How To Naturally Increase Your Testosterone

31 Day Testosterone Plan

Sick And Tired Of Low Testosterone? This Breakthrough Shortcut Technique Can Help You Unlock Floods Of Natural Free Testosterone In Just 1 Month No Matter What Your Age Or Condition Inside youll learn: The Reason Why Your T Levels are 40% Lower Than Your Grandfathers. The 3 Main Causes of Low-Testosterone (the last one will blow you away). A Unique Liver Flush Technique You Can Use to Remove Excess Estrogen From Your Body. -How Naturally To Increase dopamine, (The libido, pleasure and desire neurotransmitter). -The Man Killing Enzyme That Converts Your Testosterone Into Estrogen and How You Can Get Rid of It, Fast. This is just a Little taste of what youll find inside this e-course. Youll discover super-foods that send your T levels shooting upwards as well as some clear, frank advice on how to steer away from harmful foods that can cause testicular atrophy, man boobs and bedroom performance problems. More here...

31 Day Testosterone Plan Overview


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My 31 Day Testosterone Plan Review

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Maximum Manhood

If You're A Man Over 40 Who's Concerned About Low Testosterone, Weak Erections, An Enlarged Prostate Or Sexual Health Problems Get An Inside Look At The Newest Sexual Healing Secrets Of The World Best Anti-aging And Men's Natural Health Doctors. Discover the biggest downside of testosterone shots. Most doctors won't tell you. It can damage your heart by causing this deficiency, page 33. Learn what big drug companies hope you never know about T-gels. Most are worthless because they only give you 1-2% testosterone, far below what you actually need to raise T in your body. See how much you really need on page 30. Avoid the Wrong kind of testosterone therapy. Get the inside story about unreported problems on page 33. Read why the single best type of testosterone therapy is not what most doctors prescribe. Get this super potent form instead (10-20 times more powerful) from a specialized pharmacy, reports the noted M.D./director of Preventive Medical Clinics of the Desert. See how to find a pharmacy in your area, page 30. Get the scoop: All testosterone therapy is not alike. If you are going to take T, make sure it's in this natural form that mimics your body's own testosterone, page 35. How Chinese men naturally boost T levels and sexual prowess. This ancient secret of Traditional Chinese Medicine releases the powerful, active male animal in you. More here...

Maximum Manhood Overview

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Author: Bill Gottlieb
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Gonadotropin Releasing Hormone Receptor Mutations and Idiopathic Hypogonadotropic Hypogonadism

Idiopathic hypogonadotropic hypogonadism (IHH) consists of those patients without commonly anosmia (a poor sense of smell) or adrenal insufficiency. This subset of IHH results in reproductive failure that is caused by mutations of the GnRH (gonadotropin-releasing hormone) receptor (GNRHR) gene. Like all IHH patients, those affected experience delayed sexual development and low or apulsatile gona-dotropin levels. The impairment in sexual development, however, occurs in the absence of the anatomical abnormalities common to fertility disorders that affect the hypothalamic-pituitary axis (97,98).

Steroid Hormonal Factors in Populations with Different Risk for Prostate Cancer

Black South African men were compared 140 . In the older men, plasma levels of the testosterone precursor dehydroepiandrosterone (DHEA) were lower in the two groups of black men than in the white men, and estrone levels were higher. Plasma levels of the testosterone precursor androstenedione and 17ff-estradiol were higher in the African men than in the two American groups, but there were no differences among these groups in testosterone levels. In the study with the boys and young men, similar findings were obtained for testosterone and DHEA. However, androstenedione levels were lower (and not higher) in the African than in the American subjects, and 17f-estradiol was lower in young black boys than in white boys but higher in older black boys and young black men than in white boys and men. These interesting data suggest a complex interaction between ethnic background and environmental differences that change during sexual maturation. In these studies by Hill and co-workers among South...

