Skip to main content
SpringerLink
Log in

Testicular Function in Critical Illness

  • Chapter
Endocrinology of Critical Disease

Part of the book series: Contemporary Endocrinology ((COE,volume 4))

  • 113 Accesses

Abstract

Like other regulated endocrine axes, the hypothalamo—pituitary—testicular (HPT) axis in men is subject to modification from external influences. Both acute and chronic illnesses as well as numerous medications can profoundly affect levels of circulating testosterone and can inhibit spermatogenesis (1). In certain instances, such as hemochromatosis, the alteration in gonadal function is a well-recognized concomitant of the disease process, whereas in other circumstances, the apparent modification of gonadal function may simply represent a nonspecific effect of illness on the HPT axis (2). It is generally accepted that virtually any illness, whether acute, self-limited, or chronic, may have an impact on testicular function. The purpose of this chapter is to explore, specifically, the effects of critical illness and medications on the HPT axis. As well as discussing the possible pathologic consequences owing to these modifications of testicular function (3).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Dong Q, Hawker F, McWilliam D, Bangah M, Burger H, Handelsman DJ. Circulating immunoreactive inhibin and testosterone levels in men with critical illness. Clin Endocrinol 1992; 36: 399–404.

    Article  CAS  Google Scholar 

  2. Cundy T, Butler J, Bomford A, Williams R. Reversibility of hypogonadotropic hypogonadism associated with genetic hemochromatosis. Clin Endocrinol 1993; 38: 617–620.

    Article  CAS  Google Scholar 

  3. Plymate S, Paulsen C, McLachlan R. Relationship of serum inhibin levels to FSH and sperm production in normal men and men with a varicocele. J Clin Endocrinol Metab 1992; 74: 859–864.

    Article  PubMed  CAS  Google Scholar 

  4. Van den Berghe G, de Zegher F, Lauwers P, Veldhuis J. Luteinizing hormone secretion and hypoandrogenaemia in critically ill men: effect of dopamine. Clin Endocrinol 1994; 41: 563–569.

    Article  Google Scholar 

  5. Reincke M, Lehmann R, Karl M, Magiaou A, Chrousos GP, Allolio B. Severe illness:neuroendocrinology. Ann NY Acad Sci 1995; 771: 556–569.

    Article  PubMed  CAS  Google Scholar 

  6. Goussis O, Pardridge W, Judd H. Critical illness and low testosterone: effects of human serum on testosterone transport into rat brain and liver. J Clin Endocrinol Metab 1983; 56: 710–714.

    Article  PubMed  CAS  Google Scholar 

  7. Plymate S, Tenover J, Bremner W. Circadian variation in testosterone, sex hormone binding globulin, and calculated non-sex hormone binding globulin bound testosterone in healthy young and elderly men. J Androl 1989; 10: 366–371.

    PubMed  CAS  Google Scholar 

  8. Raffi F, Brisseau J, Planchon B, R’emi J, Barrier J, Grolleau J. Endocrine function in 98 HIV-infected patients: a prospective study. AIDS 1991; 5: 729–733.

    Google Scholar 

  9. daCunha M, Meistrich M, Fuller L, al. e. Recovery of spermatogenesis after treatment for Hodgkin’s disease: limiting dose of MOPP chemotherapy. J Clin Oncol 1984; 2: 571–577.

    CAS  Google Scholar 

  10. Semple C, Gray C, Beastall G. Male hypogonadism-a non-specific consequence of illness. Q J Med 1987; 64: 601–607.

    PubMed  CAS  Google Scholar 

  11. Jarek MJ, Legare EJ, McDermott MT. Endocrine profiles for outcome prediction from the intensive care unit. Crit Care Med 1996; 21: 543–550.

    Article  Google Scholar 

  12. Woolf P, Hamill R, McDonald J, Lee L, Kelly M. Transient hypogonadotropic hypogonadism caused by critical illness. J Clin Endocrinol Metab 1985; 60: 444–450.

    Article  PubMed  CAS  Google Scholar 

  13. Blackman M, Weintraub B, Rosen S, Harman S. Comparison of the effects of lung cancer, benign lung disease, and normal aging on pituitary-gonadal function in men. J Clin Endocrinol Metab 1988; 66: 88–95.

    Article  PubMed  CAS  Google Scholar 

  14. MacAdams M, White R, Chipps B. Reduction in serum testosterone levels during chronic glucocorticoid therapy. Ann Int Med 1986; 104: 648–651.

    PubMed  CAS  Google Scholar 

  15. Schneider B, Pickett C, Zwillich C, Weil J, McDermott M, Santen R, Varano L, White, D. Influence of testosterone on breathing during sleep. J Appl Physiol 1986; 61: 618–623.

