Melatonin Research

Blood Pressure
Scheer FA, Van Montfrans GA, van Someren EJ, et al. Daily nighttime melatonin reduces blood pressure in male patients with essential hypertension. Hypertension 2004;43:192-7.

Study: Researchers sought to examine whether hypertension could be lowered by better sleep.

The researchers stated: “In patients with essential hypertension, repeated bedtime melatonin intake significantly reduced nocturnal blood pressure. Future studies in larger patient group should be performed to define the characteristics of the patients who would benefit most from melatonin intake. The present study suggests that support of circadian pacemaker function may provide a new strategy in the treatment of essential hypertension.”

Melatonin’s Beneficial Effects on Night-Time Blood Pressure and Women Aged 47 to 63
Researchers writing in the American Journal of Hypertension examined the question: “The nocturnal decline of blood pressure (BP) is almost coincident with the elevation of melatonin, which may exert vasodilatating and hypotensive effects. In this study we investigated whether prolonged nocturnal administration of melatonin could influence the daily rhythm of BP in women.”

How was the study conducted?
“In a randomized double-blind study, 18 women, 47 to 63 years of age (nine with normal blood pressure and nine being treated treated for essential hypertension) received a 3-week course of a slow-release melatonin pill (3 mg) or placebo 1 hour before going to bed. They were then crossed over to the other treatment for another 3 weeks.”

What did they conclude?
“In comparison with placebo, melatonin administration did not influence (daytime) BP but did significantly decrease nocturnal systolic, diastolic, and mean BP without modifying heart rate. The effect was inversely related to the day–night difference in BP…These data indicate that prolonged administration of melatonin may improve the day–night rhythm of BP, particularly in women with a blunted nocturnal decline.”

Cagnaccia A, Cannolettaa M, Renzia A, Baldassaria F, Aranginob S, Volpea A. Prolonged Melatonin Administration Decreases Nocturnal Blood Pressure in Women. American Journal of Hypertension. Volume 18, Issue 12, Pages 1614-1618

Immune Stimulation
Poon AM, Liu ZM, Pang CS, et al. Evidence for a direct action of melatonin on the immune system. Biol Signals. 1994 Mar-Apr;3(2):107-17.

From the abstract: “Pineal melatonin modulates the mammalian immune system. In vivo studies showed that melatonin enhanced the natural and acquired immunity while in vitro studies demonstrated its inhibitory influence.”

Melatonin, Immune Function and Aging
Researchers writing in the medical Journal Immunity & Aging say: (From the abstract) “Aging is associated with a decline in immune function (immunosenescence), a situation (sp) known to correlate with increased incidence of cancer, infections and degenerative diseases….Melatonin has the potential therapeutic value to enhance immune function in aged individuals and in patients in an immunocompromised state.”

Venkatramanujam Srinivasan, Georges J.M. Maestroni, Daniel P. Cardinali, Ana I. Esquifino, S. R. Pandi-Perumal and Sandra C. Miller. Melatonin, Immune Function and Aging. Immunity & Ageing 2005, 2:17

Read the abstract

Melatonin Randomized Trial for Insomnia in the Elderly
Nalaka S. Gooneratne, MD,MSc, Principal Investigator, University of Pennsylvania
Study start: October 2004; Expected completion: July 2007

From the study details “Melatonin is a hormone secreted predominantly during the sleep period, suspected to have a strong link to the circadian sleep-wake cycle. Melatonin is also available in a pill form and, when administered during the day, tends to have a sedative effect. Clinical trials that have examined the nocturnal effects of melatonin have focused on patients of any age who have insomnia, regardless of their endogenous melatonin levels. Data indicate, however, that individuals with low endogenous melatonin levels may be more responsive to exogenous melatonin. Generally, melatonin levels decrease with age; therefore, older individuals with insomnia represent an ideal population in which to study the effects of exogenous melatonin on sleep. This study will provide older adults with insomnia melatonin tablets to determine whether the tablets will increase their sleep.”

Read more about this current research

Melatonin and Alzheimer-like Neurodegeneration
Writing in the medical journal Acta Pharmacologica Sinica, researchers studied the effect of melatonin and cognitive impairment. They wrote: “Alzheimer disease (AD), an age-related neurodegenerative disorder with progressive loss of memory and deterioration of comprehensive cognition, is characterized by extracellular senile plaques of aggregated beta-amyloid (Abeta), and intracellular neurofibrillary tangles that contain hyperphosphorylated tau protein. Recent studies showed that melatonin, an indoleamine secreted by the pineal gland, may play an important role in aging and AD as an antioxidant and neuroprotector. Melatonin decreases during aging and patients with AD have a more profound reduction in this hormone. Data from clinical trials indicate that melatonin supplementation improves sleep, ameliorates sundowning, and slows down the progression of cognitive impairment in Alzheimer patients.” Wang JZ, Wang ZF. Acta Pharmacol Sin. 2006 Jan;27(1):41-9.

Read the abstract here

Does Melatonin Protect Vision As We Age?
Researchers writing in the Journal of Pineal Research say that Melatonin maybe beneficial in preserving visual functions.

Excerpts from the study abstract:
“Current evidence suggests that melatonin may act as a protective agent in ocular conditions such as photo-keratitis, cataract, glaucoma, retinopathy of prematurity and ischemia/reperfusion injury.

These diseases are sight-threatening and they currently remain, for the most part, untreatable. The pathogenesis of these conditions is not entirely clear but oxidative stress has been proposed as one of the causative factors.

Oxidative damage in the eye leads to apoptotic degeneration of retinal neurons and fluid accumulation. Retinal degeneration decreases visual sensitivity and even a small change in the fluid content of the cornea and crystalline lens is sufficient to disrupt ocular transparency. In the eye, melatonin is produced in the retina and in the ciliary body. Continuous regeneration of melatonin in the eye offers a frontier antioxidative defense for both the anterior and posterior eye.

However, melatonin production is minimal in newborns and its production gradually wanes in aging individuals as indicated by the large drop in circulating blood concentrations of (Melatonin).

These individuals are possibly at risk of contracting degenerative eye diseases that are free radical-based. Supplementation with melatonin, a potent antioxidant, in especially the aged population should be considered as a prophylaxis to preserve visual functions.”

Siu AW, Maldonado M, Sanchez-Hidalgo M, Tan DX, Reiter RJ. Protective effects of melatonin in experimental free radical-related ocular diseases. J Pineal Res. 2006 Mar;40(2):101-9.

Why am I so driven to work in the age management field?

Basically it was for my own personal, mental, and spiritual well being.

A few years back when I was in my early forties, I began to notice a significant decrease in my energy levels. In other words, I was dragging.

I also noticed that I was losing muscle mass, I was getting softer. I didn’t have the energy to “pump up,” anymore and I was not able to exercise at levels I was accustomed to. “Well, that’s it, I am getting old,” I thought.

I was at a medical convention and spoke to a colleague about “my condition,” and he suggested that I should get my hormone levels checked. When I got my test results back my testosterone levels were so low they didn’t make the charts; way below the normal of anyone I had ever seen before.

Suffice to say, my curiosity in hormone supplementation was sparked. Because my testosterone was so very low and testosterone is the well known builder of bone, I immediately got a Bone Densitometry Test to measure my bone density. I was stunned as the tech told me the news in disbelief. It was very low as well, putting me at a high risk for fracture. I was absolutely stunned, I had to stop a lot of sports I was doing, and loved. I realized that snow skiing, snow shoeing, water skiing, and surfing, some of my favorites, no longer existed for me. No more vacations in the snow or ice. No more high-speed water sports.

It was then that I started to study and research HGH (Human growth hormone), pregenenolone, DHEA, thyroid, Melatonin and the affects of diet on all of them and how the body works with this big maze of hormones to keep people feeling good, not only increasing quality of life but making them healthy on many levels. Initially, I used testosterone intermittently, because of the fear doctors projected based on the problems with body builders, and men with prostate cancer. As I researched more and more, I learned the healthy truth about hormones, and later began total Hormone Replacement Therapy.

