Andrology最新文献

{"title":"Impact of varicocoelectomy on male semen parameters: A long-term analysis of sperm quality and outcomes.","authors":"Max D Sandler, Julio Yanes, Rohan Dureja, Vishal Ila, Aaron A Gurayah, Adam D Williams, David Miller","doi":"10.1111/andr.70075","DOIUrl":"https://doi.org/10.1111/andr.70075","url":null,"abstract":"<p><strong>Background: </strong>Varicocoeles are common in 40% of men presenting with infertility. Semen parameters including sperm motility, low sperm count and sperm morphology are altered by the presence of varicocoeles. Though varicocoelectomy has been associated with improvements in these parameters, studies on long-term outcomes are limited.</p><p><strong>Objectives: </strong>Analyze pre-operative samples with those collected at multiple post-operative timepoints to assess if sperm parameters continue to improve in the period following varicocoelectomy.  MATERIALS AND METHODS: Adult men who underwent varicocoelectomy under a single surgeon from 2017 to 2023 with at ≥1 post-operative semen analysis (SA) were included. Motile sperm count, progressive motility, round cells, semen volume, sperm concentration, sperm morphology, total motility and viability was collected from each patient's SA. Wilcoxon signed-rank tests were used to compare medians of sperm parameters from pre-operative baseline to 6, 12, 18 and 24 months follow up.</p><p><strong>Results: </strong>At 6 months, number of motile sperm increased from 4 to 8 million/mL (p < 0.0001), progressive motility increased from 34% to 42% (p < 0.0001), total motility rose from 37% to 45% (p <0.0001), concentration increased from 6.9 mil/mL to 9 mil/mL (p <0.0001), and morphology increased from 1% to 2% (p = .0026). Viability increased from 60% to 62% (p = .0002). At 6-12 months, number of motile sperm (7 mil/mL, p < 0.0001), progressive motility (38.5%, p = 0.0005), sperm concentration (8 mil/mL, p < 0.0001), and total motility (41.5%, p < 0.0001) remained statistically significant compared to baseline. At 12-18 months, significant increases in progressive motility (35%, p = 0.0272) and total motility (37%, p = 0.0022) persisted.</p><p><strong>Conclusions: </strong>Our retrospective study demonstrates significant short-term improvements across multiple parameters at 6-months after varicocoelectomy. While we note individual improvement in sperm parameters during longer follow-up period, there was variability based on the time frame. Our findings underscore the impact of varicocoelectomies may have on enhancing short-term male fertility. Future, prospective research is needed to validate these findings.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of suprapubic pedicled phalloplasty to address genital gender-affirming surgery in transgender men: A single-center cohort analysis.","authors":"Anfosso Mattia, Cirigliano Lorenzo, Preto Mirko, Gontero Paolo, Falcone Marco","doi":"10.1111/andr.70074","DOIUrl":"https://doi.org/10.1111/andr.70074","url":null,"abstract":"<p><strong>Background: </strong>Over the years, numerous techniques have been used to address genital gender-affirming surgery (GGAS) in transgender men. Among the proposed surgical options to address TPC in transgender men, suprapubic pedicled phalloplasty (SPP) has rarely been considered in the current scientific literature.</p><p><strong>Objectives: </strong>The aim of the study is to report the surgical outcomes of the first step of suprapubic pedicled phalloplasty (SPP)-with or without urethral lengthening (UL)-evaluating possible risk factors affecting the incidence of complications.</p><p><strong>Methods: </strong>The study was conducted as a retrospective, single-center analysis at a regional tertiary referral center. Between April 2006 and August 2024, 40 transgender men underwent GGAS at our center. GGAS was conducted as a multistage procedure, consisting of (1) SPP (2) eventual radial artery-based forearm free-flap urethroplasty, (3) glans sculpting, join-up, vaginectomy and scrotoplasty, and (4) penile prosthesis implantation. Surgery time, intra- and postoperative complications, and hospital stay were selected as variables for surgical outcomes.</p><p><strong>Results: </strong>The median operative time was 130 min (111-158 min). Partial necrosis of the phallus was detected in 4 cases (10.5%) it was easily managed through a minor outpatient procedure. The median length loss after debridement was 1.3 cm (0.5-2 cm), without significant impact on the final length. A total loss of the neophallus occurred in a single case (2.5%) and required a staged salvage TPC. In the present series, only 14 patients (35%) opted for urethral reconstruction: 8 (20%) required a perineostomy, 4 (10%) underwent radial artery urethroplasty (RAU), while the remaining 5% required an additional metoidioplasty with urethral lengthening, ensuring that the clitoris was not incorporated into the neophallus during penile construction. Univariate and multivariate analyses failed to highlight any possible risk factors influencing the incidence of postoperative complications. The lack of a comparison group or randomization, the limited follow-up, and the absence of patient-reported outcome analysis are the main limitations of our study.</p><p><strong>Conclusion: </strong>Our evidence suggests that SPP is a reliable and technically accessible option for GGAS in transgender men, particularly when microsurgery is contraindicated. The technique offers the advantage of accommodating the patient's needs for urethral lengthening, simplifying the surgical process, and reducing operative times. While vascular complications may occur relatively frequently, they are mostly minor and can be managed with simple outpatient procedures.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of androgen deprivation therapy on sexual health in patients who underwent brachytherapy for prostate cancer.","authors":"Kenta Onishi, Yasushi Nakai, Fumisato Maesaka, Mitsuru Tomizawa, Takuto Shimizu, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Makito Miyake, Kaori Yamaki, Isao Asakawa, Fumiaki Isohashi, Kiyohide Fujimoto, Nobumichi Tanaka","doi":"10.1111/andr.70066","DOIUrl":"https://doi.org/10.1111/andr.70066","url":null,"abstract":"<p><strong>Background: </strong>Androgen deprivation therapy (ADT) is used in the management of prostate cancer. Post-therapy recovery from the induced hypogonadal state is protracted and correlates with diminished quality of life (QOL).</p><p><strong>Objective: </strong>This study assessed the impact of short-term ADT on sexual health following brachytherapy.</p><p><strong>Materials and methods: </strong>The study included patients administered brachytherapy with or without short-term neoadjuvant ADT (≤6 months) at our institution from 2010 to 2018. Serum total testosterone levels, chronological changes in erectile function, and health-related QOL were evaluated.</p><p><strong>Results: </strong>Of 139 participants, 41 received neoadjuvant ADT (median, 4 months). Sexual health inventory for men (SHIM) scores and sexual function domain of the expanded prostate cancer index composite (EPIC) scores deteriorated significantly up to 36 months post-treatment in patients receiving brachytherapy with neoadjuvant ADT compared to those without. A significant decline was observed in the sexual bother domain of the EPIC scores of patients without neoadjuvant ADT up to 6 months post-treatment relative to those with neoadjuvant ADT. Total testosterone levels in the brachytherapy with neoadjuvant ADT group gradually recovered post-treatment and were similar to those in the brachytherapy without neoadjuvant ADT group after 12-month treatment. Neoadjuvant ADT and a lower pre-treatment SHIM score were risk factors for severe erectile dysfunction 12 months after treatment.</p><p><strong>Discussion: </strong>Restoring sexual health extends beyond the normalization of testosterone levels following cessation of ADT. ADT significantly influences erectile dysfunction after brachytherapy. Our research identified a time lag between the restoration of testosterone levels and the improvement of erectile function and sexual QOL. We hypothesized that individuals undergoing ADT had diminished sexual distress, attributable to fewer opportunities for sexual engagement than their untreated counterparts.</p><p><strong>Conclusion: </strong>Persistent sexual dysfunction occurs despite the normalization of testosterone levels post-ADT. Understanding sexual QOL changes following brachytherapy with ADT will help guide treatment recommendations and patient decision-making.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paternal ischemic heart disease and chance of successful pregnancy outcomes.","authors":"Anne-Sofie Sønnichsen-Dreehsen, Caroline Theilgaard Thorarinsson, Bente Mertz Nørgård, Jens Fedder, Mette Wod","doi":"10.1111/andr.70065","DOIUrl":"https://doi.org/10.1111/andr.70065","url":null,"abstract":"<p><strong>Background: </strong>Only approximately 30% of conceptions result in live births. Historically, research has predominantly focused on maternal factors impacting pregnancy success, despite the cause remaining unidentified in most cases. The influence of paternal factors on a couple's likelihood of achieving a successful pregnancy is still not well understood and warrants further investigation.</p><p><strong>Objectives: </strong>This study aims to examine the chance of biochemical pregnancy, clinical pregnancy, and a live-born child in couples where the male partner has ischemic heart disease.</p><p><strong>Materials and methods: </strong>This nationwide cohort study based on Danish health registries included couples undergoing in vitro fertilization with or without intracytoplasmic sperm injection from 2006 to 2019. The cohort was divided into two groups: exposed and unexposed. The exposed cohort included embryo transfers in couples where the male partner had ischemic heart disease, while the unexposed group included those where the male partner did not have this condition.</p><p><strong>Results: </strong>A total of 101,875 couples with a known male partner were included. Among these, 653 couples were included in the exposed cohort and 101,222 were included in the unexposed cohort. The adjusted odd ratios (ORs) for a biochemical pregnancy, clinical pregnancy, and live-born child were 0.99 (95% confidence interval [CI]: 0.79; 1.23), 0.79 (95% CI: 0.51, 1.23), and 0.94 (95% CI: 0.62, 1.44), respectively.</p><p><strong>Conclusions: </strong>These findings indicate that paternal ischemic heart disease prior to oocyte retrieval is not associated with a statistically significant decrease in the chances of biochemical pregnancy, clinical pregnancy, or live birth.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-intensity shockwave therapy for erectile dysfunction due to diabetes mellitus or coronary artery disease: An individual participant data meta-analysis from a single center.","authors":"Nikolaos Pyrgidis, Dimitrios Kalyvianakis, Ioannis Mykoniatis, Dimitrios Hatzichristou","doi":"10.1111/andr.70069","DOIUrl":"https://doi.org/10.1111/andr.70069","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity shockwave therapy (LiST) is a first-line treatment for vasculogenic erectile dysfunction (ED). However, its efficacy in challenging cases, such as ED solely due to type 2 diabetes mellitus (DM) or coronary artery disease (CAD), has not been adequately assessed. Materials and Methods This study presents an individual participant data meta-analysis of five double-blind randomized controlled trials involving 208 patients treated in a single academic center using a standardized LiST protocol (ARIES 2 generator, 5000 impulses/session). Results For outcomes, including International Index of Erectile Function-Erectile Function Domain scores, sexual encounter profile question 3 responses, resistance index, and minimal clinically important differences, LiST was equally effective in patients with ED due to DM or CAD compared to other causes. Subgroup analyses showed equivalent efficacy for 6 versus 12 LiST sessions. No adverse events were reported. Conclusions These findings confirm LiST's safety and effectiveness across different causes of vasculogenic ED, supporting its broader application in clinical practice.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of germ cell neoplasia in situ and testicular cancer risk in men with testicular microlithiasis: Real world results through 10 years.","authors":"Karoline Skov Lundager, Rasmus Hassing Frandsen, Emil Durukan, Nadia Zeeberg Belhouche, Christian Fuglesang S Jensen, Peter Busch Østergren, Jens Sønksen, Mikkel Fode","doi":"10.1111/andr.70071","DOIUrl":"https://doi.org/10.1111/andr.70071","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend biopsies for men <50 years with testicular microlithiasis and cancer risk factors to rule out germ cell neoplasia in situ. Limited data support this practice.</p><p><strong>Objectives: </strong>To clarify the significance of testicular microlithiasis by examining pathological findings in men with testicular microlithiasis.</p><p><strong>Materials and methods: </strong>We reviewed charts of men diagnosed with testicular microlithiasis at a tertiary referral center from 2013 to 2023. Patient characteristics, clinical findings, and cancer risk factors including testicular hypotrophy (volume ≤12 mL), infertility, and cryptorchidism were recorded. Men with unknown fertility were offered semen analyses. Histological findings from testicular biopsies and subsequent cancers were noted. Primary endpoints were rates of germ cell neoplasia in situ and testicular cancer diagnoses.</p><p><strong>Results: </strong>We included 334 men (median age 33 years, range 16-73 years): 27 had testicular hypotrophy, 18 infertility, 25 cryptorchidism, and 56 multiple risk factors. The remaining 208 men had no apparent risk factors. Of these 36 were had reduced semen quality. Overall, 137 of 334 men (41%) underwent biopsies, with germ cell neoplasia in situ in 10 cases (7.3%, 95% confidence interval 3.6%-13%). Four had multiple risk factors (hypotrophy and infertility in two; hypotrophy, infertility, and cryptorchidism in two), three had hypotrophy alone, one had infertility, and two had reduced semen quality. Germ cell neoplasia in situ was unilateral in all cases and only found in testicles with testicular microlithiasis. Unilateral orchiectomy was performed in all germ cell neoplasia in situ cases, with hypotrophy found in all but one. Over a median follow-up of 4.7 years (range 1.16-11.49 years), testicular cancer developed in three men (0.9%, 95% confidence interval 0.19%-2.6%).</p><p><strong>Discussion: </strong>Germ cell neoplasia in situ was only detected in cases with both testicular microlithiasis and testicular hypotrophy, and the rate of subsequent cancer development was low. This suggests that testicular microlithiasis alone does not increase cancer risk in otherwise morphologically normal testicles.</p><p><strong>Conclusion: </strong>Biopsies should only be considered in men with incidental testicular microlithiasis if the testicular size is reduced.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topological abnormalities of left middle orbital frontal gyrus and amygdala associated with hypoactive sexual desire disorder: A diffusion tensor imaging study.","authors":"Yan Xu, Peining Niu, Tao Liu, Jinbo Tian, Ao Wang, Zhaoxu Yang, Shaowei Liu, Yun Chen, Jianhuai Chen","doi":"10.1111/andr.70064","DOIUrl":"https://doi.org/10.1111/andr.70064","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual desire has been found to be associated with brain areas involved in sexual excitation and inhibition. However, little is known regarding whether hypoactive sexual desire disorder patients have structural abnormalities related to hypofunctional excitation or hyperfunctional inhibition in the brain.</p><p><strong>Methods: </strong>Magnetic resonance imaging data were collected from 26 hypoactive sexual desire disorder patients and 28 healthy controls. The structural brain networks were constructed based on diffusion tensor imaging data. Finally, the nodal parameters were calculated by the graph theoretical analysis and were compared between hypoactive sexual desire disorder and healthy controls.</p><p><strong>Results: </strong>There were no significant differences in the age, education level, and scores of emotional scales between groups. Meanwhile, all hypoactive sexual desire disorder patients showed normal hormone levels. Compared with healthy controls, hypoactive sexual desire disorder patients showed higher scores on the Arizona Sexual Experience Scale and its sexual desire subscale. In fractional anisotropy-weighted brain networks, a decreased clustering coefficient was found in the left middle frontal gyrus (orbital part), and decreased local efficiency was found in the left amygdala of hypoactive sexual desire disorder patients when compared with healthy controls.</p><p><strong>Conclusion: </strong>The present study demonstrated impaired left middle orbital frontal gyrus and amygdala in the structural brain network of hypoactive sexual desire disorder patients, which might be the central pathological mechanisms underlying hypoactive sexual desire disorder and could be used as a neuroimaging diagnostic biomarker for hypoactive sexual desire disorder.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D levels and biomarkers of male fecundity: A study from the Danish National Birth Cohort.","authors":"Anne Gaml-Sørensen, Nis Brix, Sandra Søgaard Tøttenborg, Christian Lindh, Karin Sørig Hougaard, Siri Eldevik Håberg, Gunnar Toft, Jens Peter Ellekilde Bonde, Cecilia Høst Ramlau-Hansen","doi":"10.1111/andr.70061","DOIUrl":"https://doi.org/10.1111/andr.70061","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D is metabolised throughout the male reproductive system, suggesting a direct regulatory role of vitamin D in male reproduction.</p><p><strong>Objectives: </strong>To investigate the association between plasma vitamin D levels at sperm ejaculation and during spermatogenesis and biomarkers of male fecundity in young men.</p><p><strong>Materials and methods: </strong>From the Fetal Programming of Semen Quality cohort, Denmark, 2017-2019, 1047 young men provided a semen and a blood sample, and self-measured their testes volume at a clinical visit. Plasma levels of vitamin D (25(OH)D₃) and reproductive hormones were measured in the blood sample. Relative percentage differences in semen characteristics, testes volume and reproductive hormone levels were analysed according to measured vitamin D levels (categorised, continuous and as restricted cubic splines) at sperm ejaculation. Additionally, we used the seasonal variation in endogenous vitamin D synthesis to estimate individual vitamin D levels 3 months prior to sperm ejaculation (at initiation of spermatogenesis) in addition to 2 and 1 month before. This was analysed following the same strategy.</p><p><strong>Results: </strong>Compared to measured vitamin D levels >75 nmol/L, levels <25 nmol/L at sperm ejaculation were associated with lower total sperm count (‒15% [95% confidence interval: ‒33%; 8%]), and a higher proportion of non-progressive and immotile spermatozoa (11% [95% confidence interval: 0%; 24%]). Lower measured vitamin D levels were also associated with higher oestradiol, lower sex hormone-binding globulin and lower follicle-stimulating hormone, in dose-dependent manners. Vitamin D levels estimated before and during spermatogenesis yielded similar associations as vitamin D levels measured at sperm ejaculation.</p><p><strong>Discussion: </strong>By using the seasonal variation in endogen vitamin D synthesis, we were able to estimate individual vitamin D levels during spermatogenesis.</p><p><strong>Conclusion: </strong>Lower vitamin D levels before and during spermatogenesis and at sperm ejaculation were associated with lower total sperm count and sperm motility and an altered reproductive hormone profile.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle strength changes and physical activity during gender-affirming hormone therapy: A systematic review.","authors":"Mathilde Kamp Nørlund, Louise Lehmann Christensen, Marianne Skovsager Andersen, Tine Taulbjerg Kristensen, Jan Frystyk, Jonas Mathiesen, Jakob Lindberg Nielsen, Dorte Glintborg","doi":"10.1111/andr.70058","DOIUrl":"https://doi.org/10.1111/andr.70058","url":null,"abstract":"<p><strong>Background: </strong>Higher muscle strength is associated with improved overall health and lower mortality. Muscle strength changes during gender-affirming hormone therapy is possibly linked to gender-affirming hormone therapy modality, age at initiation, gender-affirming hormone therapy duration, and physical activity.</p><p><strong>Aim: </strong>To review published literature on muscle strength changes during gender-affirming hormone therapy.</p><p><strong>Methods: </strong>Studies were included if they met the PICOS criteria; P: transgender individuals ≥18 years, I: gender-affirming hormone therapy, C: gender-affirming hormone therapy-naïve transgender persons or cisgender controls, O: muscle strength and physical activity in relation to muscle strength, S: prospective cohorts or cross-sectional.</p><p><strong>Results: </strong>Fifteen studies with data on 1206 transgender persons (722 transmasculine persons, median age 23-37 years and 484 transfeminine persons, median age 27-41 years) were included. Prospective design was used in eight out of 15 studies (two out of eight on transmasculine, two out of eight on transfeminine, and four out of eight on both) and seven out of 15 were cross-sectional (two out of seven on transmasculine, four out of seven on transfeminine, and one out of seven on both). Isometric elbow flexion/extension, lower body strength, and handgrip strength were assessed in one out of 15 studies, four out of 15, and 12 out of 15 studies, respectively. Bias rating was moderate to high.