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R S Swerdloff

Publications and source records attributed to R S Swerdloff.

At least 19 recordsLinked to original sources
PubMed1992

Effect of androgens on the brain and other organs during development and aging.

Androgens have important biological effects on accessory sexual organs and have a broad range of effects on metabolic processes. Male hormones have been shown to have important organizational and activational effects on morphological, behavioral, and cognitive activity in experimental animals. Sexual dimorphic effects on cognitive and behavioral activities in animals have been linked to androgens during the fetal period. The effects of testosterone on sexual drive are well established in humans, although the threshold for such activity appears to be lower than that required for many of the other and organic effects of testosterone. There are suggestive data to link fetal androgen levels to cognitive and behavioral activities in children and adults, but the behavioral activities may be modified by social and other learning processes. Androgen levels fall in older men at a time when impaired sexual function, osteopenia, and decreased muscle mass can be identified. The relative importance of androgen deficiency in these disorders requires further study, since they are likely to be multifactorial in pathogenesis. Replacement therapy of elderly men who have lowered testosterone levels has been proposed to decrease bone and muscle loss as well as to improve sexual function and general well-being. Careful studies will be required to assess the risk-to-reward ratio of such treatment, since theoretical adverse effects on prostate and cardiovascular diseases may occur. While conservation in management has its virtues, we should be reminded that several decades ago estrogen replacement of postmenopausal women was highly criticized until data supporting its favorable therapeutic ratio were demonstrated.

Aged↗
PubMed1992

Evaluation of testicular function.

The evaluation of testicular function is based primarily on a detailed medical history, a careful physical examination, basal measurements of FSH, LH and testosterone and a routine semen analysis. In a patient with androgen deficiency, the diagnosis can often be made with these basic tests. The clinician will then decide on other investigations to localize the organic lesion and to plan further treatment for the patient. Sperm function tests are often performed in patients presenting with infertility. These newer tests may help to delineate the abnormality of the spermatozoa at each stage during the achievement of fertilizing capacity such as adequate forward motility, penetration of cervical mucus, acrosome reaction, development of hyperactivated motility, binding to the zona pellucida, and fusion with the oocyte. Currently, many of these sperm function tests depend on cumbersome bioassays with many limiting factors contributing to their availability, accuracy and precision. The development of biochemical tests as markers of sperm function may allow more precise definition of sperm functional abnormalities. With the continued improvement of computer-aided sperm analysis, objective motion parameter measurements are possible and morphological assessment are being developed. These newer objective methods of semen analysis have to be shown to be valuable in the clinical assessment of patients with testicular dysfunction.

Endocrine System Diseases↗
PubMed1992

Developments in the control of testicular function.

Clinicians and clinical investigators have developed improved means for controlling testicular function in men. New and refined approaches for stimulation and inhibition of the hypothalamic-pituitary-testicular axis are now available. This chapter reviewed the most successful ways to inhibit the reproductive axis in men and its current application to the treatment of precocious puberty, metastatic prostate cancer, benign prostate hyperplasia and as prospective male contraceptives. Safe, effective and reversible medical approaches to male contraception are now approaching reality. Azoospermia and severe oligozoo/azoospermia can now be accomplished in the majority of men with combined GnRH antagonists and replacement doses of testosterone. Androgens and androgen-progestogen concentrations will induce azoospermia in over 90% of Asian men and azoospermia or severe oligospermia in Caucasian ethnic groups. Field trials are ongoing to determine whether testosterone administration will be more effective than condoms as contraceptives. True precocious puberty can now be managed more effectively than in the past by suppression of gonadotropin secretion with GnRH analogues. Precocious puberty due to other causes can be treated more effectively with inhibitors of steroidogenesis and blockers of androgen action. Metastatic prostate cancer, previously treatable with either castration or oestrogens, is now amenable to suppression of androgen secretion. GnRH analogues are given either alone or combined with blockers of androgen action. While significant palliative effects are observed with endocrine ablative therapy in most men with Stage C or D prostate cancer, modest increases in duration of survival may be seen. Benign prostate hyperplasia was previously approachable only with surgical intervention. Recent data have suggested that medical treatment with 5 alpha-reductase inhibitors and/or selective alpha-adrenergic blockers may offer non-surgical alternatives in some patients. More data are needed to determine the role of medical management of this common disorder.

5-alpha Reductase Inhibitors↗
PubMed1992

A biodegradable testosterone microcapsule formulation provides uniform eugonadal levels of testosterone for 10-11 weeks in hypogonadal men.

Limitations of presently available testosterone esters (enanthate and cypionate) include the fluctuating serum testosterone levels and the need for relatively frequent injections (every 10-21 days). These limitations of testosterone esters have prompted the development of more physiological and longer acting systems for androgen delivery. This paper reports pharmacokinetic and pharmacodynamic data with a second generation long-acting testosterone microcapsule formulation in hypogonadal men. This was a single dose, open label, nonrandomized study. Ten hypogonadal men with primary (n = 6) or secondary (n = 4) hypogonadism, otherwise in good health, received 630 mg microencapsulated testosterone in dextran solution (IM) on day 1. Serum total and free testosterone; LH; FSH; dihydrotesterone; estradiol; sex hormone-binding globulin; total cholesterol; high, low, and very low density lipoprotein cholesterol; triglycerides; and apoprotein-AII and -B were measured on multiple occasions during the 2-week control period and the 16-week treatment period. In addition, on days 0, 1, 28, 56, and 84, subjects were hospitalized for detailed hormone analyses over the 24-h period. Serum total and free testosterone levels rose quickly into the midnormal range and stayed uniformly in the eugonadal range for about 70-77 days, after which serum testosterone levels declined gradually into the hypogonadal range. Testosterone release from the microcapsule formulation over the first 10 weeks approximated zero order kinetics. Serum dihydrotestosterone levels rose into the normal range, and testosterone to dihydrotestosterone ratios remained in the physiological range. Serum estradiol levels rose and stayed in the midnormal male range. Serum sex hormone-binding globulin levels decreased significantly during treatment. Serum LH and FSH levels also significantly decreased in the six hypergonadotropic men. Total cholesterol low and very low density lipoprotein cholesterol and triglyceride levels did not change, but plasma high density lipoprotein cholesterol levels decreased significantly during treatment. These data indicate that testosterone microcapsule formulation provides uniform eugonadal levels of testosterone for about 10 weeks. The long duration and zero order kinetics make it an attractive alternative to existing methods of androgen replacement.

Adolescent↗
PubMed1992

Induction of azoospermia in normal men with combined Nal-Glu gonadotropin-releasing hormone antagonist and testosterone enanthate.

The effects of a combined GnRH antagonist and testosterone (T) replacement regimen on gonadotropins and spermatogenesis were examined to assess its potential as a male contraceptive regimen. The potent Nal-Glu GnRH antagonist ([Ac-D2-Nal1,D4-Cl-Phe2,D3-Pal3,Arg5, D4-p-methoxybenzoyl-2-amino butyric acid6,D-Ala10]GnRH) was administered daily (7.5 mg, sc) to eight normal men for 16 weeks. T enanthate was given im starting at week 2 and every 2 weeks thereafter through week 14 of the treatment phase. Serum LH, FSH, T, and estradiol concentrations were measured frequently during the 5-week control period, the 16-week treatment phase, and the 14-week recovery phase. Semen analyses were performed every week during the control phase and every 2 weeks during the treatment and recovery phases. Seven of eight subjects became azoospermic by 6-10 weeks of treatment; the eighth subject, who failed to achieve azoospermia, suppressed his sperm count to 7 million/mL by week 14 (from a mean baseline of 42 million/mL) before treatment was prematurely terminated because of localized swelling at each of his injection sites. Sperm counts returned to baseline 10-14 weeks after the end of Nal-Glu administration. Seven of the eight subjects showed suppression of LH to the limit of assay detection (less than 0.2 U/L), whereas the eighth subject showed incomplete suppression. Serum bioactive and immunoreactive LH concentrations showed concordant responses. Mean serum FSH concentrations were also markedly suppressed. Serum T and estradiol concentrations declined dramatically during the first 2 weeks of Nal-Glu GnRH treatment, but returned to the normal physiological range after T enanthate replacement was initiated. Libido and sexual potency were maintained. No systemic side-effects, other than erythema and induration at injection sites, were observed. These data demonstrate that combined GnRH antagonist plus T treatment can predictably and reversibly induce azoospermia in most men and has potential as a male contraceptive regimen.

Adult↗
PubMed1992

Effect of improved assay sensitivity on luteinizing hormone pulse detection after gonadotropin-releasing hormone antagonist treatment in man.

When serum levels of a hormone are at or below the detection limit of the measurement system, accurate characterization and quantitation of pulsatile hormone secretion may be difficult. This point is well illustrated in this study, which used two immunoassays with markedly different assay sensitivities to quantitate pulsatile LH secretion in men in whom serum LH levels had been suppressed by the administration of a GnRH antagonist. Five normal men received 5 mg Nal-Glu, sc, daily for 21 days. Blood was drawn at 10-min intervals over 8 h on days 0 and 21. Samples were assayed in triplicate in both a conventional LH RIA with a sensitivity of 0.6-1.0 IU/L and a two-site-directed ultrasensitive immunofluorometric assay (IFMA) with assay sensitivity ranging from 0.05-0.125 IU/L. LH pulses were analyzed by Cluster analysis (C) and were corroborated by the Detect algorithm (D). Nal-Glu suppressed LH (C) pulse amplitude from 4.0 +/- 0.7 to 0.40 +/- 0.03 IU/L by LH RIA and from 7.8 +/- 2.1 to 0.21 +/- 0.04 IU/L by LH IFMA. An apparent reduction in LH pulse number was observed in the RIA data on day 21 by both pulse detection methods [4.2 +/- 0.4 vs 2.4 +/- 0.2/8 h on days 0 and 21 by C (P < 0.005); 5.8 +/- 0.8 vs. 2.8 +/- 0.7 by D (P < 0.05)]. However, the IFMA measurements in the same samples using the more sensitive LH IFMA showed no difference in pulse number between days 0 and 21. The RIA data correlated well with the IFMA data, with a concordance coefficient ranging from 0.66-0.9. In summary, the Nal-Glu GnRH antagonist markedly decreases LH pulse amplitude, but not pulse frequency. These observations are consistent with competitive inhibition of GnRH action at the pituitary site by the Nal-Glu antagonist; they indicate that assay characteristics can significantly affect quantitation of hormone pulse pattern and underscore the need for ultrasensitive LH assays for accurate assessment of LH pulse characteristics when LH levels are low or suppressed.

Adult↗
PubMed1979

Body fat at puberty in rats: alteration by changes in diet.

The body composition (percent body fat) at vaginal opening of groups of rats fed different diets was determined. Serial changes in body composition prior to vaginal opening were also measured to assess the temporal relationship between first achievement of the body composition subsequently found at puberty and the actual onset of puberty (vaginal opening). The body weight at vaginal opening and the total carcass fat at vaginal opening were significantly different among the three dietary groups (F = 43.06 and 44.60, respectively; P less than 0.001). In addition, the percent body fat at vaginal opening was also significantly different among the three dietary groups (F = 30.30; P less than 0.001). In one group, the percent body fat was the same at the age of 31 days as it was at vaginal opening (mean age 41 days). In a group where food intake was restricted, the percent body fat prior to and at vaginal opening remained lower than that seen at vaginal opening in a group fed the same diet ad libitum. Thus, attainment of a critical level of body weight, total body fat stores, or percent body fat does not trigger puberty in rats.

Adipose Tissue↗
PubMed1979

Hypoandrogenism and abnormal regulation of gonadotropin secretion in rats fed a low protein diet.

The function of the hypothalamic-pituitary-testicular axis was evaluated in rats fed a low protein diet for 4 weeks beginning at 21 days of age. Compared to control, the low protein group had decreased seminal vesicle and prostate weights as well as decreased testicular testosterone output in vitro, although serum testosterone was not different. The low protein group showed no consistent alterations in serum LH (basal, post-LHRH, and postcastration) compared to control although serum FSH (basal and post-LHRH) was lower in the low protein group. Despite this lower basal FSH, the low protein group had supranormal serum FSH after castration. Seminiferous tubule diameter and testicular histology were normal in the low protein group although testicular androgen-binding protein was absent. Testicular androgen-binding protein was also undetectable in a modestly food-restricted control group which had normal testicular size, testicular histology, androgen output, and serum FSH. This finding suggests that loss of testicular androgen-binding protein may be a sensitive sign of undernutrition. We conclude that rats fed a low protein diet have hypoandrogenism, normal testicular histology, and supranormal FSH after castration despite subnormal basal FSH. The latter combination suggests overproduction of an FSH inhibitor of testicular origin.

Androgens↗
PubMed1979

Separation of bound from free hormone in radioimmunoassay of lutropin and follitropin.

A new technique in which polyethylene glycol is added to double-antibody assays of lutropin and follitropin eliminates the need for an incubation period during the separatory phase. After the antigen-first-antibody equilibrium reaction, the second antibody and polyethylene glycol (30 g/L final dilution) are added, the tubes are immediately centrifuged, each supernate is aspirated, and the precipitated antibody-bound hormone is counted. With this combined polyethylene glycol-second-antibody separatory method, the incubation time is shorter than the usual double-antibody separation procedure, but avoids the problem of high nonspecific precipitation, which occurs with polyethylene glycol alone. In addition, the combined separation technique allows the use of sera containing low titers of second antibody and use of smaller volumes of sera containing high titers of second antibodies, thus conserving second-antibody reagent.

Animals↗
PubMed1978

Secondary amenorrhea in obesity: etiologic role of weight-related androgen excess.

A massively obese, amenorrheic young woman had elevated levels of plasma androgens which could be reduced either acutely by dexamethasone administration or chronically by weight loss. Normalization of plasma androgen levels in both instances led to resumption of ovulation, suggesting that weight-related hyperandrogenism is a cause of amenorrhea in obesity.

Adult↗