As time passed, more and more patients arrived with similar issues that I had, and many with sexual dysfunction. Hormone supplementation was working miracles. I treated friends for free, and eventually learned the art of balancing female hormones. Many relationships were revitalized as the couples individually found their “mojo” again. Romance once again arose in couples that were ready to give it up, because they thought the chemistry was gone.

I have now been doing this work for years and continue to attend different seminars around the country to learn as much new research as possible. The field of age management medicine, as it is called by some is growing so quickly. Us baby boomers expect the best out of life, and demand the best quality of life, which is greatly enhanced by hormone supplementation. My goal in life is to remain young and loving, not only on the inside, but also physically, mentally, emotionally, and spiritually. My children are my finest teachers.

DHEA Selected Research

Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function.
“CONCLUSIONS: Although aging male symptoms and the effects of hormonal changes on these symptoms have been controversial, DHEA-S and E(2) (Estradiol) might play some important roles in the symptoms of aging men.”

Basar MM, Aydin G, Mert HC, Keles I, Caglayan O, Orkun S, Batislam E. Relationship between serum sex steroids and Aging Male Symptoms score and International Index of Erectile Function. Urology. 2005 Sep;66(3):597-601.

Dehydroepiandrosterone treatment in the aging male–what should the urologist know?
“CONCLUSION: Although long-term clinical trials (applying the standards of evidence-based methods) are not available at present, the consistency of the data and the extensive practical experience may justify the use of DHEA in aging men given the rules of classical endocrinology are thoroughly followed including diagnosis based on clinical picture and biochemical evidence, compliance to periodic evaluations, and individual dose adjustment to maintain serum concentrations in the physiological range of young males. Being one among other important hormonal factors, DHEA can delay and correct age-related disorders only to a certain degree

Saad F, Hoesl CE, Oettel M, Fauteck JD, Rommler A. Dehydroepiandrosterone treatment in the aging male–what should the urologist know? Eur Urol. 2005 Nov;48(5):724-33; discussion 733. Epub 2005 Jul 18.

Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age.
Morales AJ, Nolan JJ, Nelson JC, Yen SS. Effects of replacement dose of dehydroepiandrosterone in men and women of advancing age. J Clin Endocrinol Metab 1994 Jun;78(6):1360-7.

Study: The researchers sought to test the effect of Dehydroepiandrosterone (DHEA) and DHEA sulfate (DS) replacement on aging.

Noted the researchers: “…observations together with improvement of physical and psychological well-being in both genders and the absence of side-effects constitute the first demonstration of novel effects of DHEA replacement in age-advanced men and women.”

Activation of immune function by dehydroepiandrosterone (DHEA) in age-advanced men.
Khorram O, Vu L, Yen SS. J Gerontol A. Activation of immune function by dehydroepiandrosterone (DHEA) in age-advanced men. Biol Sci Med Sci 1997 Jan;52(1):M1-7

Study: the researchers sought to study DHEA’s effect on the human immune system.

The researchers stated: “Administration of oral DHEA at a daily dose of 50 mg to age-advanced men with low serum DHEA-S levels significantly activated immune function. While extended studies are required, our findings suggest potential therapeutic benefits of DHEA in immunodeficient states.”

Coronary Disease
Dehydroepiandrosterone and coronary atherosclerosis
Herrington DM. Dehydroepiandrosterone and coronary atherosclerosis. Ann N Y Acad Sci 1995 Dec 29;774:271-80.

Study: Researchers examined “Tissue culture, animal model, and epidemiologic studies.”

The researchers stated: (DHEA) may inhibit atherosclerosis through its potent antiproliferative effects. Data suggest that low plasma levels of DHEA may facilitate, and high levels may retard, the development of coronary atherosclerosis and coronary allograft vasculopathy.

Dehydroepiandrosterone inhibits human platelet aggregation in vitro and in vivo
Jesse RL, Loesser K, Eich DM, et al. Dehydroepiandrosterone inhibits human platelet aggregation in vitro and in vivo. Ann N Y Acad Sci 1995 Dec 29;774:281-90.

Interperation: Researchers sought to measure the effects of DHEA’s cardioprotective actions.

The researchers noted: “Findings suggest that DHEA retards platelet aggregation in humans. Inhibition of platelet activity by DHEA may contribute to the putative antiatherogenic and cardioprotective effects of DHEA.”

Dehydroepiandrosterone treatment of midlife dysthymia
Schmidt PJ, Danaceau MA, et al. Dehydroepiandrosterone treatment of midlife dysthymia. Bloch M, Biol Psychiatry 1999 Jun 15;45(12):1533-41.

Study: The researchers noted a “significant response was seen after 3 weeks of treatment on 90 mg per day. The symptoms that improved most significantly were anhedonia, loss of energy, lack of motivation, emotional “numbness,” sadness, inability to cope, and worry. This pilot study suggests that dehydroepiandrosterone is an effective treatment for midlife-onset dysthymia.”

Dehydroepiandrosterone (DHEA) increases production and release of Alzheimer’s amyloid precursor protein.
Danenboerg HD, Haring R, Fisher A, et al. Dehydroepiandrosterone (DHEA) increases production and release of Alzheimer’s amyloid precursor protein. Life Sci 1996;59(19):1651-7.

Study: The researchers noted: DHEA significantly declines with advanced age. “We propose that the age-associated decline in DHEA levels may be related to the pathological APP metabolism observed in Alzheimer’s disease.”

DHEA administration increases rapid eye movement sleep and EEG power in the sigma frequency range
Friess E, Trachsel L, Guldner J, et al. DHEA administration increases rapid eye movement sleep and EEG power in the sigma frequency range. Am J Physiol 1995 Jan;268(1 Pt 1):E107-13.

Study: “Investigated was the effects of a single oral dose of DHEA (500 mg) on sleep stages, sleep stage-specific electroencephalogram (EEG) power spectra, and concurrent hormone secretion in 10 healthy young men. DHEA administration induced a significant increase in rapid eye movement (REM) sleep, whereas all other sleep variables remained unchanged compared with the placebo condition. Because REM sleep has been implicated in memory storage, its augmentation in the present study suggests the potential clinical usefulness of DHEA in age-related dementia.”

Dehydroepiandrosterone (DHEA) treatment of depression
Wolkowitz OM, Reus VI, Roberts E, et al. Dehydroepiandrosterone (DHEA) treatment of depression. Biol Psychiatry 1997 Feb 1;41(3):311-8

Study: Researchers looked at “six middle-aged and elderly patients with major depression,” and increased their DHEA levels to those “observed in younger healthy individuals.”

The researchers said: “Depression ratings, as well as aspects of memory performance significantly improved. These preliminary data suggest DHEA may have antidepressant and pro-memory effects and should encourage double-blind trials in depressed patients.”

Inflammatory Disease
van Vollenhoven RF, Morabito LM, Engleman EG, et al. Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol 1998 Feb;25(2):285-9

Study: Researchers study whether long-term therapy (up to 1 year) with DHEA is beneficial in patients with mild to moderate systemic lupus erythematosus (SLE).

The researchers stated: “DHEA was well tolerated and appeared clinically beneficial, with the benefits sustained for at least one year in those patients who maintained therapy.”

Menopausal
Genazzani AD, Stomati M, Strucchi C, et al. Oral dehydroepiandrosterone supplementation modulates spontaneous and growth hormone-releasing hormone-induced growth hormone and insulin-like growth factor-1 secretion in early and late postmenopausal women. Fertil Steril 2001 Aug;76(2):241-8.

Study: The researchers sought to see if DHEA effected lean and obese post-menopausal women differently. The results suggested that lean and obese women benefitted equally.

The researchers noted: “This suggests that DHEA is more than a more than a simple “diet supplement” or “anti-aging product”; rather it should be considered an effective hormonal replacement treatment.”

Abdominal Fat
Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial.