</p><p><strong>Prospective studies: </strong>Masculinizing gender-affirming hormone therapy resulted in increased (four out of six studies) or unchanged (two out of six studies) muscle strength, while feminizing gender-affirming hormone therapy resulted in decreased (three out of six studies) or unchanged (three out of six studies) muscle strength. Muscle strength changes mainly occurred during the first year after initiating gender-affirming hormone therapy and age at initiation had no impact.</p><p><strong>Cross-sectional studies: </strong>Transmasculine and transfeminine persons had higher strength compared with cisgender women, but lower strength than cisgender men. Physical activity was unchanged during gender-affirming hormone therapy in five out of prospective studies, while transfeminine persons were less physically active than cisgender men in five out of five prospective studies.</p><p><strong>Conclusion: </strong>Muscle strength appeared to increase during masculinizing gender-affirming hormone therapy and decrease during feminizing gender-affirming hormone therapy, whereas physical activity was unchanged. Given high risk of bias, more research is necessary. Improving transgender care requires engagement of transgender persons in physical activity.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular safety of testosterone therapy-Insights from the TRAVERSE trial and beyond: A position statement of the European Expert Panel for Testosterone Research.","authors":"Michael Zitzmann, Giulia Rastrelli, Robert D Murray, David Edwards, Yacov Reisman, Preethi Mohan Rao, Alexander Sahi, Thomas Hugh Jones, Alberto Ferlin, Eleni Armeni, Emiliano Corpas, Jann-Frederik Cremers, Janine David, Stefan Arver, Leen Antonio, Giovanni Corona","doi":"10.1111/andr.70062","DOIUrl":"https://doi.org/10.1111/andr.70062","url":null,"abstract":"<p><strong>Introduction: </strong>Testosterone therapy has become a cornerstone treatment for men with hypogonadism, offering significant benefits such as improved sexual function, mood, muscle mass, and bone density. However, concerns about its cardiovascular safety have historically tempered its use. This position statement synthesizes the current evidence on the cardiovascular safety of testosterone therapy, drawing from key studies including the TRAVERSE trial, other trials, and recent meta-analyses.</p><p><strong>Background and importance: </strong>Testosterone therapy aims to restore testosterone levels in men with hypogonadism, a condition associated with increased cardiovascular and metabolic risks. Early research produced mixed results, with some studies suggesting a potential increase in cardiovascular events such as myocardial infarction and stroke, while others indicated possible cardiovascular benefits, particularly in men with coexisting conditions like metabolic syndrome and type 2 diabetes.</p><p><strong>Findings from recent studies: </strong>The TRAVERSE trial, a large-scale, randomized, placebo-controlled study, provided robust evidence that testosterone therapy does not significantly increase the risk of major adverse cardiovascular events. Testosterone therapy was found to effectively mitigate anemia in hypogonadal men, highlighting a dual benefit of increasing red blood cell production while managing cardiovascular risks. The findings from the TRAVERSE trial align with those from previous meta-analyses that concluded that testosterone therapy is safe and does not increase cardiovascular risk.</p><p><strong>Consensus and clinical implications: </strong>There is consensus that testosterone therapy, when prescribed to appropriately selected patients and monitored regularly, is safe from a cardiovascular standpoint, with the potential benefits outweighing the risks when the therapy is used responsibly. Current guidelines recommend individualized treatment plans with careful monitoring, especially of hematocrit levels. This position statement amalgamates previous knowledge with current data and is in agreement with recent United States Food and Drug Administration label changes for testosterone products.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}