    PubMed  CAS  Google Scholar 

  16. Sandblom R, Matsumoto A, Schoene R, Lee K, Giblin E, Bremner W, Pierson D. Obstructive sleep apnea induced by testosterone administration. N Engl J Med 1983; 308: 508–510.

    Article  PubMed  CAS  Google Scholar 

  17. Matsumoto A, Sandblom R, Schoene R, Lee K, Giblin E, Pierson D, Bremner W. Testosterone replacement in hypogonadal men:effects on obstructive sleep apnea, respiratory drives, and sleep. Clin Endocrinol 1985; 22: 713–721.

    Article  CAS  Google Scholar 

  18. Handelsman D. Hypothalamic-pituitary-gonadal dysfunction in chronic renal failure, dialysis, and renal transplantation. Endoc Rev 1985; 6: 151–182.

    Article  CAS  Google Scholar 

  19. Levitan D, Moser S, Goldstein D, Kletzky O, Lobo R, Massry S. Disturbances in the hypothalamic-pituitary-gonadal axis in male patients with acute renal failure. Am J Nephrol 1984; 4: 99–106.

    Article  PubMed  CAS  Google Scholar 

  20. Shilo S, Livshin Y, Sheshkin J, Spitz I. Gonadal function in Lepromatous Leprosy. Lepr Rev 1981; 52: 127–136.

    PubMed  CAS  Google Scholar 

  21. Chlebowski R, Heber D. Hypogonadism in male patients with metastatic cancer prior to chemotherapy. Cancer Res 1981; 42: 2495–2498.

    Google Scholar 

  22. Aasebo U, Bremnes R, deJong F, Aakvag A, Slordal L. Pituitary-gonadal dysfunction in male patients with lung cancer. Association with serum inhibin levels. Acta Oncol 1994; 33: 177–180.

    Article  PubMed  CAS  Google Scholar 

  23. Constine L, Woolf P, Cann D, et al. Hypothalamic-pituitary function after irradiation for brain tumors. N Eng J Med 1983; 328: 87–92.

    Article  Google Scholar 

  24. Baker H, Burger H, deKretser D, et al. A study of the endocrine manifestations of hepatic cirrhosis. Q J Med 1976; 45: 145–178.

    PubMed  CAS  Google Scholar 

  25. Griggs R, Pandya S, Florence J, et al. Randomized controlled trial of testosterone in men with myotonic dystrophy. Neurology 1989; 39: 219–222.

    Article  PubMed  CAS  Google Scholar 

  26. Farthing M, Edwards C, Rees L, Dawson A. Male gonadal dysfunction in coeliac disease: 1. Sexual dysfunction, infertility, and semen quality. Gut 1982; 23: 608–618.

    Article  PubMed  CAS  Google Scholar 

  27. Farthing M, Edwards C, Rees L, Dawson A. Male gonadal dysfunction in coeliac disease: 3. Pituitary regulation. Clin Endocrinol 1983; 19: 661–671.

    Article  CAS  Google Scholar 

  28. Green J, Goble H, Edwards C, Dawson A. Reversible insensitivity to androgens in men with untreated gluren enteropathy. Lancet 1977; 1: 280–282.

    Article  PubMed  CAS  Google Scholar 

  29. Birnie C, McCleod T, Watkinson G. Incidence of sulfasalazine-induced male infertility. Gut 1981; 22: 452–455.

    Article  PubMed  CAS  Google Scholar 

  30. Consentino M, Chey W, Takihara H, Cockett A. The effects of sulphasalazine on human male fertility and seminal prostaglandins. J Urol 1984; 57: 682–686.

    Google Scholar 

  31. Knigge U, Dejgaard A, Wollesen F, et al. The acute and long term effect of the H2-receptor anta gonists cimetidine and ranitidine on the pituitary-gonadal axis in men. Clin Endocrinol 1983; 118: 307–318.

    Article  Google Scholar 

  32. van Thiel D, Gavaler J, Smith W, Paul G. Hypothalamic-pituitary-gonadal dysfunction in men using cimetidine. N Eng J Med 1979; 300: 1012–1015.

    Article  Google Scholar 

  33. el-Hazami M, Bahakim H, al-Fawaz I. Endocrine functions in sickle-cell anemia patients. J Trop Pediatr 1991; 38: 307–313.

    Article  Google Scholar 

  34. Croxon T, Chapman W, Miller L, et al. Changes in the hypothalamic-pituitary-gonadal axis in human immunodeficiency virus-infected homosexual men. J Clin Endocrinol Metab 1989; 68: 317–321.

    Article  Google Scholar 

  35. de Paepe M, Waxman M. Testicular atrophy in AIDS:a study of 57 autopsy cases. Hum Pathol 1989; 20: 210–214.