Villareal DT, Holloszy JO. Effect of DHEA on abdominal fat and insulin action in elderly women and men: a randomized controlled trial. JAMA. 2004 Nov 10;292(18):2243-8.

“CONCLUSION: DHEA replacement could play a role in prevention and treatment of the metabolic syndrome associated with abdominal obesity.”

DHEA, Bone Mineral Density, Older Adults
Researchers writing in the medical journal The Journal of Clinical Endocrinology & Metabolism, say that DHEA replacement therapy for one year improved hip Bone Mineral Density in older adults and spine Bone Mineral Density in older women.

DHEA What is It?
DHEA MAIN PAGE

Hot Flashes and Insomnia

Researchers writing in the Archives of Internal Medicine say: “Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.”

Ohayon MM. Severe hot flashes are associated with chronic insomnia. Arch Intern Med. 2006 Jun 26;166(12):1262-8

BACKGROUND: Because hot flashes can occur during the night, their presence has been frequently associated with insomnia in women with symptoms of menopause. However, many factors other than hot flashes or menopause can be responsible for insomnia, and several factors associated with insomnia in the general population are also commonly observed in perimenopausal and postmenopausal women who have hot flashes.

METHODS: A random sample of 3243 subjects (aged >/=18 years) representative of the California population was interviewed by telephone. Included were 982 women aged 35 to 65 years. Women were divided into 3 groups according to menopausal status: premenopause (57.2%), perimenopause (22.3%), and postmenopause (20.5%). Hot flashes were counted if they were present for at least 3 days per week during the last month and were classified as mild, moderate, or severe according to their effect on daily functioning.

Chronic insomnia was defined as global sleep dissatisfaction, difficulty initiating sleep, difficulty maintaining sleep, or nonrestorative sleep, for at least 6 months. Diagnoses of insomnia were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classification.

RESULTS: Prevalence of hot flashes was 12.5% in premenopause, 79.0% in perimenopause, and 39.3% in postmenopause. Prevalence of chronic insomnia was reported as 36.5% in premenopause, 56.6% in perimenopause, and 50.7% in postmenopause.

Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes, reaching more than 80% in perimenopausal women and postmenopausal women who had severe hot flashes. In multivariate analyses, severe hot flashes were significantly associated with symptoms and a diagnosis of chronic insomnia. Poor health, chronic pain, and sleep apnea were other significant factors associated with chronic insomnia.

CONCLUSIONS: Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.

Estrogen Selected Research

Estrogen and Women’s Heart Disease
Grodstein F, Stampfer MJ. Estrogen for women at varying risk of coronary disease. Maturitas 1998;30:19-26.

Study: Researchers cited that estrogen was beneficial for heart disease risk. “However, few studies have assessed the impact of estrogen use among women with a distinctly higher cardiovascular risk.”

The researchers stated: “Analysis of the effect of estrogen within different risk factor categories in the 16-year follow up of the Nurses’ Health Study confirms that although relevant risk estimates are highly similar, the magnitude of the protective effect of estrogen is more pronounced among women with high baseline risk of disease.”

Estrogen, Depression, and Blood Pressure

Canada SA, Hofkamp M, Gall EP, et al. Estrogen replacement therapy, subsyndromal depression, and orthostatic blood pressure regulation. Behav Med. 2003;29:101-106.

Study: From the abstract: “Although estrogen replacement therapy (ERT) alleviates depressed moods in postmenopausal women, it is not known whether ERT is equally effective in reducing affective and somatic depressive complaints. One of the authors’ goals in this study was to examine possible differences between women receiving and not receiving ERT.”

The researchers stated: “The authors studied a group of postmenopausal women. Somatic symptoms in the ERT group were significantly lower than in the Non-ERT group. Affective scores were only marginally lower in the ERT group…In response to orthostatic challenge, the change in systolic blood pressure was significantly smaller in the ERT group. Apparently ERT is associated with more effective blood pressure regulation.”

Breast Cancer and Estrogen Replacement Therapy
Researchers writing in the August 6, 2005 edition of the British Medical Journal say maybe the risk of developing breast cancer from estrogen replacement therapy is not as great as everyone thought.

The researchers noted that estrogen therapy accounted for eight additional cases out of 10,000 women.

In 2002, headlines cited that researchers discovered that estrogen therapy could double the risk for getting breast cancer.Read abstract

Estrogen and Physical Appearance
Women With Higher Levels of Estrogen Have Prettier Faces
Researchers at the University of St. Andrews in Scotland announced that women who had higher amounts of estrogen in their urine were found to be more attractive than women who had lesser amounts.

What Effects Does Estrogen Have On The Skin?
Researchers have found that “Estrogen loss at menopause has a profound influence on skin.” Writing in the medical journal Climacteric, study authors noted, “Estrogen treatment in postmenopausal women has been repeatedly shown to increase collagen content, dermal thickness and elasticity, and data on the effect of estrogen on skin water content are also promising.”

Hormone Replacement Therapy and Possible Cardiovascular Benefits in Women
Researchers writing in the medical journal Climacteric say that “Women who receive 2-3 years of HRT after menopause do not have increased all-cause mortality, and results of the present study suggest relative cardiovascular benefits compared to those who had not used hormones.” Read more

Estrogen and Sun Damaged Skin
Researchers at the University of Michigan Department of Dermatology are currently recruiting subjects to participate in a study to test Estrogen’s effect on the skin.

Risk of stroke and hormone replacement therapy
Researchers writing in the medical journal Maturitas say that there is no significant association between hormone therapy and risk of total stroke in women during 10.5 years follow-up.

Postmenopause and periodontal disease
A recent study in the Journal of Periodontology says that in an 11.7 year follow up, 57.5 percent of women lost at least one tooth after menopause.

Women, Testosterone and Cardiovascular Disease

Researchers writing in the medical journal Coronary Artery Disease say that their study “could suggest that the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline.”

Montalcini T, Gorgone G, Gazzaruso C, Sesti G, Perticone F, Pujia A. Endogenous testosterone and endothelial function in postmenopausal women Coron Artery Dis. 2007 Feb;18(1):9-13.

OBJECTIVE: It is well known that coronary heart disease incidence increases in women after menopause. This phenomenon was related to reduced levels of female sex hormones. Estrogen decline, however, is not the only hormonal change during the postmenopausal period and estrogen administration did not protect women from cardiovascular disease. Therefore, it is justified to explore other hormonal changes. The role of androgens is still controversial. The aim of the present study was to investigate the relationship between endogenous sex hormones and endothelial function, measuring the brachial artery flow-mediated dilation.

METHODS AND RESULTS: Sixty postmenopausal women were consecutively enrolled and underwent a clinical and biochemical examination. Brachial artery flow-mediated dilation was also evaluated by ultrasound. After correction for confounding variables, testosterone was positively correlated to flow-mediated dilation (beta=0.277, P=0.03). Indeed, women in the lowest testosterone tertile had a flow-mediated dilation smaller than that in the highest tertile (P=0.02).

CONCLUSIONS: This result could suggest that the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline. More studies are needed to evaluate the role of androgen replacement therapy on postmenopausal women with low level of this hormone.

Testosterone For Women Studies and News

Testosterone and Libido in Post Menopausal Women
Researchers writing in the medical journal Gynecological Endocrinology say that there is emerging evidence that androgens are significant independent determinants affecting libido and satisfaction, as well as mood, energy and other components of women’s health.

Testosterone in postmenopausal women
An article in the medical journal Current Opinion in Obstetrics & Gynecology says that testosterone therapy is a promising option for treating women with HSDD (very low libido or desire)

Testosterone enhances libido and decreases depression
Researchers reporting in the Journal of Neuropsychiatry and Clinical Neurosciences say Testosterone enhances libido and decreases depression.

Schutter, et al. J Neuropsychiatry Clin Neurosci.2005; 17: 372-377. Depression Administration of Testosterone Increases Functional Connectivity in a Cortico-Cortical Depression Circuit.

