Testosterone Is a Contraceptive and Should Not Be Used in Men Who Desire Fertility

Patel, Amir Shahreza; Leong, Joon Yau; Ramos, Libert; Ramasamy, Ranjith

doi:10.5534/wjmh.180036

Cited by 56 publications

(41 citation statements)

References 65 publications

(95 reference statements)

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“…Reduced serum testosterone affects millions of men and is associated with numerous pathologies including infertility, cardiovascular diseases, metabolic syndrome, and decreased sexual function. Although exogenous replacement therapies are largely successful in ameliorating these symptoms, they carry increased risks of cardiovascular and prostate disease or infertility (Baburski et al, 2019;Patel et al, 2019;Yeap et al, 2018). Thus, there is a need to develop approaches for transplanting testosterone-producing cells or activating endogenous progenitors to produce testosterone.…”

Section: Discussionmentioning

confidence: 99%

Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

Shen

Larose

Shami

et al. 2020

Preprint

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2 Highlights • Multipotent Tcf21 + MPs can differentiate into somatic testis cell types • Tcf21 + cells contribute to testis and ovary somatic cells during gonadal development • Tcf21 + cells replenish somatic cells of the aging testis and in response to tissue injury • Testis Tcf21 cells resemble resident fibroblast populations in multiple organs 3 Summary Testicular development and function relies on interactions between somatic cells and the germline, but similar to other organs, regenerative capacity decline in aging and disease. Whether the adult testis maintains a reserve progenitor population with repair or regenerative capacity remains uncertain. Here, we characterized a recently identified mouse testis interstitial population expressing the transcription factor Tcf21. We found that Tcf21 + cells are bipotential somatic progenitors present in fetal testis and ovary, maintain adult testis homeostasis during aging, and act as reserve somatic progenitors following injury. In vitro, Tcf21 + cells are multipotent mesenchymal progenitors which form multiple somatic lineages including Leydig and myoid cells. Additionally, Tcf21 + cells resemble resident fibroblast populations reported in other organs having roles in tissue homeostasis, fibrosis, and regeneration. Our findings reveal that the testis, like other organs, maintains multipotent mesenchymal progenitors that can be leveraged in development of future therapies for hypoandrogenism and/or infertility.

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Section: Discussionmentioning

confidence: 99%

Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

Shen

Larose

Shami

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…35 Unlike positive effects on sexual functioning, exogenous testosterone therapy negatively affects fertility and therefore is used in male contraception. 36,37 By suppressing the pulsatile release of gonadotropin-releasing hormone, luteinizing hormone and follicle-stimulating hormone, testosterone preparations reduce testicular testosterone production and deprive developing sperm of the signals required for normal maturation. 36,37 Interestingly, testosterone produced a neutral effect on all semen parameters assessed in the subpopulation of patients participating in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…36,37 By suppressing the pulsatile release of gonadotropin-releasing hormone, luteinizing hormone and follicle-stimulating hormone, testosterone preparations reduce testicular testosterone production and deprive developing sperm of the signals required for normal maturation. 36,37 Interestingly, testosterone produced a neutral effect on all semen parameters assessed in the subpopulation of patients participating in the current study. It is possible that the unfavourable direct effect of testosterone on semen quality was counterbalanced by an indirect beneficial effect associated with the reduction in thyroid autoimmunity.…”

Section: Discussionmentioning

confidence: 99%

The effect of testosterone on thyroid autoimmunity in euthyroid men with Hashimoto's thyroiditis and low testosterone levels