Comparisons of Steroid Hormonal Factors in Nested Case Control Studies

P450C17a 17a-hydroxylase and 17,20-lyase enzyme activity. The CYP17A2 allele that contains a single base-pair mutation was found in 69 of cases and 57 of controls and it was significantly associated with prostate cancer risk (odds ratio of 1.7). The association was limited to men younger than 65 years with no increased odds ratio for men 65 years or older. Opposite findings of this association between prostate cancer risk and the presence of the CYP17A2 allele were reported from a Swedish case-control study by Wadelius et al. 176 . The frequency of the A1 A2 or A2 A2 genotype was 61 in prostate cancer cases (n 178) and 71 in population controls (n 160). The odds ratio of having the A1 A1 genotype as compared to the A1 A2 or A2 A2 genotype was 1.61 (significant at the 95 level). This latter finding is consistent with a preliminary report of higher circulating testosterone levels found in men that are homozy-gous for the A1 allele as compared with men with an CYP17A2 allele 176 .

Critical Interpretation of the Studies

Meikle and co-workers 185, 186 reported that serum levels of testosterone and DHT were significantly lower, not higher, in blood relatives of prostate cancer patients (brothers and sons of prostate cancer patients who have a three- to fourfold excess risk) than in unrelated control subjects. Zumoff et al. 187 observed that circulating levels of testosterone, but not DHT, in prostate cancer patients were markedly lower in those younger than 65 years than those of 65 years and older, whereas control subjects had testosterone levels that were similar to those of prostate cancer patients of 65 years and older. In several of the earlier summarized epidemiologic studies, some hormonal findings were markedly different when comparing younger (18 to 25 -40 years) and older healthy men (over 40 years of age), or comparing younger (less than 62 to 70 years) and older (older than 65 to 70 years) prostate cancer patients with their age-matched controls. Circulating...

Epidemiology Summary and Conclusions

Elevation of bioavailable and bioactive androgens in the circulation and in the prostatic target tissue may be an important and biologically very plausible risk factor. As will be detailed later, the results of several animal model studies strongly support this contention, but more research is needed to confirm and further define this association in humans, and to establish its underlying biological mechanisms (increased androgen production or 5a-reductase activity and decreased DHT catabolism) (see also 173 ). Since circulating testosterone levels may be lower in men with a family history of prostate cancer than in other

Testosterone as Tumor Promotor of Prostate Carcinogenesis

The enhancing effect of testosterone on prostate carcinogenesis is remarkably confined to the dorsolateral and anterior prostate, and no tumors occur in the ventral prostate. Moreover, chronic testosterone treatment produces a shift of the site of DMAB- and BOP-induced carcinoma occurrence from exclusively the ventral lobe to predominantly the dorsolateral and anterior lobes 197,200, 226 . The dose-response relationship between testosterone dose and prostate carcinoma yield is very steep elevation of circulating testosterone levels by less than 1.5-fold is sufficient for a near-maximal enhancement of the tumor response, and a two- to threefold elevation is sufficient for a maximal response these concentrations are within the normal range of circulating testosterone levels in the rat 199 . Thus, testosterone is a powerful tumor promotor for the rat prostate.

Perinatal Estrogen Exposure Hormonal Imprinting

The precise mechanism of these complex imprinting effects is not clear. Perinatal estrogen treatment may act indirectly on the male accessory sex glands by imprinting permanent alterations in the secretion of pituitary hormones and testicular androgen, or directly by imprinting altered expression of androgen, estrogen, and prolactin receptors or changes in steroid metabolism in the accessory sex gland 260-263 . For example, in neonatally estrogenized mice, the plasma levels of luteinizing hormone and follicle stimulating hormone were elevated 261 , while circulating testosterone levels were decreased 260,263 or unchanged 261 . Prostatic DHT formation via 5a-reductase was impaired in adult mice neonatally treated with DES 246 . Nuclear androgen receptor levels in these mice were decreased in dorsal and ventral prostate but not affected in the lateral lobe, and the numbers of androgen receptor-positive stromal cells was increased in all three lobes 263 . However, although the exact...