    Article  PubMed  Google Scholar 

  36. Poretsky L, Can S, Zumoff B. Testicular dysfunction in human immunodeficiency virus-infected men. Metabolism 1995; 44: 946–953.

    Article  PubMed  CAS  Google Scholar 

  37. Wagner G, Rabkin J, Rabkin R. Illness stage, concurrent medications, and other correlates of low testosterone in men with HIV illness. J Acquired Immune Defic Syndrome Hum Retrovirol 1995; 8: 204–207.

    CAS  Google Scholar 

  38. Rabkin JG, Rabkin R, Wagner G. Testosterone replacement therapy in HIV illness. Gen Hosp Psychiatry 1995; 17: 37–42.

    Article  PubMed  CAS  Google Scholar 

  39. Luppa P, Munker R, Nagel D, Weber M, Engelhardt D. Serum androgens in intensive-care patients: correlations with clinical findings. Clin Endocrinol 1991; 34: 305–310.

    Article  CAS  Google Scholar 

  40. Spratt DI, Bigos ST, Beitins I, Cox P, Longcope C, Orav J. Both hyper-and hypogonadotroic occur transiently in acute illness: bio-and immunoactive gonado tropins. J Clin Endocrinol Metab 1992.

    Google Scholar 

  41. Plymate S, Vaughn G, Mason A, Pruitt B. Central hypogonadism in burned men. Horm Res 1987; 27: 152–158.

    Article  PubMed  CAS  Google Scholar 

  42. Nadin L, Butler A, Farrell G, Murray M. Pretranslational downregulation of cytochromes P 450 2c11 and 3A2 in male rat livers by tumor necrosis factor alpha.Gastroenterology 1995; 198–205.

    Google Scholar 

  43. Hales D. Interleukin-1 inhibits Leydig cell steroidogenesis primarily by decreasing 17 alph-hydroxylase C17–20lyase cytochrome P450 expression. Endocrinology 1992; 131: 2165–2172.

    Article  PubMed  CAS  Google Scholar 

  44. Warren D, Pasupuleti V, Lu Y, Platler B, Horton R. Tumor necrosis factor and interleukin-1 stimulate testosterone secretion in adulte male rat Leydig cells in vitro. J Andol 1990; 11: 353–360.

    CAS  Google Scholar 

  45. Amado J, L’opez-Espadas F, Vazquez-Barquero A, Salas J, Lopez-Cordovilla J, Garcia-Unzueta M. Blood levels of cytokines in brain-dead patients: relationship with circulating hormones and acute-phase reactants. Metabolism 1995; 44: 812–816.

    Article  PubMed  CAS  Google Scholar 

  46. Meikle A, Cardoso de Sousa J, Dacosta N, Bishop D, Samlowski W. Direct and indirect effects of murine interleukin-2, gamma interferon, and tumor necrosis factor on testosterone synthesis on mose Leydig cells. J Androl 1992; 13: 437–443.

    PubMed  CAS  Google Scholar 

  47. Barak V, Mordel N, Holzer H, Zajicek G, Treves A, Laufer N. The correlation of interleukin-1 and tumor necrosis factor to oestradiol, progesterone, and testosterone levels in periovulatory follicular fluid of in-vitro fertilization. Hum Reprod 1992; 7: 462–464.

    PubMed  CAS  Google Scholar 

  48. Watson M, Newman R, Payne A, Abdelrahim M, Francis G. The effect of macrophage conditioned media on Leydig cell function. Ann Clin Lab Sci 1994; 24: 84–95.

    PubMed  CAS  Google Scholar 

  49. Gray A, Feldman HA, McKinley JB, Longcope C. Age, disease, and changing sex hormone levels in middle-aged men: Results of the Massachusetts male aging study. J Clin Endocrinol Metab 1991; 73: 1016–1025.

    Article  PubMed  CAS  Google Scholar 

  50. Wang C, Chan V, Yeung R. Effect of surgical stress on pituitary-testicular function. Clin Endocrinol 1978; 9: 255–266.

    Article  CAS  Google Scholar 

  51. Wang C, Chan V, Yeung R. Effect of acute myocardial infarction on pituitary-testicular function. Clin Endocrinol 1978; 9: 249–253.

    Article  CAS  Google Scholar 

Download references

Authors
  1. Stephen R. Plymate MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert E. Jones MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Endocrinology and Metabolism, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC, USA

    K. Patrick Ober MD

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Plymate, S.R., Jones, R.E. (1997). Testicular Function in Critical Illness. In: Ober, K.P. (eds) Endocrinology of Critical Disease. Contemporary Endocrinology, vol 4. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-4757-2584-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-2584-1_14

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-032-8

  • Online ISBN: 978-1-4757-2584-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation