The Direct and Indirect Costs among U.S. Privately Insured Employees with Hypogonadism

Kaltenboeck, Anna; Foster, Stephan L.; Ivanova, Jasmina I.; Diener, Melissa; Bergman, Rachel; Birnbaum, Howard G.; Kinchen, Kraig; Swindle, Ralph

doi:10.1111/j.1743-6109.2012.02810.x

Cited by 21 publications

(16 citation statements)

References 21 publications

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“…This decrease in circulating testosterone results in decreases in muscle mass and strength, energy, mood, libido, erectile function, and bone density . Economic costs of hypogonadism is significant . Clomid is approved and widely used in women for induction of ovulation.…”

Section: Introductionmentioning

confidence: 99%

Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel

Kaminetsky

Werner

Fontenot

et al. 2013

The Journal of Sexual Medicine

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Introduction Clomiphene citrate is employed off-label in men who have low testosterone and for the restoration of sperm counts in men who have used exogenous testosterone. Clomiphene is a mixture of two diastereoisomers: zuclomiphene and enclomiphene. We evaluated enclomiphene citrate in men with secondary hypogonadism. Aim Our aim was to compare oral enclomiphene citrate as an alternative to topical testosterone. Main Outcome Measures Blood levels of total testosterone (TT), estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone binding globulin, thyroid stimulation hormone, prolactin, and insulin-like growth factor 1 IGF-1 were measured at certain times after treatment with each agent. Sperm parameters were determined at the same visits. Free testosterone (FT) was calculated. Methods This was a proof-of-principle, randomized, open-label, fixed dose, active-control, two-center phase IIB study in 12 men with secondary hypogonadism treated previously with topical testosterone. Results After discontinuation of topical testosterone, morning TT values averaged 165 ± 66 pg/dL. After 3 months, there was a significant rise in men receiving enclomiphene citrate and gel that was sustained for 3 months. At 6 months, TT levels were 545 ± 268 and 525 ± 256 pg/dL for groups receiving the gel and enclomiphene citrate, respectively. Only men in the enclomiphene citrate group demonstrated increased LH and FSH. TT decreased one month posttreatment to pretreatment values. Enclomiphene citrate elevated sperm counts in seven out of seven men at 3 months and six out of six men at 6 months with sperm concentrations in the 75–334 × 106/mL range. The gel was ineffective in raising sperm counts above 20 × 106/mL for all five men at 3 months and raised counts in only two or five men at 6 months. At follow-up, only enclomiphene citrate treatment was associated with elevated sperm counts. Conclusions Enclomiphene citrate increased testosterone and sperm counts. Concomitant changes in LH and FSH suggest normalization of endogenous testosterone production and restoration of sperm counts through the hypothalamic–pituitary–testicular axis.

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Section: Introductionmentioning

confidence: 99%

Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel

Kaminetsky

Werner

Fontenot

et al. 2013

The Journal of Sexual Medicine

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“…It has been projected that in years to come the Western world will face an increasing burden of male HG [6]. Furthermore, due to higher comorbidity among hypogonadal men, this will be associated with considerable economic costs [7]. Although acute everyday stress is physiological, it has been well established that chronic psychological stress can lead to functional hypogonadotropic hypogonadism [8].…”

Section: Introductionmentioning

confidence: 99%

Przewlekła ekspozycja na hałas a niedobór testosteronu — metaanaliza i metaregresja wyników badań na gryzoniach

Dzhambov

Dimitrova

2015

Endokrynologia Polska

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Introduction: Chronic psychological distress can cause suppression of the hypothalamic-pituitary-testicular axis and thus lead to male hypogonadism, which is associated with psycho-social dysfunction, chronic diseases, and as a result, considerable economic costs. Conversely, noise is a prototypal environmental stressor of growing importance, already linked to birth outcomes and diabetes. However, its effects on male testosterone levels have been paid little attention. Material and methods: This paper reports a systematic review and meta-analysis of experimental studies in rodents, which have examined the effect of chronic noise stress on serum testosterone levels. A systematic search in MEDLINE, EMBASE and the Internet yielded seven studies. A quality effects meta-analytical model was applied to compute pooled Hedges's g. Quality effects meta-regression was carried out as well. Results: We found pooled Hedges's g of -2.41 (95% CI: -3.28, -1.54), indicating a very large effect of noise exposure on testosterone. Metaregression confirmed that the overall duration of exposure explained a significant proportion of the variance across individual effect sizes (Q (1) = 3.95, p = 0.047). However, there was considerable inter-study heterogeneity (I 2 = 82%) and publication bias (p = 0.016). After inputting two studies previously thought to be missing, the pooled effect dropped to g = -1.53 (95% CI: -3.01, -0.05). Conclusions: Chronic noise exposure of ≈ 100 dB leads to a significant reduction of serum testosterone in male rodents. Research on humans is highly warranted, especially given the steady trend in Western societies for increasing the burden of both male hypogonadism and noise pollution.

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“…Hypogonadism is associated with comorbidity. 23,24 It is possible that men with more severe comorbidities may have had lower testosterone levels at baseline and therefore testosterone suppression may have had a reduced effect in these men. It is also possible that ADT increased cardiovascular and other-cause mortality in men who already suffered from severe comorbidities mitigating any FFS or overall survival benefit provided by ADT.…”

Section: Discussionmentioning

confidence: 96%

The Influence of Age and Comorbidity on the Benefit of Adding Androgen Deprivation to Dose-escalated Radiation in Men With Intermediate-risk Prostate Cancer

Bian

Kuban

Levy

et al. 2016

American Journal of Clinical Oncology

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The Direct and Indirect Costs among U.S. Privately Insured Employees with Hypogonadism

Cited by 21 publications

References 21 publications

Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel

Oral Enclomiphene Citrate Stimulates the Endogenous Production of Testosterone and Sperm Counts in Men with Low Testosterone: Comparison with Testosterone Gel

Przewlekła ekspozycja na hałas a niedobór testosteronu — metaanaliza i metaregresja wyników badań na gryzoniach

The Influence of Age and Comorbidity on the Benefit of Adding Androgen Deprivation to Dose-escalated Radiation in Men With Intermediate-risk Prostate Cancer

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