Summary and Conclusion

Familial aggregation of prostate cancer risk is consistently observed and confers a considerable increased risk, but explains 10 or less of all cases. Putative susceptibility loci have been identified on chromosome 1q and the X chromosome, but there are no indications that these are related to hormonal factors. The role of hormones in familial aggregation of prostate cancer risk is unclear, since circulating testosterone levels appear to be lower in men with a family history of prostate cancer than in other men.

GnRh Lhrh antagonists

When administered to patients with prostatic cancer, GnRH antagonists act by direct inhibition of GnRH receptors and therefore LH secretion, leading to a faster onset of the action (hours instead of days) and avoiding the initial rise of testosterone levels induced by GnRH receptor agonists.

Potential Adverse Effects of Dietary Estrogens

Concern has been expressed that some phytoestrogens may disrupt the developing endocrine system similarly to the effects of other endogenous estrogens 264,265 . Much of this concern has stemmed from animal research. There are well-described examples of phytoestrogen-containing plants inhibiting fertility via estrogenic activity in animals. For instance, sheep grazing on Australian pastures containing a particular type of clover rich in formononetin, which is converted to daidzein in the rumen during fermentation, developed a widespread infertility in the 1940s 248, 266 . Other examples are the moldy corn syndrome in pigs and cattle fed corn contaminated by Fusarium sp., which produces the estrogenic b-resorcyclic acid lactone, zearalenone 267 , and the inhibition of reproduction of California quail by phytoestrogens produced by plants growing in dry conditions 266 . The use of soybean in captive cheetah in Cincinnati zoo was also shown to be responsible for an infertility syndrome,...

Testosterone Testosterone

Year of discovery 1935 Drug category Anabolic steroid hormone Main uses Treatment of male hypogonadism Related drugs Testosterone enanthate (Delatestryl), Testosterone cypionate (Depo-testosterone) Other brand names Androderm, Androgel, Testim, Striant. The steroid testosterone is the principal male sex hormone. The main approved therapeutic use of testosterone is the treatment of testosterone deficiency (hypogonadism). Although testosterone and other anabolic hormones enhance muscle development and improve athletic performance, risks are involved with their use. Testosterone deficiency in men can result from inadequate function either of the testes (primary hypogonadism), or of the hypothalamus and pituitary (secondary hypogonadism). Testosterone levels in men generally decrease with age. Although administration of testosterone to elderly men produces beneficial results, such as increased muscle mass, bone mineral density, and mental function, its use is limited due to the possible...

Depression And Reproductive Hormone Changes

In women with a previous episode of depression, times of rapidly changing gonadal steroid concentrations, such as those occurring premenstrually or postpartum, mark particularly vulnerable times for the occurrence of depressive symptoms. Several studies have shown that in women, a history of depression increases the risk of both postpartum blues and postpartum major depression (O'Hara 1986 O'Hara et al. 1991 Reich and Winokur 1970) and that hormonal changes occurring premenstrually may affect mood (Halbreich et al. 1984, 1986). When they were euthymic, 62 of women with a history of major depressive episodes reported the occurrence of premenstrual mood changes and biological symptoms typical of major depressive disorder. Other studies found a relationship between the rise in estrogen and testosterone levels and the rising incidence of depression in girls during adolescence (Angold et al. 1999). More recently in two epidemiological cohorts (Cohen et al. 2006 Freeman et al. 2006), there...

Biochemistry And Toxicity 151 Biological Persistence

TCDD reduces testosterone levels in adult male rats by decreasing the production of testosterone from cholesterol in the testes at a critical rate-limiting step. The pituitary (and or hypothalamus) normally responds to low testosterone concentration by increasing secretion of luteinizing hormone, causing increased production of testosterone. TCDD interferes with this feedback system, preventing the compensatory increase of luteinizing hormone. 107-110

Adverse Male Endpoints in Relation to Endogenous Hormone Exposure

While few data are available on pregnancy hormone levels in relation to adverse male endpoints, the literature supports relationships between these endpoints and several other pregnancy-related factors. There are also data suggesting that these factors, in turn, are reflective of the hormonal milieu of pregnancy. Birth order (and the correlated variable, maternal age) is quite consistently associated with adverse male reproductive outcomes, with risks of testicular cancer (particularly seminomas), cryptorchidism, and hypospadias greater among first birth. This elevated risk may be related to a higher level of estradiol 73-75 , particularly unbound estradiol 76 , in first compared to later pregnancies. The increase in risk was, in some studies, most marked among women experiencing their first birth at an older age. This finding may reflect a higher level of free estradiol in pregnancy among women delaying their first pregnancy until later in life. Bernstein et al. found free estradiol...

Exposure in the Workplace and from Industrial Accidents

Structurally similar to diethylstilbestrol. A study in 1981 -1983 of 39 DAS workers reported low testosterone in 37 of men tested, as well as impotence 116 . A follow-up study found significantly reduced testosterone (both total and free) in both current and former DAS-exposed workers compared to unexposed controls 117 . Thus, it is clear that at the high levels present in the work place, a variety of EDCs have the capacity to alter significantly male reproductive function.

Effects of Estrogenic Chemicals on Accessory Reproductive Organs Interaction with Endogenous Androgens

The importance of the conversion of testosterone to DHT in selected target tissues is that DHT is as much as ten times more potent relative to testosterone 169 . Thus, while testosterone levels in the circulation are too low to induce differentiation of the Wolffian ducts without supplemental diffusion from the adjacent testis, 5a-reductase serves to amplify the action of testosterone in tissues by virtue of converting testosterone into the more potent DHT. Any chemical that interferes with the action of 5a-reductase will thus profoundly alter the differentiation of organs that express this enzyme during sexual differentiation 161 .

Occupational Exposure to Amsonic Acid

It is surprising to learn that occupational exposures to potential EDCs at effective concentrations apparently have not been eliminated from the workplace. A series of publications from about 1990 to 1996 presented documentation of sexual impotence in chemical factory workers exposed to a DES-like stilbene derivative. The National Institute of Occupation Safety and Health conducted two studies in response to complaints of impotence and decreased libido among male workers involved in the manufacture of 4,4'-diaminostilbene-2,2' -disulfonic acid (DAS), a key ingredient in the synthesis of dyes and fluorescent whitening agents. Both current and former workers had lower serum testosterone levels 63 and reduced libido 64 as compared to control workers. In addition, duration of employment was negatively correlated with testosterone levels. These studies replicated the observations reported by Quinn et al. 65 who reported low levels of serum testosterone and problems with impotence in male...

PpDDE and Lake Apopka Alligators and Birds

And other species have been well documented. This 12,500-hectare lake is polluted with contaminants from agricultural activities around the lake, sewage treatment from a nearby town, and a spill in 1980 at Tower Chemical Company. Although this spill reportedly resulted in contamination of the lake with dicofol, DDT, and sulfuric acid, some confusion exists about the actual contaminants released into the lake 158 . Shortly after this spill, there was a 90 decline in the alligator population that persisted from 1980-1984 and the population remains depressed to date. Alligator egg clutch viability was depressed due to an embryonic mortality rate of 80 in the first month after fertilization 140 . In addition, juvenile alligators continue to display endocrine and morphological abnormalities 15,140 . Lake Apopka female alligators displayed polyovular follicles in their ovaries with multinucleated oocytes, males exhibited plasma testosterone levels one-third those of Lake Woodruff males (the...

