Bob recently asked about using hCG (human chorionic gonadotropin) rather than clomiphene to increase testosterone. As I explained in How Clomid Works in Men, clomiphene stimulates the pituitary to make luteinizing hormone (LH), which then acts on the Leydig cells in the testis to make testosterone. So why not use LH directly?
One way to take over the pituitary’s production of its reproductive hormones is to use human chorionic gonadotropin (hCG), which looks like LH to the body. It effectively stimulates the Leydig cells to make testosterone. But it’s expensive and must be injected. So if the pituitary is working, clomiphene may be a better choice to start. If the pituitary isn’t working, hCG can be tried. But if the man’s LH is already very high, neither clomiphene or LH will help all that much, as the man’s body is already trying that strategy by itself.
Canadian television recently interviewed me on work in our bioengineering lab investigating how bicycle seats may cause problems with erections, and how current seats fall short in protecting men. The interview may be viewed here. It took place over Skype, and the sound quality is poor. (I don’t really sound as if speaking through tissue paper.)
October 7th, 2011 § Comments Off on PSA and Prostate Cancer Interview § permalink
The U.S. Preventative Health Task Force is issuing guidelines today about the blood test PSA and its use in screening for diagnosis. While I respect those doctors involved in making the guidelines, I don’t entirely agree that PSA shouldn’t ever be used. ABC Chicago interviewed me this morning, and the segment can be found here.
I have the pleasure to welcome Doctor Eve Feinberg as a new writer for this blog. Dr. Feinberg is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. She completed her residency in Obstetrics and Gynecology at Northwestern University in Chicago and completed a three-year fellowship in Reproductive Endocrinology and Infertility at the National Institutes of Health. Dr. Feinberg is nationally recognized in the field of Reproductive Medicine serves as an active member of both The Society for Assisted Reproductive Technology Practice Committee and the Editorial Board of Fertility and Sterility. Welcome, Doctor Feinberg!
July 20th, 2011 § Comments Off on Needles and Sperm § permalink
A reader recently asked whether acupuncture helps sperm.
I have to admit I’m a Western thinker, but that doesn’t mean that I automatically dismiss anything Eastern. It does mean that, as is true of any treatment, I will want to see evidence of effectiveness before I believe that it works. The most compelling proof will include:
A comparison of those patients who are treated and those who are not,
Patients (and preferably doctors) who don’t know which patients are being treated and which are not,
Statistics that demonstrate the chances that the conclusion is wrong,
More than one study that says it is right.
A number of published studies report how sperm fares with acupuncture. One, published in Fertility and Sterility in 2009, described the use of a special device that either performed acupuncture or just looked like it did, so that patients did not know whether or not they were being treated. Comparing men who were actually treated to those who weren’t, the authors could say with around 95% confidence that motility after acupuncture increased about 10%. The authors didn’t observe an increase in sperm count, and semen volume decreased a little.
If effective, acupuncture would be a great treatment for men who need to improve motility. But first, I’d like to see a study similar to the one done in 2009, but from different investigators and showing similar results. Until then, I’d say acupuncture looks promising but needs a bit more study.
