Testosterone Health Dictionary

Finasteride is a drug which inhibits the ENZYME that metabolises TESTOSTERONE into the more potent ANDROGEN, dihydrotestosterone. This action results in a reduction of prostate tissue. The drug is used to treat an enlarged PROSTATE GLAND, thus improving urinary ?ow. Its side-effects include reduced LIBIDO, and IMPOTENCE. Finasteride o?ers an alternative to PROSTATECTOMY for some men but a signi?cant minority do not improve. Women of childbearing age should not handle broken or crushed tablets.... finasteride

The general term for any one of a group of HORMONES which govern the development of the sexual organs and the secondary sexual characteristics of the male. TESTOSTERONE, the androgenic hormone formed in the interstitial cells of the testis (see TESTICLE), controls the development and maintenance of the male sex organs and secondary sex characteristics. In small doses it increases the number of spermatozoa (see SPERMATOZOON) produced, but in large doses it inhibits the gonadotrophic activity of the anterior PITUITARY GLAND and suppresses the formation of the spermatozoa. It is both androgenic and anabolic in action. The anabolic e?ect includes the ability to stimulate protein synthesis and to diminish the catabolism of amino acids, and this is associated with retention of nitrogen, potassium, phosphorus and calcium. Doses in excess of 10 mg daily to the female may produce VIRILISM.

Unconjugated testosterone is rarely used clinically because its derivatives have a more powerful and prolonged e?ect, and because testosterone itself requires implantation into the subcutaneous fat using a trocar and cannula for maximum therapeutic bene?t. Testosterone propionate is prepared in an oily solution, as it is insoluble in water; it is e?ective for three days and is therefore administered intramuscularly twice weekly. Testosterone phenyl-propionate is a long-acting microcrystalline preparation which, when given by intramuscular or subcutaneous injection, is e?ective for four weeks. Testosterone enantate is another long-acting intramuscular preparation. Mesterolone is an e?ective oral androgen and is less hepatoxic: it does not inhibit pituitary gonadotrophic production and hence spermatogenesis is unimpaired. Testosterone undecanoate is also an e?ective oral form.... androgen

The surgical removal of one or both of the testes. Orchidectomy may be performed for testicular cancer (see testis, cancer of) or gangrene due totorsion (see testis, torsion of), or to reduce production of testosterone in the treatment of cancer of the prostate gland (see prostate, cancer of). Removal of one testis does not affect sex drive, potency, or the ability to have children.... orchidectomy

Ashwagandha is the Ayurvedic equivalent of ginseng but heats the body less. It is well known for promoting semen and helps treat both infertility and impotency. So, the biggest issue I hear from clients who are looking for help in this area is that they are too stressed and don’t have enough energy for a healthy sex life. Enter ashwagandha. This herb boosts energy, reduces stress and has been shown to increase sperm count and the production of sex hormones (in either sex). The various active principles in this herb (alkaloids, anoloids, withanolides and other technical jargon) are sexually stimulating and support longevity. One thing, though—only take this herb when you’re, you know, in the moment (well, a few hours before you’re in the moment). The body can build up a tolerance for this herb and, as it can increase testosterone, it can cause aggression in some testosterone-sensitive people. My advice? Try taking one 500mg capsule a few times a week and see how it goes.... ashwagandha

(BPH) The benign buildup in the prostate of “warts” or epithelial neoplasias that can block or interrupt urination, and which are usually concurrent with moderate prostate enlargement. They cause a dull ache on urination, ejaculation, and/or defecation. The diagnosis is medical, since the same subjective conditions can result from cancer of the prostate. BPH is common in men over fifty and can be the result either of diminished production of complete testosterone or poor pelvic circulation. Alcohol, coffee, speed, and antihistamines can all aggravate the problem.... benign prostatic hypertrophy, or hyperplasia

Natural steroid hormones or synthetic analogues, usually taken for suppressing inflammation (and immunity) and therefore having cortisone-like functions, or taken as analogues to adrenocortical androgen...or even testosterone, in order to impress the other gym members, make varsity by your junior year or to join the WWF and get newbie-mangled for two years by The Hangman or even the Hulkster Himself. Then, if your gonads don’t fall off and your back holds up you get promoted to Good Guy, have your chance to Take A Name and finally wear your chosen costume...a spandex violet nurse’s uniform.... corticosteroids

Organs whose function it is to secrete into the blood or lymph, substances known as HORMONES. These play an important part in general changes to or the activities of other organs at a distance. Various diseases arise as the result of defects or excess in the internal secretions of the di?erent glands. The chief endocrine glands are:

Adrenal glands These two glands, also known as suprarenal glands, lie immediately above the kidneys. The central or medullary portion of the glands forms the secretions known as ADRENALINE (or epinephrine) and NORADRENALINE. Adrenaline acts upon structures innervated by sympathetic nerves. Brie?y, the blood vessels of the skin and of the abdominal viscera (except the intestines) are constricted, and at the same time the arteries of the muscles and the coronary arteries are dilated; systolic blood pressure rises; blood sugar increases; the metabolic rate rises; muscle fatigue is diminished. The super?cial or cortical part of the glands produces steroid-based substances such as aldosterone, cortisone, hydrocortisone, and deoxycortone acetate, for the maintenance of life. It is the absence of these substances, due to atrophy or destruction of the suprarenal cortex, that is responsible for the condition known as ADDISON’S DISEASE. (See CORTICOSTEROIDS.)

Ovaries and testicles The ovary (see OVARIES) secretes at least two hormones – known, respectively, as oestradiol (follicular hormone) and progesterone (corpus luteum hormone). Oestradiol develops (under the stimulus of the anterior pituitary lobe – see PITUITARY GLAND below, and under separate entry) each time an ovum in the ovary becomes mature, and causes extensive proliferation of the ENDOMETRIUM lining the UTERUS, a stage ending with shedding of the ovum about 14 days before the onset of MENSTRUATION. The corpus luteum, which then forms, secretes both progesterone and oestradiol. Progesterone brings about great activity of the glands in the endometrium. The uterus is now ready to receive the ovum if it is fertilised. If fertilisation does not occur, the corpus luteum degenerates, the hormones cease acting, and menstruation takes place.

The hormone secreted by the testicles (see TESTICLE) is known as TESTOSTERONE. It is responsible for the growth of the male secondary sex characteristics.

Pancreas This gland is situated in the upper part of the abdomen and, in addition to the digestive enzymes, it produces INSULIN within specialised cells (islets of Langerhans). This controls carbohydrate metabolism; faulty or absent insulin production causes DIABETES MELLITUS.

Parathyroid glands These are four minute glands lying at the side of, or behind, the thyroid (see below). They have a certain e?ect in controlling the absorption of calcium salts by the bones and other tissues. When their secretion is defective, TETANY occurs.

Pituitary gland This gland is attached to the base of the brain and rests in a hollow on the base of the skull. It is the most important of all endocrine glands and consists of two embryologically and functionally distinct lobes.

The function of the anterior lobe depends on the secretion by the HYPOTHALAMUS of certain ‘neuro-hormones’ which control the secretion of the pituitary trophic hormones. The hypothalamic centres involved in the control of speci?c pituitary hormones appear to be anatomically separate. Through the pituitary trophic hormones the activity of the thyroid, adrenal cortex and the sex glands is controlled. The anterior pituitary and the target glands are linked through a feedback control cycle. The liberation of trophic hormones is inhibited by a rising concentration of the circulating hormone of the target gland, and stimulated by a fall in its concentration. Six trophic (polypeptide) hormones are formed by the anterior pituitary. Growth hormone (GH) and prolactin are simple proteins formed in the acidophil cells. Follicle-stimulating hormone (FSH), luteinising hormone (LH) and thyroid-stimulating hormone (TSH) are glycoproteins formed in the basophil cells. Adrenocorticotrophic hormone (ACTH), although a polypeptide, is derived from basophil cells.

The posterior pituitary lobe, or neurohypophysis, is closely connected with the hypothalamus by the hypothalamic-hypophyseal tracts. It is concerned with the production or storage of OXYTOCIN and vasopressin (the antidiuretic hormone).

PITUITARY HORMONES Growth hormone, gonadotrophic hormone, adrenocorticotrophic hormone and thyrotrophic hormones can be assayed in blood or urine by radio-immunoassay techniques. Growth hormone extracted from human pituitary glands obtained at autopsy was available for clinical use until 1985, when it was withdrawn as it is believed to carry the virus responsible for CREUTZFELDT-JAKOB DISEASE (COD). However, growth hormone produced by DNA recombinant techniques is now available as somatropin. Synthetic growth hormone is used to treat de?ciency of the natural hormone in children and adults, TURNER’S SYNDROME and chronic renal insu?ciency in children.

Human pituitary gonadotrophins are readily obtained from post-menopausal urine. Commercial extracts from this source are available and are e?ective for treatment of infertility due to gonadotrophin insu?ciency.

The adrenocorticotrophic hormone is extracted from animal pituitary glands and has been available therapeutically for many years. It is used as a test of adrenal function, and, under certain circumstances, in conditions for which corticosteroid therapy is indicated (see CORTICOSTEROIDS). The pharmacologically active polypeptide of ACTH has been synthesised and is called tetracosactrin. Thyrotrophic hormone is also available but it has no therapeutic application.

HYPOTHALAMIC RELEASING HORMONES which affect the release of each of the six anterior pituitary hormones have been identi?ed. Their blood levels are only one-thousandth of those of the pituitary trophic hormones. The release of thyrotrophin, adrenocorticotrophin, growth hormone, follicle-stimulating hormone and luteinising hormone is stimulated, while release of prolactin is inhibited. The structure of the releasing hormones for TSH, FSH-LH, GH and, most recently, ACTH is known and they have all been synthesised. Thyrotrophin-releasing hormone (TRH) is used as a diagnostic test of thyroid function but it has no therapeutic application. FSH-LH-releasing hormone provides a useful diagnostic test of gonadotrophin reserve in patients with pituitary disease, and is now used in the treatment of infertility and AMENORRHOEA in patients with functional hypothalamic disturbance. As this is the most common variety of secondary amenorrhoea, the potential use is great. Most cases of congenital de?ciency of GH, FSH, LH and ACTH are due to defects in the hypothalamic production of releasing hormone and are not a primary pituitary defect, so that the therapeutic implication of this synthesised group of releasing hormones is considerable.

GALACTORRHOEA is frequently due to a microadenoma (see ADENOMA) of the pituitary. DOPAMINE is the prolactin-release inhibiting hormone. Its duration of action is short so its therapeutic value is limited. However, BROMOCRIPTINE is a dopamine agonist with a more prolonged action and is e?ective treatment for galactorrhoea.

Thyroid gland The functions of the thyroid gland are controlled by the pituitary gland (see above) and the hypothalamus, situated in the brain. The thyroid, situated in the front of the neck below the LARYNX, helps to regulate the body’s METABOLISM. It comprises two lobes each side of the TRACHEA joined by an isthmus. Two types of secretory cells in the gland – follicular cells (the majority) and parafollicular cells – secrete, respectively, the iodine-containing hormones THYROXINE (T4) and TRI-IODOTHYRONINE (T3), and the hormone CALCITONIN. T3 and T4 help control metabolism and calcitonin, in conjunction with parathyroid hormone (see above), regulates the body’s calcium balance. De?ciencies in thyroid function produce HYPOTHYROIDISM and, in children, retarded development. Excess thyroid activity causes thyrotoxicosis. (See THYROID GLAND, DISEASES OF.)... endocrine glands

Goat weed helps enhance both blood testosterone and sperm production in animals. In human men, this herb is known to promote both sperm production and the male sex drive. It also helps in some cases of impotence. In women, this herb helps ease fatigue and postmenopausal hypertension.... goat weed

Gonadotrophins, or gonadotrophic hormones, are hormones that control the activity of the gonads (i.e. the testes and ovaries). In the male they stimulate the secretion of TESTOSTERONE and the production of spermatozoa (see SPERMATOZOON); in the female they stimulate the production of ova (see OVUM) and the secretion of OESTROGENS and PROGESTERONE. There are two gonadotrophins produced by the PITUITARY GLAND. CHORIONIC GONADOTROPHIC HORMONE is produced in the PLACENTA and excreted in the urine.... gonadotrophins

Having either low secretion levels of testosterone by the testes, having low functional effects because of poor circulation, having competition by less active testosterone metabolites, or having high levels of adipose-released estradiol (former testosterone) in obesity that ends up suppressing testosterone. There are, of course, organic diseases that can cause the condition.... hypotestosteronism

A hormone secreted by the anterior PITUITARY GLAND which stimulates OVULATION, maturation of the CORPUS LUTEUM, and the synthesis of progesterone by the ovary (see OVARIES) and testosterone by the testis (see TESTICLE).... luteinising hormone

Dioscorea spp.

Dioscoreaceae

The growing need for steroidal drugs and the high cost of obtaining them from animal sources led to a widespread search for plant sources of steroidal sapogenins, which ultimately led to the most promising one. It is the largest genus of the family constituted by 600 species of predominantly twining herbs. Among the twining species, some species twine clockwise while others anti-clockwise (Miege, 1958). All the species are dioceous and rhizomatous. According to Coursey (1967), this genus is named in honour of the Greek physician Pedenios Dioscorides, the author of the classical Materia Medica Libri Quinque. Some of the species like D. alata and D. esculenta have been under cultivation for a long time for their edible tubers. There are about 15 species of this genus containing diosgenin. Some of them are the following (Chopra et al, 1980).

D. floribunda Mart. & Gal.

D. composita Hemsl; syn. D. macrostachya Benth.

D. deltoidea Wall. ex Griseb; syn. D. nepalensis Sweet ex Bernardi.

D. aculeata Linn. syn. D. esculenta

D. alata Linn. syn. D. atropurpurea Roxb.

D. Globosa Roxb; D. purpurea Roxb; D. rubella Roxb.

D. bulbifera Linn. syn. D. crispata Roxb.

D. pulchella Roxb.; D. sativa Thunb. Non Linn.

D. versicolor Buch. Ham. Ex Wall.

D. daemona Roxb. syn. D. hispida Dennst.

D. oppositifolia Linn.

D. pentaphylla Linn. syn. D. jacquemontii Hook. f.

D. triphylla Linn.

D. prazeri Prain & Burkil syn. D. clarkei Prain & Burkill

D. deltoidea Wall. var. sikkimensis Prain

D. sikkimensis Prain & Burkill

Among the above said species, D. floribunda, D. composita and D. deltoidea are widely grown for diosgenin production.

1. D. floribunda Mart. & Gal D. floribunda Mart. & Gal. is an introduction from central America and had wide adaptation as it is successfully grown in Karnataka, Assam, Meghalaya, Andaman and Goa. The vines are glabrous and left twining. The alternate leaves are borne on slender stems and have broadly ovate or triangular ovate, shallowly cordate, coriaceous lamina with 9 nerves. The petioles are 5-7cm long, thick and firm. Variegation in leaves occurs in varying degrees. The male flowers are solitary and rarely in pairs. Female flowers have divericate stigma which is bifid at apex. The capsule is obovate and seed is winged all round. The tubers are thick with yellow coloured flesh, branched and growing upto a depth of 30cm (Chadha et al, 1995).

2. D. composita Hemsl.

D. composita Hemsl. according to Knuth (1965) has the valid botanical name as D. macrostachya Benth. However, D. composita is widely used in published literature. It is a Central American introduction into Goa, Jammu, Bangalore, Anaimalai Hills of Tami Nadu and Darjeeling in W. Bengal. The vines are right twinning and nearly glabrous. The alternate leaves have long petioles, membraneous or coriaceous lamina measuring upto 20x18cm, abruptly acute or cuspidate-acuminate, shallowly or deeply cordate, 7-9 nerved. The fasciculate-glomerate inflorescence is single or branched with 2 or 3 sessile male flowers having fertile stamens. Male fascicle is 15-30cm long. The female flowers have bifid stigma. Tubers are large, white and deep-rooted (upto 45cm) (Chadha et al, 1995).

3. D. deltoidea Wall. ex. Griseb.

D. deltoidea Wall. ex. Griseb. is distributed throughout the Himalayas at altitudes of 1000-3000m extending over the states of Jammu-Kashmir, H. P, U. P, Sikkim and further into parts of W. Bengal. The glabrous and left twining stem bears alternate petiolate leaves. The petioles are 5-12 cm long. The lamina is 5-15cm long and 4-12cm wide widely cordate. The flowers are borne on axillary spikes, male spikes 8-40cm long and stamens 6. Female spikes are 15cm long, 3. 5cm broad and 4-6 seeded. Seeds are winged all round. Rhizomes are lodged in soil, superficial, horizontal, tuberous, digitate and chestnut brown in colour (Chadha et al, 1995). D. deltoidea tuber grows parallel to ground covered by small scale leaves and is described as rhizome. The tubers are morphologically cauline in structure with a ring of vascular bundles in young tubers which appear scattered in mature tubers (Purnima and Srivastava, 1988). Visible buds are present unlike in D. floribunda and D. composita where the buds are confined to the crown position (Selvaraj et al, 1972).

Importance of Diosgenin: Diosgenin is the most important sapogenin used as a starting material for synthesis of a number of steroidal drugs. For commercial purposes, its -isomer, yamogenin is also taken as diosgenin while analysing the sample for processing. Various steroidal drugs derived from diosgenin by artificial synthesis include corticosteroids, sex hormones, anabolic steroids and oral contraceptives. Corticosteroids are the most important group of steroidal drugs synthesized from diosgenin. First group of corticosteroids regulates carbohydrate and protein metabolism. The second group consists of aldosterone, which controls balance of potassium, sodium and water in the human body. The glucocorticoids in the form of cortisone and hydrocortisone are used orally, intramuscularly or topically for treatment of rheumatoid arthritis, rheumatic fever, other collegen diseases, ulcerative colitis, certain cases of asthma and a number of allergic diseases affecting skin, eye and the ear. These are also used for treatment of gout and a variety of inflammations of skin, eye and ear and as replacement therapy in Addison’s diseases. The minerato corticoides, desoxycorticosterone or desoxycortone are used in restoring kidney functions in cases of cortical deficiency and Addison’s disease.

Both male and female sex hormones are also synthesized from disosgenin. The main male sex hormone (androgen) which is produced from disogenin is testosterone. The main female sex hormones produced are oestrogen and progesterone. Recently oestrogen has also been used in cosmetic lotions and creams to improve the tone and colour of skin. One of the main uses of progesterone during recent years has been as antifertility agent for oral contraceptives. These artificial steroids have increased oral activity and fewer side effects, as they can be used in reduced doses. Oral contraceptives are also used for animals like pigs, cows and sheep to control fertility and to give birth at a prescribed period in a group of animals at the same time. These compounds are also used to reduce the interval between the lactation periods to have more milk and meat production. Anti-fertility compounds are also used as a pest-control measure for decreasing the multiplication of pests like rodents, pigeons and sea gulls (Husain et al, 1979).

Although yam tubers contain a variety of chemical substances including carbohydrates, proteins, alkaloids and tannins, the most important constituents of these yams are a group of saponins which yield sapogenins on hydrolysis. The most imp ortant sapogenin found in Dioscorea are diosgenin, yamogenin and pannogenin. Diosgenin is a steroid drug precursor. The diogenin content varies from 2-7% depending on the age of the tubers. Saponins including 5 spirastanol glucoside and 2 furostanol glucoside, 4 new steroid saponins, floribunda saponins C, D, E and F. Strain of A and B are obtained from D. floribunda (Husain et al, 1979). Rhizomes of D. deltoidea are a rich source of diosgenin and its glycoside. Epismilagenin and smilagenone have been isolated from D. deltoidea and D. prazeri (Chakravarti et al, 1960; 1962). An alkaloid dioscorine has been known to occur in D. hispida (Bhide et al,1978). Saponin of D. prazeri produced a fall of blood pressure when given intravenously and saponin of D. deltoidea has no effect on blood pressure (Chakravarti et al,1963). Deltonin, a steroidal glycoside, isolated from rhizomes of D. deltoidea showed contraceptive activity (Biokova et al, 1990).

Agrotechnology: Dioscorea species prefer a tropical climate without extremity in temperature. It is adapted to moderate to heavy rainfall area. Dioscorea plants can be grown in a variety of soils, but light soil is good, as harvesting of tubers is easier in such soils. The ideal soil pH is 5.5-6.5 but tolerates fairly wide variation in soil pH. Dioscorea can be propagated by tuber pieces, single node stem cuttings or seed. Commercial planting is normally established by tuber pieces only. Propagation through seed progeny is variable and it may take longer time to obtain tuber yields. IIHR, Bangalore has released two improved varieties, FB(c) -1, a vigorously growing strain relatively free from diseases and Arka Upkar, a high yielding clone. Three types of tuber pieces can be distinguished for propagation purpose, viz. (1) crown (2) median and (3) tip, of which crowns produce new shoots within 30 days and are therefore preferred. Dipping of tuber pieces for 5 minutes in 0.3% solution of Benlate followed by dusting the cut ends with 0.3% Benlate in talcum powder in mo ist sand beds effectively checks the tuber rot. The treatment is very essential for obtaining uniform stand of the crop. The best time of planting is the end of April so that new sprouts will grow vigorously during the rainy season commencing in June in India. Land is to be prepared thoroughly until a fine tilth is obtained. Deep furrows are made at 60cm distance with the help of a plough. The stored tuber pieces which are ready for planting is to be planted in furrows with 30cm between the plants for one year crop and 45cm between the plants for 2 year crop at about 0.5 cm below soil level. The new sprouts are to be staked immediately. After sprouting is complete, the plants are to be earthed up. Soil from the ridges may be used for earthing up so that the original furrows will become ridges and vice versa. Dioscorea requires high organic matter for good tuber formation. Besides a basal doze of 18-20t of FYM/ha, a complete fertilizer dose of 300kg N, 150kg P2O5 and K2O each are to be applied per hectare. P and K are to be applied in two equal doses one after the establishment of the crop during May-June and the other during vigorous growth period of the crop (August- September). Irrigation may be given at weekly intervals in the initial stage and afterwards at about 10 days interval. Dioscorea vines need support for their optimum growth and hence the vines are to be trailed over pandal system or trellis. Periodic hand weeding is essential for the first few months. Intercropping with legumes has been found to smother weeds and provide extra income. The major pests of Dioscorea are the aphids and red spider mites. Aphids occur more commonly on young seedlings and vines. Young leaves and vine tips eventually die if aphids are not controlled. Red spider mites attack the underside of the leaves at the base near the petiole. Severe infestations result in necrotic areas, which are often attacked by fungi. Both aphids and spider mites can be very easily controlled by Kelthane. No serious disease is reported to infect this crop. The tubers grow to about 25-30 cm depth and hence harvesting is to be done by manual labour. The best season for harvesting is Feb-March, coinciding with the dry period. On an average 50-60t/ha of fresh tubers can be obtained in 2 years duration. Diosgenin content tends to increase with age, 2.5% in first year and 3-3.5% in the second year. Hence, 2 year crop is economical (Kumar et al, 1997).... medicinal yams

A means of avoiding pregnancy despite sexual activity. There is no ideal contraceptive, and the choice of method depends on balancing considerations of safety, e?ectiveness and acceptability. The best choice for any couple will depend on their ages and personal circumstances and may well vary with time. Contraceptive techniques can be classi?ed in various ways, but one of the most useful is into ‘barrier’ and ‘non-barrier’ methods.

Barrier methods These involve a physical barrier which prevents sperm (see SPERMATOZOON) from reaching the cervix (see CERVIX UTERI). Barrier methods reduce the risk of spreading sexually transmitted diseases, and the sheath is the best protection against HIV infection (see AIDS/HIV) for sexually active people. The e?ciency of barrier methods is improved if they are used in conjunction with a spermicidal foam or jelly, but care is needed to ensure that the preparation chosen does not damage the rubber barrier or cause an allergic reaction in the users. CONDOM OR SHEATH This is the most commonly used barrier contraceptive. It consists of a rubber sheath which is placed over the erect penis before intromission and removed after ejaculation. The failure rate, if properly used, is about 4 per cent. DIAPHRAGM OR CAP A rubber dome that is inserted into the vagina before intercourse and ?ts snugly over the cervix. It should be used with an appropriate spermicide and is removed six hours after intercourse. A woman must be measured to ensure that she is supplied with the correct size of diaphragm, and the ?t should be checked annually or after more than about 7 lbs. change in weight. The failure rate, if properly used, is about 2 per cent.

Non-barrier methods These do not provide a physical barrier between sperm and cervix and so do not protect against sexually transmitted diseases, including HIV. COITUS INTERRUPTUS This involves the man’s withdrawing his penis from the vagina before ejaculation. Because some sperm may leak before full ejaculation, the method is not very reliable. SAFE PERIOD This involves avoiding intercourse around the time when the woman ovulates and is at risk of pregnancy. The safe times can be predicted using temperature charts to identify the rise in temperature before ovulation, or by careful assessment of the quality of the cervical mucus. This method works best if the woman has regular menstrual cycles. If used carefully it can be very e?ective but requires a highly disciplined couple to succeed. It is approved by the Catholic church.

SPERMICIDAL GELS, CREAMS, PESSARIES, ETC.

These are supposed to prevent pregnancy by killing sperm before they reach the cervix, but they are unreliable and should be used only in conjunction with a barrier method.

INTRAUTERINE CONTRACEPTIVE DEVICE (COIL) This is a small metal or plastic shape, placed inside the uterus, which prevents pregnancy by disrupting implantation. Some people regard it as a form of abortion, so it is not acceptable to all religious groups. There is a risk of pelvic infection and eventual infertility in women who have used coils, and in many countries their use has declined substantially. Coils must be inserted by a specially trained health worker, but once in place they permit intercourse at any time with no prior planning. Increased pain and bleeding may be caused during menstruation. If severe, such symptoms may indicate that the coil is incorrectly sited, and that its position should be checked. HORMONAL METHODS Steroid hormones have dominated contraceptive developments during the past 40 years, with more than 200 million women worldwide taking or having taken ‘the pill’. In the past 20 years, new developments have included modifying existing methods and devising more e?ective ways of delivering the drugs, such as implants and hormone-releasing devices in the uterus. Established hormonal contraception includes the combined oestrogen and progesterone and progesterone-only contraceptive pills, as well as longer-acting depot preparations. They modify the woman’s hormonal environment and prevent pregnancy by disrupting various stages of the menstrual cycle, especially ovulation. The combined oestrogen and progesterone pills are very e?ective and are the most popular form of contraception. Biphasic and triphasic pills contain di?erent quantities of oestrogen and progesterone taken in two or three phases of the menstrual cycle. A wide range of preparations is available and the British National Formulary contains details of the commonly used varieties.

The main side-e?ect is an increased risk of cardiovascular disease. The lowest possible dose of oestrogen should be used, and many preparations are phasic, with the dose of oestrogen varying with the time of the cycle. The progesterone-only, or ‘mini’, pill does not contain any oestrogen and must be taken at the same time every day. It is not as e?ective as the combined pill, but failure rates of less than 1-per-100 woman years can be achieved. It has few serious side-effects, but may cause menstrual irregularities. It is suitable for use by mothers who are breast feeding.

Depot preparations include intramuscular injections, subcutaneous implants, and intravaginal rings. They are useful in cases where the woman cannot be relied on to take a pill regularly but needs e?ective contraception. Their main side-e?ect is their prolonged action, which means that users cannot suddenly decide that they would like to become pregnant. Skin patches containing a contraceptive that is absorbed through the skin have recently been launched.

HORMONAL CONTRACEPTION FOR MEN There is a growing demand by men worldwide for hormonal contraception. Development of a ‘male pill’, however, has been slow because of the potentially dangerous side-effects of using high doses of TESTOSTERONE (the male hormone) to suppress spermatogenesis. Progress in research to develop a suitable ANDROGEN-based combination product is promising, including the possibility of long-term STEROID implants. STERILISATION See also STERILISATION – Reproductive sterilisation. The operation is easier and safer to perform on men than on women. Although sterilisation can sometimes be reversed, this cannot be guaranteed and couples should be counselled in advance that the method is irreversible. There is a small but definite failure rate with sterilisation, and this should also be made clear before the operation is performed. POSTCOITAL CONTRACEPTION Also known as emergency contraception or the ‘morning after pill’, postcoital contraception can be e?ected by two di?erent hormonal methods. Levonorgesterol (a synthetic hormone similar to the natural female sex hormone PROGESTERONE) can be used alone, with one pill being taken within 72 hours of unprotected intercourse, but preferably as soon as possible, and a second one 12 hours after the ?rst. Alternatively, a combined preparation comprising ETHINYLESTRADIOL and levonorgesterol can be taken, also within 72 hours of unprotected intercourse. The single constituent pill has fewer side-effects than the combined version. Neither version should be taken by women with severe liver disease or acute PORPHYRIAS, but the ethinylestradiol/levonorgesterol combination is unsuitable for women with a history of THROMBOSIS.

In the UK the law allows women over the age of 16 to buy the morning-after pill ‘over the counter’ from a registered pharmacist.... contraception

Sexual activity with a member of the same sex. There has been considerable debate among psychiatrists as to whether homosexuality should be regarded as a normal sexual variant or as a psycho-pathological development or deviation. Although homosexuality is found in virtually every society and culture, there is no society in which it is the predominant or preferred mode of sexual activity. Various attempts have been made to link homosexuality to hormonal factors, particularly lowered TESTOSTERONE levels, or to ?nd a genetic explanation, but there is no evidence for either. Psychoanalytic theories link homosexuality to early child-rearing in?uences, in particular the close-binding and intimate mother.

The number of homosexual men and women in the UK is unknown. Re-analysis of the Kinsey report suggests that only 3 per cent of adult men have exclusively homosexual leanings and a further 3 per cent have extensive homosexual and heterosexual experience. Homosexuality among women (lesbianism) seems to be less common. Some homosexual men have high rates of sexual activity and multiple partners and, as with heterosexual men and women, this increases the risk of acquiring sexually transmitted diseases, unless appropriate precautionary measures are taken – for example, the use of condoms for penetrative sex, whether vaginal or anal. It was in homosexual males that the virus responsible for AIDS (see AIDS/HIV) was ?rst identi?ed, but the infection now occurs in both sexes.... homosexuality

(LH) This is a sugar-bearing protein manufactured by the anterior pituitary. Like a lot of the pituitary hormones, it surges on and off, since constant secretion would overload and deaden receptors. In women, it builds up after menses, stimulating the release of estrogen from the ovaries. Estrogen in turn stimulates the hypothalamus to increase its stimulation of LH from the pituitary, until, a day or two before ovulation, they produce a guitar-amp feedback, and the cells that produce LH start to surge follicle-stimulating hormone (FSH). The egg pops, being replaced by the corpus luteum, which produces progesterone for the next eleven to twelve days. Progesterone inhibits and lowers LH levels, as well as inhibiting levels of estrogen already being produced by the young follicles that will produce next month’s egg. In men, LH is responsible for stimulation of testosterone, although FSH and the testes hormone inhibin are responsible for both the production of sperm and controlling testosterone.... luteinizing hormone

Maca is a native plant of Peru and is used to increase libido, strength, stamina, and energy (I know, right? It’s like the perfect herb. Time to bake it into some cookies and deliver them to that co-worker/friend/neighbor you’ve had your eye on…). Further, maca can normalize all the sex hormones: testosterone, progesterone, and estrogen (i.e. a great option for combating the natural hormonal downslide that occurs with aging). If fertility issues are on your radar, maca is a great herb to include, as it regulates menstrual cycles and eases cycle pain. For menopause? Again, spotlight on hormones. Maca can ease this transition as well. It also decreases stress which, as we know, is a major downer to any sexual liaison. How to take maca? Well, you can buy it in supplement form, but you’re going to need a lot of it. I don’t care what the bottle says, you want to aim for 6-10 500mg capsules per day (at least!). Or, you can buy the powdered herb and blend a tablespoon into a smoothie or juice every day. The more you take? The better. There are no toxic side effects to this herb.... maca (lepidium meyenii)

Characterised by scanty (or absent) MENSTRUATION, INFERTILITY, hirsutism (excessive hairiness) and OBESITY and the sufferers often have multiple cysts in their OVARIES.

The condition is caused by an imbalance between LUTEINISING HORMONE (LH) and FOLLICLE-STIMULATING HORMONE (FSH); this imbalance stops OVULATION and varies the TESTOSTERONE output of the ovaries. The treatment may be with CLOMIPHENE; with a PROGESTOGEN drug; with LUTEINISING HORMONE-RELEASING HORMONE (LHRH); or with oral contraceptives (see under CONTRACEPTION – Non-barrier methods). The treatment chosen depends on the severity of the disease and whether the woman wants to conceive. Rarely a section of ovarian tissue is surgically removed.... polycystic ovary syndrome

Linn. var. italica Kochne.

Family: Salicaceae.

Habitat: North-western Himalaya at 900-3,700 m.

English: Black Lombardy Poplar.

Action: Bark and balsam from leaf bud— used for cold. Bark— depurative. Leaf bud—antiseptic, anti- inflammatory.

The bud exudate contains dimethyl- caffeic acid, which was found active against herpes simplex virus type 1.

A 50% ethanol extract of a mixture of flowers and buds showed 11% inhibition of enzymatic conversion of testosterone into 5 alpha-dihydrotesterone and 4-androstene-3,17-dione. The extract was partitioned between ethylac- etate and water and the resultant ethy- lacetate fraction contained the active compounds, pinobanksin, demethyl- quercetin and pinocembrin. It exhibited 15% inhibitory activity on the enzyme. Pinocembrin was the most potent, almost equal to estradiol, which was used as a control.

The bark of all Populus species contains, phenolic glycosides, salicin and populin (salicinbenzoate). Tannins are also present (5-9%).

Both salicin and populin cause elimination of uric acid. Salicin is antiperi- odic and is used like quinine in intermittent fever, also in coryza, rheumatism and neuralgia.... populus nigra

This is a walnut-sized gland that surrounds the beginning of the urethra in men. It secretes the alkaline transport fluid that mixes with sperm from the testes to form semen. The prostate needs adequate anabolic steroid stimulation for its health and growth, especially testosterone. Because of diminished healthy hormone levels, pelvic congestion, and decreased blood (and hormone) circulation, or because of sexually transmitted or urinary tract infections, a male may get prostatitis. (See BPH.)... prostate

Sarsaparilla possesses saparins, which are believed to imitate the action of some of the human hormones. Sarsaparilla is used as a supportive tonic for the male reproductive system in particular. It helps regulate a healthy routine of both progesterone and testosterone production, which both increase male sexual energy.... sarsaparilla

Medicines are drugs made stable, palatable and acceptable for administration. In Britain, the Medicines Act 1968 controls the making, advertising and selling of substances used for ‘medicinal purposes’, which means diagnosing, preventing or treating disease, or altering a function of the body. Permission to market a medicine has to be obtained from the government through the MEDICINES CONTROL AGENCY, or from the European Commission through the European Medicines Evaluation Agency. It takes the form of a Marketing Authorisation (formerly called a Product Licence), and the uses to which the medicine can be put are laid out in the Summary of Product Characteristics (which used to be called the Product Data Sheet).

There are three main categories of licensed medicinal product. Drugs in small quantities can, if they are perceived to be safe, be licensed for general sale (GSL – general sales list), and may then be sold in any retail shop. P (pharmacy-only) medicines can be sold from a registered pharmacy by or under the supervision of a pharmacist (see PHARMACISTS); no prescription is needed. P and GSL medicines are together known as OTCs – that is, ‘over-thecounter medicines’. POM (prescription-only medicines) can only be obtained from a registered pharmacy on the prescription of a doctor or dentist. As more information is gathered on the safety of drugs, and more emphasis put on individual responsibility for health, there is a trend towards allowing drugs that were once POM to be more widely available as P medicines. Examples include HYDROCORTISONE 1 per cent cream for skin rashes, CIMETIDINE for indigestion, and ACICLOVIR for cold sores. Care is needed to avoid taking a P medicine that might alter the actions of another medicine taken with it, or that might be unsuitable for other reasons. Patients should read the patient-information lea?et, and seek the pharmacist’s advice if they have any doubt about the information. They should tell their pharmacist or doctor if the medicine results in any unexpected effects.

Potentially dangerous drugs are preparations referred to under the Misuse of Drugs Act 1971 and subsequent regulations approved in 1985. Described as CONTROLLED DRUGS, these include such preparations as COCAINE, MORPHINE, DIAMORPHINE, LSD (see LYSERGIC ACID

DIETHYLAMIDE (LSD)), PETHIDINE HYDROCHLORIDE, AMPHETAMINES, BARBITURATES and most BENZODIAZEPINES.

Naming of drugs A European Community Directive (92/27/EEC) requires the use of the Recommended International Non-proprietary Name (rINN) for medicinal substances. For most of these the British Approved Name (BAN) and rINN were identical; where the two were di?erent, the BAN has been modi?ed in line with the rINN. Doctors and other authorised subscribers are advised to write titles of drugs and preparations in full because uno?cial abbreviations may be misinterpreted. Where a drug or preparation has a non-proprietary (generic) title, this should be used in prescribing unless there is a genuine problem over the bioavailability properties of a proprietary drug and its generic equivalent.

Where proprietary – commercially registered

– names exist, they may in general be used only for products supplied by the trademark owners. Countries outside the European Union have their own regulations for the naming of medicines.

Methods of administration The ways in which drugs are given are increasingly ingenious. Most are still given by mouth; some oral preparations (‘slow release’ or ‘controlled release’ preparations) are designed to release their contents slowly into the gut, to maintain the action of the drug.

Buccal preparations are allowed to dissolve in the mouth, and sublingual ones are dissolved under the tongue. The other end of the gastrointestinal tract can also absorb drugs: suppositories inserted in the rectum can be used for their local actions – for example, as laxatives – or to allow absorption when taking the drug by mouth is di?cult or impossible – for example, during a convulsion, or when vomiting.

Small amounts of drug can be absorbed through the intact skin, and for very potent drugs like OESTROGENS (female sex hormones) or the anti-anginal drug GLYCERYL TRINITRATE, a drug-releasing ‘patch’ can be used. Drugs can be inhaled into the lungs as a ?ne powder to treat or prevent ASTHMA attacks. They can also be dispersed (‘nebulised’) as a ?ne mist which can be administered with compressed air or oxygen. Spraying a drug into the nostril, so that it can be absorbed through the lining of the nose into the bloodstream, can avoid destruction of the drug in the stomach. This route is used for a small number of drugs like antidiuretic hormone (see VASOPRESSIN).

Injection remains an important route of administering drugs both locally (for example, into joints or into the eyeball), and into the bloodstream. For this latter purpose, drugs can be given under the skin – that is, subcutaneously (s.c. – also called hypodermic injection); into muscle – intramuscularly (i.m.); or into a vein – intravenously (i.v.). Oily or crystalline preparations of drugs injected subcutaneously form a ‘depot’ from which they are absorbed only slowly into the blood. The action of drugs such as TESTOSTERONE and INSULIN can be prolonged by using such preparations, which also allow contraceptive ‘implants’ that work for some months (see CONTRACEPTION).... medicines

Fluid produced by the male on ejaculation from the penis at sexual orgasm. Each ejaculate contains up to 500 million spermatozoa (male germ cells) suspended in a ?uid that is secreted by the PROSTATE GLAND, seminal vesicles (see TESTICLE), and Cowper’s glands – a pair of small glands (also called the bulbo-urethral glands) that open into the URETHRA at the base of the penis. Semen, or seminal ?uid, contains a form of sugar (fructose) essential for the motility of sperm. The hormone TESTOSTERONE is a key element in the production of sperm and of seminal ?uid.... semen

Presence of hair in areas where it is not usually found and excessive growth. Due to excess of the male hormone, testosterone in the blood. More common in women. Women smokers face threat of hirsutism. Ovarian cyst is often a forerunner of hirsutism, as also is hormone imbalance. Alternatives. Agnus Castus, (tea, tablets or tincture). Evening Primrose oil capsules: 500mg thrice daily.

Red Clover tea. (Walter Thompson, MNIMH)

Vitamin E capsules: 400iu thrice daily. Vitamin A-rich foods. Zinc supplement. ... hirsutism

The removal of the testes (see orchidectomy). The term is sometimes used for removal of the ovaries (see oophorectomy). Castration is performed when organs are diseased or to reduce the level of testosterone or of oestrogen in people who have certain types of cancer that are stimlated by these hormones.... castration

A group of hormonal or hormone-related drugs used to treat some types of infertility.

In women, fertility drugs may be given when abnormal hormone production by the pituitary gland or ovaries disrupts ovulation or causes mucus around the cervix to become so thick that sperm cannot penetrate it. In men, fertility drugs are less effective, but they may be used when abnormal hormone production by the pituitary gland or testes interferes with sperm production. (See also clomifene; gonadotrophin hormones; testosterone.)... fertility drugs

Linn.

Family: Poaceae.

Habitat: Ladakh, Lahul and other north-western Himalayan areas; and as host for cultivation of medicinal ergot (fungus) in Kashmir.

English: Rye Grass.

Action: Grass—used for benign prostatic hyperplasia (BPH), chronic prostatis and prostatodynia.

Rye bread, biscuits, porridge and alcoholic products are available in European countries and the US. Rye grain contains 12.1% protein; made up of 42% gliadin (a prolamine), 42% glutelin, 8% globulin and 8% albumin. The biological value of Rye protein at 5% level of intake is 80.4% and the coefficient of true digestibility 91.0%.

The mineral contents in the grain are: calcium 61, potassium 453, magnesium 155, phosphorus 376, sulphur 146 and iron 4.8 mg/100 g; and small amounts of zinc, copper, manganese and aluminium. The carbohydrates (73.4%) include surcose, pentosans, starch and raffinose.

Medicinally applicable part of Rye Grass is the polan extract. The extract contains beta-sitosterol; relaxes urethral smooth muscle tone and increases bladder muscle contraction. Some evidence suggests that it might affect alpha-adrenergic receptors and relax the internal and external bladder sphincter muscle. The extract does not affect LH, FSH, testosterone or dihydrotestosterone. A specific Rye Grass pollen extract 126 mg three times daily has been used for BHP. (Natural Medicines Comprehensive Database, 2007.)

(It is not known if Rye Grass pollen is comparable to finasteride or hytrin. However, it is comparable to Pygeum and Paraprost, a Japanese prostate remedy containing L-glutamic acid, L-alanine and aminoacetic acid.)... secale cereale

Miller.

Family: Liliaceae; Smilacaceae.

Habitat: Native to tropical America and the West Indies.

English: Sarsaparilla.

Unani: Ushbaa Maghrabi (Ushbaa Desi is equated with Decalepis hamiltonii.)

Action: Alterative, anti- inflammatory, antipruritic, blood purifier, antiseptic. (It was first introduced in 1563 as a drug for syphilis.)

In Western herbal, Sarsaparilla is equated with Smilax aristolochiaefo- lia (American, Mexican, Vera Cruz or Grey Sarsaparilla); S. medica, S. regelii (Jamaican, Honduras or Brown Sarsaparilla); S.febrifuga (Ecuadorian or Guayaquil Sarsaparilla). Hemides- mus indicus is equated with Indian Sarsaparilla.

Key application: Preparations of sarsaparilla root are used for skin diseases, psoriasis and its sequel, rheumatic complaints, kidney diseases, and as a diaphoretic and diuretic. (The claimed efficacy has not been established clinically.) Included among unapproved herbs by German Commission E.

The roots and rhizomes of sarsaparil- la contain saponins based on aglycones sarsapogenin and smilagenin, the major one being parillin (sarsaponin), with smilasaponin (smilacin) and sar- saparilloside; beta-sitosterol, stigmas- terol and their glucosides. Chief components of saponins (0.5-3%) are sar- saparilloside, along with parillin as a breakdown product. Parillin shows antibiotic activity.

Sarsaparilla root sterols are not anabolic steroids, nor are they converted in vivo to anabolic steroids. Testosterone, till now, has not been detected in any plant including sarsaparilla. Hemidesmus indicus contains none of the saponins or principal constituents found in sarsaparilla. (Natural Medicines Comprehensive Database, 2007.)... smilax aristolochiaefolia

Linn.

Family: Liliaceae.

Habitat: Japan, China and Cochin China.

Ayurvedic: Chobachini, Chopachi- ni, Dweepaantar-Vachaa, Madhus- nuhi, Hriddhaatri.

Unani: Chobchini.

Siddha/Tamil: Parangi chakkai.

Action: Tubers—used as alterative in venereal diseases, chronic skin diseases and rheumatic affections. Used as official sarsaparilla. (China of homoeopathic medicine is Peruvian bark, not Smilax china.)

Sarsaparilla (Smilax species) is used in Oriental as well as in Western herbal for its alterative, gentle circulatory stimulant and mild testosterone activity.

The root is known for its steroidal saponins. Pro-sapogenin-A of dioscin, dioscin, gracillin. Me-protogracillin, Me-protodioscin and its 22-hydroxy- analog; besides beta-sitosterol gluco- side, smilaxin, two furostan and one spirostane glycosides have been isolated from the root.

Dosage: Root—50-100 mg powder. (CCRAS.)... smilax china

An androgen hormone (male sex hormone) used as replacement therapy in hypogonadism because testosterone cannot be given orally.

Side effects can include prostate problems, headache, and depression.... mesterolone

The male sex cell, which is responsible for fertilization of the female ovum. Inside the head of the sperm is genetic material, while the acrosome that caps the head contains enzymes that enable sperm to penetrate the ovum’s outer covering. The tail of the sperm propels it.

Sperm are produced within the seminiferous tubules of the testes and mature in the epididymis.

Production and development of sperm cells is dependent on testosterone and on gonadotrophin hormones secreted by the pituitary gland.

Sperm production starts at puberty.... sperm

Drugs that have an anabolic (protein-building) effect similar to testosterone. Anabolic steroids build tissue, promote muscle recovery after an injury, and strengthen bones. They are used to treat to sounds in the body, particularly those made by the heart or lungs.... steroids, anabolic

The ?eld of medicine concerned with physical ?tness and the diagnosis and treatment of both acute and chronic sports injuries sustained during training and competition. Acute injuries are extremely common in contact sports, and their initial treatment is similar to that of those sustained in other ways, such as falls and road traf?c incidents. Tears of the muscles (see MUSCLES, DISORDERS OF), CONNECTIVE TISSUE and LIGAMENTS which are partial (sprains) are initially treated with rest, ice, compression, and elevation (RICE) of the affected part. Complete tears (rupture) of ligaments (see diagrams) or muscles, or fractures (see BONE, DISORDERS OF – Bone fractures) require more prolonged immobilisation, often in plaster, or surgical intervention may be considered. The rehabilitation of injured athletes requires special expertise

– an early graded return to activity gives the best long-term results, but doing too much too soon runs the risk of exacerbating the original injury.

Chronic (overuse) injuries affecting the bones (see BONE), tendons (see TENDON) or BURSAE of the JOINTS are common in many sports. Examples include chronic INFLAMMATION of the common extensor tendon where it

attaches to the later EPICONDYLE of the humerus – common in throwers and racquet sportspeople – and stress fractures of the TIBIA or METATARSAL BONES of the foot in runners. After an initial period of rest, management often involves coaching that enables the athlete to perform the repetitive movement in a less injury-susceptible manner.

Exercise physiology is the science of measuring athletic performance and physical ?tness for exercise. This knowledge is applied to devising and supervising training regimens based on scienti?c principles. Physical ?tness depends upon the rate at which the body can deliver oxygen to the muscles, known as the VO2max, which is technically di?cult to measure. The PULSE rate during and after a bout of exercise serves as a good proxy of this measurement.

Regulation of sport Sports medicine’s role is to minimise hazards for participants by, for example, framing rule-changes which forbid collapsing the scrum, which has reduced the risk of neck injury in rugby; and in the detection of the use of drugs taken to enhance athletic performance. Such attempts to gain an edge in competition undermine the sporting ideal and are banned by leading sports regulatory bodies. The Olympic Movement Anti-Doping Code lists prohibited substances and methods that could be used to enhance performance. These include some prohibited in certain circumstances as well as those completely banned. The latter include:

stimulants such as AMPHETAMINES, bromantan, ca?eine, carphedon, COCAINE, EPHEDRINE and certain beta-2 agonists.

NARCOTICS such as DIAMORPHINE (heroin), MORPHINE, METHADONE HYDROCHLORIDE and PETHIDINE HYDROCHLORIDE.

ANABOLIC STEROIDS such as methandione, NANDROLONE, stanazol, TESTOSTERONE, clenbuterol, androstenedone and certain beta-2 agonists.

peptide HORMONES, mimetics and analogues such as GROWTH HORMONE, CORTICOTROPHIN, CHORIONIC GONADOTROPHIC HORMONE, pituitary and synthetic GONADOTROPHINS, ERYTHROPOIETIN and INSULIN. (The list produced above is not comprehen

sive: full details are available from the governing bodies of relevant sports.) Among banned methods are blood doping (pre-competition administration of an athlete’s own previously provided and stored blood), administration of arti?cial oxygen carriers or plasma expanders. Also forbidden is any pharmacological, chemical or physical manipulation to affect the results of authorised testing.

Drug use can be detected by analysis of the URINE, but testing only at the time of competition is unlikely to detect drug use designed to enhance early-season training; hence random testing of competitive athletes is also used.

The increasing professionalism and competitiveness (among amateurs and juveniles as well as professionals) in sports sometimes results in pressures on participants to get ?t quickly after injury or illness. This can lead to

players returning to their activity before they are properly ?t – sometimes by using physical or pharmaceutical aids. This practice can adversely affect their long-term physical capabilities and perhaps their general health.... sports medicine

Every man has two testicles or testes which are the sexual glands. In the fetus, they develop in the abdomen, but before birth they descend into a fold or pouch of skin known as the SCROTUM. Each testicle consists of up to 1,000 minute tubes lined by cells from which the spermatozoa (see SPERMATOZOON) are formed. Around 4·5 million spermatozoa are produced per gram of testicle per day. These tubes communicate with one another near the centre of the testicle, and are connected by a much coiled tube, the EPIDIDYMIS, with the ductus, or VAS DEFERENS, which enters the abdomen and passes on to the base of the bladder. This duct, after joining a reservoir known as the seminal vesicle, opens, close to the duct from the other side of the body, into the URETHRA where it passes through the PROSTATE GLAND. Owing to the convolutions of these ducts leading from the testicles to the urethra, and their indirect route, the passage from testicle to urethra is over 6 metres (20 feet) in length. In addition to producing spermotozoa, the testicle also forms the hormone TESTOSTERONE which is responsible for the development of male characteristics.... testicle

One of 2 male sexual organs, also called testicles, that produce sperm and the hormone testosterone. The testes develop in the fetus within the abdomen and usually descend into the scrotum by birth or within the next few months.

Each testis contains seminiferous tubules that produce sperm. Cells between the seminiferous tubules produce testosterone.

Each testis is suspended by the spermatic cord, composed of the vas deferens, blood vessels, and nerves. (See also testis, undescended.)... testis

a drug used in the treatment of metastatic prostate cancer resistant to hormonal treatment. It reduces testosterone production in prostate and adrenal tissues by inhibiting an enzyme, cytochrome P450 17A1, involved in the androgen-producing pathway in these tissues (see anti-androgen). Side-effects include oedema, liver disorders, hypertension, and low potassium levels.... abiraterone acetate

n. the decline in production of testosterone that occurs with age in men. Unlike the female menopause, there is no circumscribed time at which testosterone production irreversibly ceases. Instead it tends to undergo a steady reduction from the third decade onwards.... andropause

n. see adrenarche; dehydroepiandrosterone; testosterone.... androstenedione

The previous subject is obviously an endless one, but as this is the glossary of an herbal nature, let me assure you, virtually no plants have a direct steroid hormone-mimicking effect. There are a few notable exceptions with limited application, like Cimicifuga and Licorice. Plant steroids are usually called phytosterols, and, when they have any hormonal effect at all, it is usually to interfere with human hormone functions. Beta sitosterol, found in lots of food, interferes with the ability to absorb cholesterol from the diet. Corn oil and legumes are two well-endowed sources that can help lower cholesterol absorption. This is of only limited value, however, since cholesterol is readily manufactured in the body, and elevated cholesterol in the blood is often the result of internal hormone and neurologic stimulus, not the diet. Cannabis can act to interfere with androgenic hormones, and Taraxacum phytosterols can both block the synthesis of some new cholesterol by the liver and increase the excretion of cholesterol as bile acids; but other than that, plants offer little direct hormonal implication. The first method discovered for synthesizing pharmaceutical hormones used a saponin, diosgenin, and a five-step chemical degradation, to get to progesterone, and another, using stigmasterol and bacterial culturing, to get to cortisol. These were chemical procedures that have nothing to do with human synthesis of such hormones, and the plants used for the starting materials-Mexican Wild Yam, Agave, and Soy were nothing more than commercially feasible sources of compounds widely distributed in the plant kingdom. A clever biochemist could obtain testosterone from potato sterols, but no one would be likely to make the leap of faith that eating potatoes makes you manly (or less womanly), and there is no reason to presume that Wild Yam (Dioscorea) has any progesterone effects in humans. First, the method of synthesis from diosgenin to progesterone has nothing to do with human synthesis of the corpus luteum hormone; second, oral progesterone has virtually no effect since it is rapidly digested; and third, orally active synthetic progesterones such as norethindrone are test-tube born, and never saw a Wild Yam. The only “precursor” the ovaries, testes and adrenal cortices EVER need (and the ONLY one that they can use if synthesizing from scratch) is something almost NONE of us ever run out of...Low Density Cholesterol. Unless you are grimly fasting, anorectic, alcoholic, seriously ill or training for a triathlon, you only need blood to make steroid hormones from. If hormones are off, it isn’t from any lack of building materials...and any product claiming to supply “precursors” better contain lard or butter (they don’t)...or they are profoundly mistaken, or worse. The recent gaggle of “Wild Yam” creams actually do contain some Wild Yam. (Dioscorea villosa, NOT even the old plant source of diosgenin, D. mexicana...if you are going to make these mistakes, at least get the PLANT right) This is a useful and once widely used antispasmodic herb...I have had great success using it for my three separate bouts with kidney stones...until I learned to drink more water and alkalizing teas and NEVER stay in a hot tub for three hours. What these various Wild Yam creams DO contain, is Natural Progesterone. Although this is inactive orally (oral progesterone is really a synthetic relative of testosterone), it IS active when injected...or, to a lesser degree, when applied topically. This is pharmaceutical progesterone, synthesized from stigmasterol, an inexpensive (soy-bean oil) starting substance, and, although it is identical to ovarian progesterone, it is a completely manufactured pharmaceutical. Taking advantage of an FDA loophole (to them this is only a cosmetic use...they have the misguided belief that it is not bioactive topically), coupled with some rather convincing (if irregular) studies showing the anti-osteoporotic value of topical progesterone for SOME women, a dozen or so manufacturers are marketing synthetic Natural Progesterone for topical use, yet inferring that Wild Yam is what’s doing good. I am not taking issue with the use of topical progesterone. It takes advantage of the natural slow release into the bloodstream of ANY steroid hormones that have been absorbed into subcutaneous adipose tissue. It enters the blood from general circulation the same way normal extra-ovarian estradiol is released, and this is philosophically (and physiologically) preferable to oral steroids, cagily constructed to blast on through the liver before it can break them down. This causes the liver to react FIRST to the hormones, instead of, if the source is general circulation, LAST. My objection is both moral and herbal: the user may believe hormonal effects are “natural”, the Wild Yam somehow supplying “precursors” her body can use if needed, rejected if not. This implies self-empowerment, the honoring of a woman’s metabolic choice...something often lacking in medicine. This is a cheat. The creams supply a steady source of pharmaceutical hormone (no precursor here) , but they are being SOLD as if the benefits alone come from the Wild Yam extract, seemingly formulated with the intent of having Wild Yam the most abundant substance so it can be listed first in the list of constituents. I have even seen the pharmaceutical Natural Progesterone labeled as “Wild Yam Progesterone” or “Wild Yam Estrogen precursor” or, with utter fraud, “Wild Yam Hormone”. To my knowledge, the use of Mexican Yam for its saponins ceased to be important by the early 1960’s, with other processes for synthesizing steroids proving to be cheaper and more reliable. I have been unable to find ANY manufacturer of progesterone that has used the old Marker Degradation Method and/or diosgenin (from whatever Dioscorea) within the last twenty years. Just think of it as a low-tech, non invasive and non-prescription source of progesterone, applied topically and having a slow release of moderate amounts of the hormone. Read some of the reputable monographs on its use, make your choice based solely on the presence of the synthetic hormone, and use it or don’t. It has helped some women indefinitely, for others it helped various symptoms for a month or two and then stopped working, for still other women I have spoken with it caused unpleasant symptoms until they ceased its use. Since marketing a product means selling as much as possible and (understandably) presenting only the product’s positive aspects, it would be better to try and find the parameters of “use” or “don’t use” from articles, monographs, and best of all, other women who have used it. Then ask them again in a month or two and see if their personal evaluation has changed. If you have some bad uterine cramps, however, feel free to try some Wild Yam itself...it often helps. Unless there is organic disease, hormones are off is because the whole body is making the wrong choices in the hormones it does or doesn’t make. It’s a constitutional or metabolic or dietary or life-stress problem, not something akin to a lack of essential amino acids or essential fatty acids that will clear up if only you supply some mythic plant-derived “precursor”. End of tirade.... steroids, plant

Tribulus Tea is a well known for its aphrodisiac properties and for its ability to enhance the sexual activity, even if Tribulus plant is still considered a pest in many areas of the world. Tribulus is a perennial herb that grows mainly in sunny and warm places, such as Southern Europe, Asia, Africa and Australia, with small green leaves and bright yellow flowers. Its fruits contain a fruit that is round and hard. You can recognize it by its short needles, places on the back side of the leaves and all over the roots. Tribulus Tea Properties The main ingredient of Tribulus Tea is called steroidal sapoins and it can be found mainly in the leaves. However, drinking too much Tribulus Tea may increase your body’s toxicity level and cause great damages to your health. A great amount of steroidal sapoins is hard to be flushed out of your system, so if you’re not sure about taking it and you don’t know how much steroidal sapoins your system can take, talk to a herbalist or to your doctor. Tribulus Tea Benefits Tribulus Tea is a great help when it comes to increasing the libido. However, too much of it may cause you problems. It is also used to treat infertility in men, some erectile disorders and it is said that Tribulus Tea has also anti-tumor properties. Herbalists say that this tea can also increase your muscular mass, lower your blood pressure and your cholesterol. How to make Tribulus Tea Infusion Preparing Tribulus Tea involves following a number of simple steps. Take the fresh or dried herbs (you can use any parts of tribulus plant), put them in a teapot and add boiling water. Leave it for 10 or 15 minutes and drink it hot or cold. Use a teaspoon of herbs for every cup of tea and don’t drink more than 1 or 2 cups per day, for a short time period. Do not turn drinking Tribulus Tea into a daily habit, just take it as long as you need to take advantage of its benefits and then take some time off. This way, your system will be able to flush away any trace of toxicity that this tea could leave. Tribulus Tea Side Effects The main concern when it comes to taking Tribulus Tea is that you shouldn’t drink more than one or two cups per day, for not longer than 7 days. When enhancing your libido, Tribulus Tea increases your hormone level, especially your estrogen and testosterone level. If you are a female, pay attention to hair growth and other male characterics, and if you are a male, make sure you keep an eye on how your glands are behaving. Let’s not forget that Tribulus Tea is a medical treatment and should not be used unsupervised. Before starting a Tribulus Tea Treatment, talk to a specialist. Tribulus Tea Contraindications Do not take Tribulus Tea if you are suffering from one of these conditions: stomach disorders, ulcers, breast and prostate cancers as well as other hormone-dependent problems. The same advice if you are pregnant or breastfeeding: since the active ingredient of this tea enhances your libido by increasing your hormone level, it is best to avoid taking it. If you have already taken it and you’re experiencing vomiting episodes or any other side effect, talk to your doctor as soon as possible! But, if both your health and will are strong, there’s no reason not to take Tribulus Tea. At least give it a try and enjoy the wonderful benefits of this tea!... tribulus tea libido enhancer

Gossypium herbaceum L. German: Baumwollenbaum. French: Cotonnier en arbre. Italian: Cotone arbusto. Arabian: Kuttun. Indian: Karpas. Iranian: Pambah. Dried root bark. Cotton fibre leaves.

Constituents: mucilage, flavonoids, fixed oil, resin, tannin.

Action: abortifacient. Parturient. Traditional male contraceptive (unproven). Oxytocic, (fresh gathered). Uses. For procuring abortion. Claimed to contract the womb after the action of Ergot, but safer. Alabama Indian squaws made a tea of the freshly-gathered roots to ease pains of childbirth. For absent or painful menstruation. Pain in ovaries. Morning sickness. Reduces sperm count and sexual urge in the male. Reference. Rats were made temporarily infertile without change of mating behaviour, without reducing the male hormone (testosterone) and without heart abnormalities. (Dr Yun-feng-Ren, People’s Republic of China)

Not used in pregnancy. Hypokalaemia may follow overdose. Preparations. Liquid Extract, BPC (1934). Dose, 2-4ml. Tincture BPC (1934). Dose 30-60 drops. ... cotton root

n. a steroid that is formed in the liver as a metabolite of testosterone. See also androgen.... androsterone

n. any one of a group of drugs that inhibit the action of testosterone on the prostate gland by blocking androgen receptors, competing for binding sites, or decreasing androgen production. They are therefore used in the treatment of prostate cancer, which is an androgen-dependent tumour. Anti-androgens include *abiraterone acetate, *bicalutamide, *cyproterone, *finasteride, and *flutamide.... anti-androgen

any one of a class of drugs used in the treatment of early and advanced oestrogen-dependent breast cancer in postmenopausal women. These drugs act by inhibiting the action of aromatase, an enzyme that promotes the conversion of testosterone to oestradiol. They therefore reduce oestrogen levels, which can be helpful in the control of oestrogen-dependent tumours. Aromatase inhibitors include anastrazole, exemestane, and letrozole. Side-effects include symptoms of oestrogen deficiency (e.g. hot flushes), nausea and vomiting, and headache.... aromatase inhibitor

n. a nonsteroidal *anti-androgen commonly used to treat locally advanced and metastatic prostate cancer. It binds to and blocks the androgen receptor but does not reduce the levels of testosterone in the blood, thus preserving libido and general energy levels. Side-effects include breast enlargement, tenderness, and pain.... bicalutamide

n. a *gonadotrophin-releasing hormone antagonist used in the treatment of advanced prostate cancer that does not cause an initial increase in testosterone levels. Side-effects include hot flushes and pain at the injection site.... degarelix

Absence of sexual power. Lack of sexual performance in the male whereby erection cannot be maintained to complete a satisfactory orgasm between two people. Or failure to ejaculate. Impotence puts a marriage under serious strain. Marriage Guidance Council: “About a third of sex problems we deal with concern impotence.” Pre-disposing factors: stress, marital problems, diabetes, drugs. Some cases are due to piles, fissures and other diseases of the rectum. First relieve the rectum and the impotence should look after itself. Smoking.