From the abstract: “Increasing evidence suggests that the steroid hormone testosterone (T) enhances libido and decreases depression. Even a single administration of T (0.5 mg sublingually) in healthy young women is sufficient to enhance physiological sexual responsiveness….” Read the abstract

Testosterone For Libido Loss In Women
September 19, 2005’s Washington Post reported “a position statement from the North American Menopause Society (NAMS) and published in its journal, Menopause,” that testosterone therapy may aid many post-menopausal women dealing with loss of libido. You can read the Washington Post article here.

Study: An overview of testosterone deficiency and supplementation in women.
Davis SR, Androgen treatment in women. MJA 1999;170:545-549.

The researchers state: “Women reporting loss of libido may find physicians insufficiently empathetic, and a biological cause for sexual dysfunction in women is rarely sought. However, it is gradually becoming more accepted that androgen deficiency in women may underpin a variety of symptoms and pathophysiological conditions and that, in selected women, androgen replacement therapy is of clinical benefit.”

“Testosterone insufficiency in women: fact or fiction?”
Guay, A, Davis SR. Testosterone insufficiency in women: fact or fiction? World Journal of Urology 2002;20(2):106-10.

The researchers state: “Androgen deficiency is a true medical condition in both pre- and post-menopausal women. The most important recommendation is to listen to the patient and consider androgen deficiency when the symptoms are present, even if they seem non-specific…Treatment with androgens has to be monitored carefully because of the possible harmful effects of excessive levels of testosterone.”

Bone Loss and Testosterone in Women with Anorexia Nervosa
A study is being recruited, Anne Klibanski, M.D., Principal Investigator, by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Center for Research Resources (NCRR) to determine among other things if low dose testosterone will be a benefit in preventing bone loss in women with Anorexia Nervosa.

From the abstract: “Women with Anorexia Nervosa have been found to have low bone density. The study will determine whether administration of low doses of a natural hormone, testosterone and/or risedronate, a medication to help prevent bone breakdown will improve or prevent bone loss in this condition.”

Testosterone Beneficial for Libido and Cholesterol
Researchers reviewing the current medical literature on the role of Testosterone in enhancing libido in post-menopausal women say; “The available evidence is that adding testosterone to estrogen therapy, with or without progestin, appears to be effective in improving sexual function in postmenopausal women and is associated with a reduction in high-density lipoprotein (HDL) cholesterol.”

The findings appear in The Cochrane Library, read the abstract and summary of this article .

HRT, Testosterone and Post Menopausal Women – Problems of Sexual Dysfunction
Researchers writing in the medical journal Maturitas say that HRT along with testosterone supplementation helps postmenopausal women who complain of problems related to intimacy.

Women, Testosterone and Cardiovascular Disease
Researchers writing in the medical journal Coronary Artery Disease say that their study “could suggest that the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline.”

The Use of Testosterone with Estrogen and Progestogen and Its Effect on Breast Cell Proliferation

Researchers writing in the medical journal Menopause say “Addition of testosterone may counteract breast cell proliferation as induced by estrogen/progestogen therapy in postmenopausal women.”

Testosterone and Ischemic Heart Disease

Researchers writing in Cardiovascular & Hematological Disorders Drug Targets examined lower testosterone levels in patients with ischemic heart disease. The researchers noted recent studies showing that testosterone level is lower in patients with ischemic heart diseases, and testosterone treatment alleviates the symptoms and there is increasing evidence to suggest testosterone confers cardioprotection by direct action on the myocardium.

Tsang S, Liu J, Wong TM. Testosterone and cardioprotection against myocardial ischemia. Cardiovasc Hematol Disord Drug Targets. 2007 Jun;7(2):119-25.

The researchers noted recent studies showing that testosterone level is lower in patients with ischemic heart diseases, and testosterone treatment alleviates the symptoms and there is increasing evidence to suggest testosterone confers cardioprotection by direct action on the myocardium.

Testosterone and the Aging Male

A published report in the medical journal Aging Male says “The wide-ranging benefits of testosterone therapy in young and old men are clear and it appears that the route of administration (intramuscular, oral, or transdermal) does not alter this fact, but future work could illustrate even more profound effects of testosterone (e.g., in reducing cardiovascular risk) that could result in its recommended use in a wider range of patients.”

Abstratct:

Kohn FM. Testosterone and body functions. Aging Male. 2006 Dec;9(4):183-8

Testosterone supplementation can help reduce many of the symptoms associated with androgen deficiency in the aging male by its effects on various parts of the body.

Bone mineral density can decrease in the hypogonadal man and this may contribute to the increased fracture rate in the elderly. Testosterone therapy can improve bone mineral density and bone architecture by increasing bone formation and decreasing bone resorption – the possible benefits on fracture rate are unknown.

Testosterone also improves body composition by reducing body fat mass and increasing lean body mass, and by increasing epidermal thickness, but its effects on muscle strength are still debated.

In patients with diabetes and androgen deficiency, testosterone supplementation appears to reduce blood glucose and this could have important implications for cardiovascular risk reduction in patients with diabetes or the metabolic syndrome.

The wide-ranging benefits of testosterone therapy in young and old men are clear and it appears that the route of administration (intramuscular, oral, or transdermal) does not alter this fact, but future work could illustrate even more profound effects of testosterone (e.g., in reducing cardiovascular risk) that could result in its recommended use in a wider range of patients.

Testosterone and Prostate

Research published in the Journal of Steroid Biochemistry and Molecular Biology says “Data from all published prospective studies on circulating level of total and free testosterone do not support the hypothesis that high levels of circulating androgens are associated with an increased risk of prostate cancer.”

Raynaud JP. Prostate cancer risk in testosterone-treated men.
J Steroid Biochem Mol Biol. 2006 Dec;102(1-5):261-6.

Men with classical androgen deficiency have reduced prostate volume and blood prostate-specific antigen (PSA) levels compared with their age peers. As it is plausible that androgen deficiency partially protects against prostate disease, and that restoring androgen exposure increases risk to that of eugonadal men of the same age, men using ART should have age-appropriate surveillance for prostate disease. This should comprise rectal examination and blood PSA measurement at regular intervals (determined by age and family history) according to the recommendations, permanently revisited, published by ISSAM, EAU, Endocrine Society….

Testosterone replacement therapy is now being prescribed more often for aging men, the same population in which prostate cancer incidence increases; it has been suggested that administration in men with unrecognised prostate cancer might promote the development of clinically significant disease.

In hypogonadal men who were candidates for testosterone therapy, a 14% incidence of occult cancer was found. A percentage (15.2%) of prostate cancer has been found in the placebo group (with normal DRE and PSA) in the prostate cancer prevention study investigating the chemoprevention potential of finasteride.

The hypothesis that high levels of circulating androgens is a risk factor for prostate cancer is supported by the dramatic regression, after castration, of tumour symptoms in men with advanced prostate cancer. However these effects, seen at a very late stage of cancer development, may not be relevant to reflect the effects of variations within a physiological range at an earlier stage. Data from all published prospective studies on circulating level of total and free testosterone do not support the hypothesis that high levels of circulating androgens are associated with an increased risk of prostate cancer.

A study on a large prospective cohort of 10,049 men, contributes to the gathering evidence that the long standing “androgen hypothesis” of increasing risk with increasing androgen levels can be rejected, suggesting instead that high levels within the reference range of androgens, estrogens and adrenal androgens decrease aggressive prostate cancer risk.

Indeed, high-grade prostate cancer has been associated with low plasma level of testosterone.

Furthermore, pre-treatment total testosterone was an independent predictor of extraprostatic disease in patients with localized prostate cancer; as testosterone decreases, patients have an increased likelihood of non-organ confined disease and low serum testosterone levels are associated with positive surgical margins in radical retropubic prostatectomy. A clinical implication of these results concerns androgen supplementation which has become easier to administer with the advent of transdermal preparations (patch or gel) that achieve physiological testosterone serum levels without supra physiological escape levels.

During the clinical development of a new testosterone patch in more than 200 primary or secondary hypogonadal patients, no prostate cancer was diagnosed.

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