Krysiak

Kowalcze

2019

J Clin Pharm Ther

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What is known and objective Thyroid autoimmune diseases occur much more frequently in women than men. Unfortunately, no previous study has determined whether sex hormones produce any effect on thyroid antibody titres. The primary study aim was to assess whether exogenous testosterone affects thyroid autoimmunity in men with Hashimoto's thyroiditis and low testosterone levels. Methods The study population consisted of 34 euthyroid men with autoimmune thyroiditis and testosterone deficiency. On the basis of patient preference, these patients were either treated with oral testosterone undecanoate (120 mg daily; n = 16) or remained untreated (n = 18). Circulating levels of thyrotropin, free thyroxine, free triiodothyronine, prolactin and total testosterone, as well as serum titres of thyroid peroxidase and thyroglobulin antibodies, were measured at the beginning of the study and 6 months later. The structure parameters of thyroid homeostasis (Jostel's thyrotropin index, SPINA‐GT and SPINA‐GD) were also calculated. Moreover, semen analyses were performed in eight patients in each group. Results and discussion In testosterone‐naïve men, serum hormone levels and antibody titres remained at the similar levels throughout the study. Apart from increasing serum testosterone levels, testosterone undecanoate reduced titres of thyroid peroxidase and thyroglobulin antibodies and increased SPINA‐GT. The drug produced a neutral effect on circulating levels of thyrotropin, free thyroid hormones, prolactin and testosterone, Jostel's thyrotropin index, SPINA‐GD and semen parameters. Testosterone‐induced changes in antibody titres correlated with the effect of treatment on SPINA‐GT and with serum testosterone levels. What is new and conclusion This study is the first one to have shown that exogenous testosterone may have a protective effect on thyroid autoimmunity in men with Hashimoto's thyroiditis and testosterone deficiency.

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“…Hence, the combined suppression of endogenous T and FSH leads to an accentuated decrease of germ cell survival and maturation. Furthermore, without adequate hormonal stimulation, the blood‐testis barrier can be disrupted and, instead of being properly released, sperm cells are phagocyted 53. Due to these effects, some authors have proposed to use TRT as a male anticonception method 54.…”

Section: Testosterone Replacement Therapy and Fertility Improvementmentioning

confidence: 99%

Late‐onset hypogonadism and lifestyle‐related metabolic disorders

et al. 2020

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Background Late‐onset hypogonadism (LOH) is a condition defined by low levels of testosterone (T), occurring in advanced age. LOH is promoted by senescence, which, in turn, has negative effects on male fertility. Interestingly, the impact of metabolic disorders on the male reproductive system has been the topic of several studies, but the association with LOH is still debatable. Objectives Herein, we discuss the hypothesis that the prevalence of metabolic abnormalities potentiates the effects of LOH on the male reproductive system, affecting the reproductive potential of those individuals. Material and methods We analyzed the bibliography available, until June 2019, about LOH in relation to metabolic and hormonal dysregulation, sperm quality profiles and assisted‐reproduction treatment outcomes. Results LOH affects the hypothalamic‐pituitary testis (HPT) axis. Additionally, metabolic disorders can also induce T deficiency, which is reflected in decreased male fertility, highlighting a possible connection. Indeed, T replacement therapy (TRT) is widely used to restore T levels. Although this therapy is unable to reverse all deleterious effects promoted by LOH on male reproductive function, it can improve metabolic and reproductive health. Discussion and Conclusions Emerging new evidence suggests that metabolic disorders may aggravate LOH effects on the fertility potential of males in reproductive age, by enhancing T deficiency. These results clearly show that metabolic disorders, such as obesity and diabetes, have a greater impact on causing hypogonadotropic hypogonadism than tissue senescence. Further, TRT and off‐label alternatives capable of restoring T levels appear as suitable to improve LOH, while also counteracting comorbidities related with metabolic diseases.

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Testosterone Is a Contraceptive and Should Not Be Used in Men Who Desire Fertility

Cited by 56 publications

References 65 publications

Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

The effect of testosterone on thyroid autoimmunity in euthyroid men with Hashimoto's thyroiditis and low testosterone levels

Late‐onset hypogonadism and lifestyle‐related metabolic disorders

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Testosterone Is a Contraceptive and Should Not Be Used in Men Who Desire Fertility

Cited by 56 publications

References 65 publications

Tcf21+mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

Tcf21+mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

The effect of testosterone on thyroid autoimmunity in euthyroid men with Hashimoto's thyroiditis and low testosterone levels

Late‐onset hypogonadism and lifestyle‐related metabolic disorders

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Product

Resources

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Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration

Tcf21⁺mesenchymal cells contribute to testis somatic cell development, homeostasis, and regeneration