Alternatives. With the use of Ginseng and other plant extracts it is possible for sexual desire not to diminish with age, even in the eighties. Some have children in their seventies. Reduce alcohol to a minimum. Drunk males are poor performers. Aphrodisiacs: Damiana, Siberian Ginseng, Saw Palmetto, Muira-pauama. Sarsaparilla stimulates secretion of the male hormone – testosterone. Helonias (Ellingwood). Agnus Castus. (Whitehouse)

Tablets or capsules: Sarsaparilla, Agnus Castus, Ginseng, Ginger.

Formula. Equal parts: Saw Palmetto, Kola, Damiana, Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water or honey, thrice daily.

Evening Primrose: two 500mg capsules morning and evening.

Australian Herbalism. Ginseng (panax), Withania Somnifera, Siberian Ginseng (Eleutherococus senticosus), Wu Wei Zi (Schisandra chinensis), Liquorice (Glycyrrhiza glabra), Di huang (Rehmannia giutinosa), Saw palmetto (Serenoa serrulata), Damiana (Turnera diffusa). (David McLeod, Australian

Journal of Medical Herbalism 1993, Vol 5 (2) 41-4)

Diet. See: DIET – GENERAL.

Supplementation. Zinc, 30mg daily. Vitamin E 500iu daily. Bee pollen. Counselling. Impotents Anonymous. ... impotence

Natural or synthetic androgen hormones used as drugs; one of the most important is testosterone. These drugs are used in the treatment of male hypogonadism (underactivity of the testes) to stimulate the development of sexual characteristics.

Androgen drugs are occasionally used to treat certain types of breast cancer. They have been widely used by sportsmen wishing to increase muscle bulk and strength, a practice that is dangerous to health (see steroids, anabolic).

Adverse effects include fluid retention, weight gain, increased blood cholesterol, and, rarely, liver damage. When taken by women, the drugs can cause male characteristics, such as facial hair, to develop.

androgen hormones A group of hormones that stimulate the development of male sexual characteristics.

Androgens are produced by specialized cells in the testes in males and in the adrenal glands in both sexes. The ovaries secrete very small quantities of androgens until the menopause. The most active androgen is testosterone, which is produced in the testes. The production of androgens by the testes is controlled by certain pituitary hormones, called gonadotrophins. Adrenal androgens are controlled by ACTH, another pituitary hormone.

Androgens stimulate male secondary sexual characteristics at puberty, such as the growth of facial hair and deepening of the voice. They have an anabolic effect (they raise the rate of protein synthesis and lower the rate at which it is broken down). This increases muscle bulk and accelerates growth. At the end of puberty, androgens cause the long bones to stop growing. They stimulate sebum secretion, which, if excessive, causes acne. In early adult life, androgens promote male-pattern baldness.

Androgen deficiency may occur if the testes are diseased or if the pituitary gland fails to secrete gonadotrophins. Typical effects include decreased body and facial hair, a high-pitched voice, underdevelopment of the genitalia, and poor muscle development.

Overproduction of androgens may be the result of adrenal disorders (see adrenal tumours; adrenal hyperplasia, congenital), of testicular tumours (see testis, cancer of), or, rarely, of androgensecreting ovarian tumours (see ovary, cancer of).

In men, excess androgens accentuate male characteristics; in boys, they cause premature sexual development.

In women, excess androgens cause virilization, the development of masculine features such as an increase in body hair, deepening of the voice, clitoral enlargement, and amenorrhoea.... androgen drugs

A condition, also called Stein–Leventhal syndrome, that is characterized by oligomenorrhea or amenorrhoea (scanty or absent periods), infertility, hirsutism (excessive hairiness), and obesity. Often, there are multiple ovarian cysts. Most women with polycystic ovaries begin menstruation at a normal age, but after a year or two periods become highly irregular and then cease. Hirsutism and obesity occur in about 50 per cent of cases.

The condition results from an imbalance of two gonadotrophin hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This hormonal imbalance is associated with raised levels of testosterone and oestrogen.

Treatments include clomifene and oral contraceptives. Polycystic ovaries are often associated with high oestrogen levels in the body, which increase the risk of endometrial cancer (see uterus, cancer of); treatment with progesterone may be recommended for this problem. ... ovary, polycystic

(DHEA) n. a weak androgen produced and secreted by the adrenal glands after the stage of adrenal maturation known as *adrenarche. It is produced from 17-hydroxypregnenolone and itself is largely converted to dehydroepiandrosterone sulphate and androstenedione. All three of these molecules can cause a degree of mild *androgenization but can also be converted in the circulation to the more potent androgens *testosterone and *dihydrotestosterone.... dehydroepiandrosterone

(DHT) n. a product formed from the action of the enzyme 5?-reductase on *testosterone. Mostly derived from the peripheral conversion of testosterone, some DHT is also secreted directly by the testes. DHT is an estimated 2.5 times more potent than testosterone but is present in much smaller amounts in the circulation.... dihydrotestosterone

n. a drug used in the treatment of benign prostatic hyperplasia (see prostate gland). It is a 5?-reductase inhibitor, which blocks the conversion of testosterone to dihydrotestosterone. It has the same side-effects as *finasteride.... dutasteride

a tumour of the *interstitial (Leydig) cells of the testis. Such tumours often secrete testosterone, which in prepubertal boys causes *virilization and precocious puberty.... leydig tumour

A rare inherited condition in which a genetic male with internal testes has the external appearance of a female. The syndrome is a form of intersex and is the most common form of male pseudohermaphroditism.

The cause is a defective response of the body tissues to testosterone.

The causative genes are carried on the X chromosome, and so females can be carriers. Affected individuals appear to be girls throughout childhood, and most develop female secondary sexual characteristics at puberty; but amenorrhoea occurs, and a diagnosis is usually made during investigations to find its cause. Chromosome analysis shows the presence of male chromosomes and blood tests show male levels of testosterone. Treatment of testicular feminization syndrome involves surgical removal of the testes, to prevent cancerous change in later life, and therapy with oestrogen drugs. An affected person is not fertile but can live a normal life as a woman.... testicular feminization syndrome

a family of autosomal *recessive genetic disorders causing decreased activity of any of the enzymes involved in the synthesis of *cortisol from *cholesterol. The most commonly affected enzymes are 21-hydroxylase and 11-hydroxylase, and each enzyme deficiency can itself be due to a variety of genetic mutations. The clinical manifestations depend on which enzyme is affected and the resultant deficiencies and build-up products produced. The most serious consequence is adrenal crisis and/or severe salt wasting due to lack of cortisol and/or aldosterone, which may prove fatal if undiagnosed. The condition is often easier to spot at birth in females, who may have indeterminate genitalia due to high levels of *testosterone in utero. Adrenal hyperplasia occurs due to excessive stimulation of the glands by *ACTH (adrenocorticotrophic hormone) in response to the resultant cortisol deficiency of these conditions. Less complete deficiencies of the enzymes concerned may present for the first time in young women after puberty, with signs of androgen excess and menstrual irregularity mimicking *polycystic ovary syndrome.... congenital adrenal hyperplasia

(GnRH analogue, LHRH analogue) any one of a group of analogues of *gonadotrophin-releasing hormone (gonadorelin), which stimulates release of the gonadotrophins luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. They are more powerful than the naturally occurring hormone, initially increasing the secretion of gonadotrophins by the pituitary: this acts to block the hormone receptors and to inhibit the release of further gonadotrophins, which suppresses production of oestrogens and androgens. Gonadorelin analogues include *buserelin, *goserelin, leuprorelin, and triptorelin. They are used in the treatment of endometriosis, fibroids, and some types of infertility. GnRH analogues are also used in the treatment of advanced prostate cancer. After causing an initial rise in plasma testosterone for approximately ten days the level then falls to the same low level as that achieved by castration. Because the initial flare in testosterone may cause an acute enlargement of the cancer, *anti-androgens are given usually for the first two weeks following the first injection of the gonadorelin analogue.... gonadorelin analogue

an autosomal *dominant condition of males who have all or some of the physical features of *Turner’s syndrome in females but normal sex chromosomes. It is often associated with a low testosterone level and sometimes with reduced sperm production. Other features include cardiovascular defects and most affected individuals have short stature and mild learning disabilities. [J. Noonan (1928– ), US paediatrician]... noonan’s syndrome