For example, there are studies of enzalutamide and abiraterone, commonly used drugs that, when first approved, were given to patients who had received all (available) prior therapies and chemotherapy. But then we showed that we could give them to patients with castration-resistant prostate cancer who did not have chemotherapy, and then to patients (who were) newly diagnosed, and the outcomes were better than giving standard hormonal therapy alone.

Now, studies are looking at patients who do not have metastatic disease. This is where were going with prostate cancer therapies: Optimizing their use, moving them earlier in the disease spectrum and maybe changing doses.

The next type of clinical trial would be (one that uses) new therapies and new approaches. One would be the PARP inhibitors, which are relatively new. The two that are approved currently are called Lynparza (olaparib) and Rubraca (rucaparib).

The second category thats really exciting is PSMA (prostate-specific membrane antigen) targeted therapies, and we have one thats looking really interesting. Its a molecule that targets PSMA (a protein in prostate cancer cells that fuels the disease), which arises from a very common mutation of a gene called PTEN. On one end, the treatment binds the PSMA, and on the other end, it has a sort of molecular basket.

In this basket, you can put a molecule: In this case, its the radioisotope lutetium-177. The targeted treatment sort of hand delivers the radiation therapy to the prostate cancer cell. And that looks really interesting and could get FDA (Food and Drug Administration) approval in the next few months or year.

Theres another less-known, genetic-based therapy being studied, a drug that targets a molecule called AKT (generated by a fairly uncommon) mutation. If that mutation is there, then this AKT is activated and stimulating the cancer, and the drug blocks it. We might hear data on that in the coming year, and it could become available, most likely, in the advanced castration-resistant metastatic setting.

We started maybe 20 years ago thinking about this idea of personalized medicine and targeted therapies, and were kind of there. Were not quite there totally, because were not at the point where every patient has some unique profile that leads to a special cocktail of treatment. I think thats still a little bit far off, but we are seeing the beginning of this process.

I would first recommend that patients go to the website of ZERO The End of Prostate Cancer.

ZERO is not only an informative website, its also an advocacy organization. ZERO also has an annual meeting that patients can attend. Ive spoken at it the last couple of years, and I have a number of colleagues who have, and theres a lot of information there.

I would also recommend looking at the National Cancer Institutes website. They have a thing called PDQ, patient data query, which is a very dry presentation of patient outcome data but can be helpful for making decisions.

And then, finally, the Prostate Cancer Foundation, which is a group that Ive worked with. They have patient materials that one can order, such as a cookbook for patients with prostate cancer and other things that can help them address lifestyle issues in a way that might be helpful for their long-term health.

Go here to see the original:
Treatments for Men Whose Prostate Cancer Has Spread and Become Resistant to Hormonal Therapy are Growing - Curetoday.com

The Swiss Federal Supreme Court recently dismissed an appeal by South African Caster Semenya, the womens 800m triple world champion and double Olympic gold winner, against a 2018 World Athletics regulation which ruled that athletes with hyperandrogenism needed to take testosterone reducing drugs to compete in womens track events between 400 and 1500m. The verdict could effectively bar Semenya from defending her title at the Tokyo Olympics, should she continue to refuse taking the drug. Anthropologist and bioethicist Katrina Karkazis, a senior research fellow with the Global Health Justice Partnership at Yale University, who served as expert witness in Indias Dutee Chands landmark legal battle against World Athletics over her ban over hyperandrogenism in 2015, spoke to Siddharth Saxena on the subject:

Did the Swiss courts outcome surprise you?

The Swiss Supreme Court had a very limited scope of review, which was to determine whether the regulations violate Swiss public policy. In that sense, the ruling was not surprising. What was extraordinary was, in ruling from such a narrow basis, that important findings of fact remain contested was obscured. What these cases underscore is that women athletes face significant barriers to seeking redress for violations of their human rights because these mechanisms fail to account for violations of those rights. That also holds for Dutee Chands case, because though her case was successful, it was not owing to recognition of harm.

World Athletics said the rule is to ensure a level playing field for women.

The idea of a level playing field is illusory given the myriad factors that impact athleticism. Moreover, testosterones effect on athleticism isnt straightforward. Many studies across a range of sports show mixed and unfixed relationships between performance and T [testosterone]. And while T does affect parameters related to athleticism, the relationships dont translate into better sports performance in a clear-cut way. Framing fairness this bluntly ignores that science, which has macro-level consequences, but it also affects real-life women in that it advantages women from the Global North while harming women from the Global South.

Will this ruling trigger interventions that could be potentially harmful?

The women who have been targeted under these regulations have spoken powerfully about the real and potential harms they have experienced. This ruling has authorised those harms. Policy makers, arbitrators and others have presented a scenario of opposing rights between women with higher testosterone and women with lower testosterone. This not only pits women against one another, but it inverts the operations of power and harm the least advantaged are positioned as unfairly advantaged, and any interventions that would alter their T levels are framed as necessary to fairness or even beneficial to them personally. The discrimination is not just against women. It is against womens narratives about harm.

Will this kind of ruling add to the way people connect T and athleticism?

We wouldnt have regulations like these if T was not gendered. The idea that testosterone is a male sex hormone responsible for all things manly and masculine and thus problematic in women is an idea that wont die. But this 100-year-old fallacy instigates regulations like these and enables them by making them sound logical, rational, and scientific. Some of the most pernicious misconceptions are that higher testosterone is a problem in women, it is the most important factor in athleticism, it accounts for the differences between mens and womens performances, and that there is a simple relationship between how much testosterone someone has and their athletic performance.

You have said that the hallmarks of T have been yoked exclusively to men (is) less a function of science than of ideology.

Even before testosterone was isolated, researchers worked from the assumption that so-called sex hormones would be exclusive to one sex or the other, and that their physiological roles would be restricted to sexual development and functions. Testosterone and estrogen were assumed to be antagonistic. By the 1930s, however, researchers knew that the effects of these hormones went well beyond sex. Historians and biologists have chronicled decades of experiments that cemented the identities of T as the male sex hormone and estrogen as the female sex hormone even as scientists struggled to integrate observations that didnt easily fit this paradigm. This concept has overwhelmingly shaped how scientific information about T is gathered and interpreted, and blocks recognition and acceptance of scientific evidence that does not fit the model, which is why the paradigm persists to this day.

What about testosterones relationship with women?

In the book, Testosterone: An Unauthorized Biography, we show how emerging work has demonstrated that T also plays a crucial role in female reproduction. Researchers and biomedical educators have been slow to acknowledge this relationship, which we believe is due to the way it challenges the sex hormone concept.

DISCLAIMER : Views expressed above are the author's own.

Read this article:
That testosterone is a male sex hormone and thus problematic in women is an idea that wont die - The Times of India Blog

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