Exploring testosterone-men's health link
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The review article titled“Testosterone and men's health: An in-depth exploration of their relationship”, was published on February 18, 2025 in UroPrecision.
Testosterone is a steroid hormone that holds a central position in male health, influencing numerous physiological processes throughout a man's life. Primarily secreted by the testes, with smaller contributions from the adrenal glands, it is the main androgen responsible for male-specific characteristics.
During fetal development, testosterone drives sexual differentiation, determining the male reproductive system's formation. As boys reach puberty, it triggers the development of secondary sexual traits such as facial and body hair growth, a deeper voice, and increased muscle mass. These changes are not only physical but also have psychological implications, shaping a man's self-identity.
In adulthood, testosterone continues to play a crucial role in maintaining health. It is essential for male reproductive function, stimulating sperm production in the testes. Additionally, it supports libido and erectile function. Low testosterone levels are often associated with sexual dysfunction, including decreased sexual desire and erectile problems, which can significantly impact a man's quality of life and relationships.
Beyond the reproductive system, testosterone has far-reaching effects. It helps maintain muscle mass and strength. By promoting protein synthesis, it enables muscles to grow and repair, contributing to physical performance and overall mobility. Testosterone also plays a vital role in bone health. It helps preserve bone density, reducing the risk of osteoporosis and fractures, especially as men age.
Moreover, testosterone influences metabolism. It affects fat distribution, with low levels often leading to increased abdominal fat. This is significant because abdominal obesity is linked to various health issues, such as metabolic syndrome, diabetes, and cardiovascular diseases. Adequate testosterone levels can help regulate cholesterol levels and improve insulin sensitivity, reducing the risk of these chronic conditions.
However, abnormal testosterone levels can pose problems. Hypogonadism, characterized by low testosterone, can be caused by issues in the testes, hypothalamus, or pituitary gland. It is more common in older men and those with certain health conditions like obesity and diabetes. On the other hand, hypergonadism, or excessive testosterone production, can result from tumors or genetic disorders and may lead to symptoms like early puberty in boys, aggression, and infertility.
Precision medicine offers hope in managing testosterone-related disorders. By considering genetic, hormonal, and lifestyle factors, doctors can develop personalized treatment plans. Biomarkers are key in this process, allowing for more accurate diagnosis and treatment monitoring. For instance, measuring free testosterone, SHBG, and LH levels helps assess a man's androgen status.
Despite the progress in understanding testosterone, there are still challenges. Research on testosterone replacement therapy (TRT) has limitations, including small sample sizes and safety concerns related to cardiovascular risks and prostate health. Future studies are needed to fully understand testosterone's complex role in men's health and to develop more effective and safer treatment options. In conclusion, testosterone is a critical factor in men's health, and continued research is essential for optimizing male health and well-being.
DOI: 10.1002/uro2.115
Journal
UroPrecision
Method of Research
Literature review
Subject of Research
People
Article Title
Testosterone and men's health: An in-depth exploration of their relationship
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Peyronie's disease management
Current insights & Future directions
Higher Education Press
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Biological pathways and targets for precision therapy.
view moreCredit: Skyler Howell, Travis Green, Kareim Khalafalla
The review article titled“Current insights and future directions in Peyronie's disease management: A narrative review”, was published on November 12, 2024 in UroPrecision.
PD is an inflammatory and fibrotic condition characterized by the formation of fibrous plaques in the tunica albuginea, leading to penile curvature, pain, and significant psychological distress. Affecting up to one in nine men in the United States and between 0.3% and 13.1% globally, PD progresses through two distinct phases: an acute phase marked by pain and plaque formation, and a chronic or stable phase where pain subsides, and the deformity stabilizes. Despite ongoing research, the precise etiology of PD remains unclear, though microtrauma during intercourse, genetic predisposition, and systemic inflammatory conditions are thought to play significant roles.
Diagnosis of PD relies primarily on a thorough history and physical examination, with induced erection and ultrasonography being key diagnostic tools. Imaging beyond ultrasound is not routinely recommended, as it rarely provides additional actionable information. Current management strategies are tailored to the disease phase. In the acute phase, the focus is on pain control and slowing disease progression, often using nonsteroidal anti-inflammatory drugs and, in some cases, extracorporeal shockwave therapy. In the stable phase, treatment shifts to correcting bothersome curvature, with options ranging from non-surgical interventions like traction therapy and intralesional injections to surgical procedures such as tunical plication or penile prosthesis implantation.
Non-surgical treatments, while widely used, are often poorly supported by robust evidence. Exceptions include traction therapy, which has shown promise in reducing curvature and preserving penile length, and intralesional injections of collagenase Clostridium histolyticum or interferon alpha-2b, which have demonstrated efficacy in specific patient populations. Surgical intervention is reserved for stable disease and is highly individualized, depending on the severity of curvature and the presence of erectile dysfunction. Techniques such as tunical shortening or lengthening, plaque incision or excision with grafting, and inflatable penile prosthesis placement are commonly employed, each with its own set of benefits and risks.
Future directions in PD management are focused on improving diagnostic accuracy, understanding the underlying biological mechanisms, and developing targeted therapies. Advances in imaging, such as contrast-enhanced MRI and nuclear scintigraphy, may help better distinguish between active and stable disease. Regenerative therapies, including stem cells and platelet-rich plasma, hold promise for addressing both fibrosis and erectile dysfunction. Additionally, ongoing clinical trials are exploring novel treatments, including combination therapies and new surgical techniques, which may further refine the management of PD.
In conclusion, while significant progress has been made in understanding and managing PD, many questions remain unanswered. As diagnostic tools and therapeutic options continue to evolve, the management of PD will become increasingly personalized, offering hope for improved outcomes and quality of life for affected men. This review highlights the current state of knowledge and outlines promising avenues for future research and clinical practice.
DOI: 10.1002/uro2.104
Journal
UroPrecision
Method of Research
Literature review
Subject of Research
People
Article Title
Current insights and future directions in Peyronie's disease management: A narrative review
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