Gonadotropin Releasing Hormone Agonists and Antagonists

Treatment with GnRH antagonists rapidly reduces serum testosterone levels, without the transient initial increase observed after GnRH agonists. Abarelix (plenaxis) effectively reduces serum testosterone to castrate levels within a week in most men. Other than avoidance of the initial flare, GnRH antagonist therapy offers no advantage compared with GnRH agonists, and GnRH antagonists for prostate cancer are available only in the 1-month depot formulation.

Antiandrogenic Effects of Phthalate Esters During Development

Recent publications demonstrate that perinatal exposure to a number of phthalate esters alters development of the male reproductive tract in an antian-drogenic manner, causing underdevelopment and agenesis of the epididymis at relative low dosage levels. Arcardi et al. 165 reported that administration of DEHP in the drinking water to the dam during pregnancy and lactation (estimated LOAEL of 3 mg kg day) produced testicular histopathological alterations in male rat offspring. Although DEHP is not an AR antagonist in vitro at concentrations up to 10 imol l, it inhibits fetal Leydig cell testosterone synthesis in vivo when orally administered to the dam at 0.75 g kg day starting at day 14 of pregnancy. As a consequence, fetal testosterone concentrations are reduced in males to female levels from day 17 of gestation to 2 days after birth. This reduction in testosterone levels results in a wide range of malformations of the androgen-dependent tissues in male rats including reduced AGD,...

The Most Common Signs of Alcohol Addiction

Alcohol consumption and abuse can have a variety of cutaneous manifestations, including palmar erythema and spider angioma (also known as spider telangiec-tasis, arterial spider, spider nevus, or nevus araneus) 57 . Alcohol can also induce diseases disease states with dermatologic manifestations 57 . Many endocrine changes are seen in patients with chronic alcoholism. Signs of hypogonadism and hyperestrogenism are seen in male patients. Hypogonadism is manifested by loss of libido and potency, testicular atrophy, reduced fertility, and reduced facial hair growth 57 . Gynecomastia, vascular spiders, changes in fat distribution, loss of body hair, and change of pubic hair to a female distribution 57 manifest hyperestrogenism. In contrast, female patients with alcoholism rarely manifest signs of masculinization. They may demonstrate breast atrophy or menstrual irregularities 57 .

Clinical Adverse Effects of Prolactin

Halbreich and Kahn 3 proposed that many of the clinical adverse consequences of HPRL could be accounted for by its effects on the HPG axis. HPRL is associated with suppression of gonadotropin pulsatile release, which in turn inhibits the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary leading to suppression of ovarian and testicular function in turn leading to hypogonadism 3, 27 . This potentially further led to a range of menstrual disorders, reduced fertility in both sexes, decreased sexual function in men and women including decreased libido, increased risk of cardiovascular disorders, galactorrhoea, anxiety and depression. Halbreich and Kahn 3 also postulated that adverse events such as an increased risk of breast cancer were possibly associated with HPRL. This hypothesis is supported by Harvey et al. 6 who identified that PRL has a direct action on breast tissue where it can act as a mitogen in the mammary gland. Furthermore, PRL...

Mood Stabilizers and Impact on Insulin Resistance in Women with Bipolar Disorder

We conducted the first longitudinal study of this relationship, evaluating reproductive endocrine and metabolic markers in 25 women treated for BD over a 2-year time period 21 . At baseline, 10 (40 ) women were currently undergoing treatment with valproate. Consistent with other published reports described above, 41.7 of subjects reported current oligomenorrhea, while 40 reported oligomenorrhea before starting medication. Rates of oligomenorrhea and clinical hyperan-drogenism did not differ by type of medication use. Eighty percent of all subjects had a high homeostatic model assessment of IR (HOMA-IR) at baseline. Valproate use was associated with an increase over time in total testosterone. In contrast to other studies, we did not find co-occurrence of new-onset menstrual abnormalities with hyperandrogenism. We concluded that oligomenorrhea, hyperandrogenism, and IR are common in women with BD, and increases in androgen hormones may be related to valproate use 21 .

Features of Prader Willi Syndrome

Prader-Willi syndrome is a congenital disease with an incidence of about 1 in 8,000 to 20,000 live births. Prader-Willi syndrome is the most common genetic cause of marked obesity in humans. The excess weight causes type II diabetes as a major complication. This makes PWS the most frequent genetic cause for type II diabetes (Butler et al. 2006). Early PWS is characterized by a failure to thrive, feeding difficulties and hypogonadism. Later, the patients are characterized by short stature and develop mild to moderate mental retardation, behavioral problems and hyper-phagia that leads to severe obesity. Children with PWS show low levels of growth hormone, Insulin-like growth factor 1 (IGF-I), and insulin as well as elevated levels of ghrelin (Eiholzer et al. 1998a, b Cummings et al. 2002) and often exhibit central adrenal insufficiency (de Lind van Wijngaarden et al. 2008). Subsequently, growth hormone substitution was approved for treatment of children with PWS (Carrel et al. 2006)....

Common Side Effects Associated with Antipsychotic Induced Hyperprolactinaemia

Little is known about the putative role of PRL on bone cells and bone formation in humans 36 . Adler et al. 37 investigated the effects of PRL excess and estrogen deficiency on bone in rats and concluded that HPRL with osteoporosis is likely to be due to PRL-induced hypogonadism rather than a direct effect of PRL on calcium homeostasis. Amenorrhoea associated with HPRL was the first recognised model of functional hypogonadal osteoporosis 38 showing an association with decrease cortical and trabecular bone density. Other recognised associations are smoking, lack of exercise and lithium-induced hyperparathyroidism 39 . Klibanski et al. 38 were the first to highlight that young women were vulnerable to developing osteopenia osteo-porosis. There are several studies of patients diagnosed with pituitary tumours who report increased rates of bone loss. Biller et al. 40 found that bone density decreased significantly in HPRL women who were amenorrheic for more than 20 months. This suggests...

Diet and Nutrition

Most studies of effects of dietary changes and the consumption of vegetarian or health food diets on hormonal status ( 62-66 ,summarized in 13 ) have not separately addressed effects of dietary fat. However, they clearly indicate that diet can influence circulating hormone levels by changing androgen production rates or the metabolism and clearance of androgens and estrogens. Recently, Dorgan et al. 67 reported that the combination of a high fat-low fiber diet given to healthy men increased total testosterone and testosterone bound to SHBG (sex hormone binding globulin) in the plasma and urinary testosterone excretion as compared to a low fat-high fiber diet, but lowered urinary excretion of estrone, 17 -estradiol, and the 2-hydroxy metabolites of these estrogens. Although these studies did not address the separate effects of single dietary factors such as total fat intake, they indicate that diet can affect sex steroid hormonal status.


Is a true risk factor for prostate cancer 96 - 98 . Three mechanisms by which vasectomy could enhance risk have been proposed elevation of circulating androgens, immunologic mechanisms involving anti-sperm antibodies, and reduction of seminal fluid production 34,77,78,84,89,97,99 . Most studies of pi-tuitary-gonadal function did not find any effect of vasectomy 100-104 , but some studies found changes in hormone levels 89,99,105-109 . There are reports in vasectomized men of slightly elevated circulating testosterone levels 34, 99, 107, 110 , elevated levels of 5a-dihydrotestosterone (DHT), the active metabolite of testosterone in the prostate, a decrease in SHBG 89 , and an increase in the ratio of testosterone to SHBG 34 . These reports suggest an elevation of circulating free testosterone following vasectomy which may be a critical factor associated with risk for prostate cancer, but specific mechanisms whereby vasectomy could influence the hypothalamo-pituitary-gonadal axis are...

Sexual Factors

Several case-control studies have addressed the possibility that sexual factors play a role in prostate cancer etiology (see 13,32-34,111-113 ). In general, the results of these studies suggest that prostate cancer risk may be associated with (1) an early onset of sexual activity, (2) high sexual drive, particularly at young age, (3) a low frequency of intercourse, especially at older age, or (4) a high frequency of intercourse up to 50 years of age and a low frequency thereafter (see 13 ). A positive association has been reported between the level of sexual activity and circulating total testosterone levels in men of 60-79 114 . These findings suggest that a hormonal mechanism may underlie the associations between prostate cancer risk and sexual activity observed in the case-control studies.

Endogenous Hormones

It has been suggested that phytoestrogens would exert their effects via the stimulation of SHBG, reducing the proportion of free estrogens circulating in plasma. This observation is based on cross-sectional comparisons and some studies with cell lines 42 . However, cross-sectional comparisons are difficult because SHBG can be affected by many factors, such as changes in body weight. In controlled intervention studies, there appears to be no effect of soybean on SHBG levels in premenopausal women 39,155,156 . There is also no effect in premenopausal women receiving lignans 157 . Hence, existing evidence to date suggests that a protective effect of phytoestrogens is unlikely to be brought about by lowering the levels of free estrogens in plasma, since they do not seem to have a direct effect on serum E2 or SHBG levels. Nagata et al. 12 examined a cross-sectional relationship of soy product intake to serum concentrations of E2 and SHBG in 50 healthy premenopausal Japanese women. The...


Goldman et al. 190 produced male PH in rats with inhibitors of steroid 17a-hydroxylase and C17-20 lyase. Developmental alterations can also be obtained from in utero treatment with drugs that inhibit 5a-reductase, which is not a P450 enzyme, blocking the conversion of testosterone to DHT 191,192 . The antifungal imidazole derivative, ketoconazole, inhibits various enzymes which belong to the cytochrome-P450-dependent mono-oxygenases in rodents and humans such as side chain cleavage of cholesterol, 11 -hydroxylase in the adrenal, and 17a-hydroxylase and C17-20 lyase in rat and human testes. For example, human testicular mono-oxygenase activities in vitro are reduced by 50 by 3.1 imol l ketoconazole. Schurmeyer and Nieschlag 193 demonstrated that ketoconazole and other imidazole fungicides inhibited testosterone production in males, while Pepper et al. 194 reported that ketoconazole was useful in the treatment of ovarian hyperandrogenism in women. Ketoconazole also has been shown to...


Testosterone supplementation may improve depressive symptoms for a subset of male patients with low or borderline testosterone levels suffering from refractory depression. A randomized, double-blind, placebo-controlled trial in 23 patients with a low or borderline serum testosterone level (range 100-350 ng dl normal range is 270-1,070 ng dl) who met the DSM-IV criteria for current MDD and were being treated with antidepressant medications prior to and during the trial received either testosterone gel (1 gel, 10 g day) or placebo for 8 weeks (335). There was significantly greater improvement in HAM-D scores in the testosterone-treated group compared to placebo in both the vegetative and affective symptom subscales of the HAM-D Scale. Overall, the testosterone gel was well tolerated. One patient in the study experienced exacerbation of benign prostatic hyperplasia, which may be attributed to testosterone supplementation and was withdrawn from the study, although the relationship of...

Class A GPCRs

Loss-of-function mutations in the LH receptor (LHR) lead to Leydig cell hypoplasia, a rare form of male pseudohermaphroditism. In females, LHR inactivation results in hypergonatropic hypogonadism and primary amenor-rhea. Like congenital hypothyroidism, the pattern of inheritance is autosomal recessive, with homozygous or compound heterozygous patients. To date, 22 distinct mutations have been described in this receptor (for review, see Reference 180. . The mutant forms V144F, F194V, and C343S in the ECD, C543R in TM domain V, A593P in TM domain VI, S616Y and I625K in TM domain VII, and two frameshift mutations, 33 base pairs in exon 1 and a microdeletion in TM domain VII (AL608 V609), impair trafficking and cell surface expression 200-206 .

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