Circulating free testosterone in obese men after bariatric surgery increases in parallel with insulin sensitivity Changes in Testosterone Levels and Sex Hormone-Binding Globulin Levels in Extremely Obese Men after Bariatric Surgery Weight loss is a major contributor to improved sexual function after bariatric surgery Determinants of testosterone recovery after bariatric surgery: is it only a matter of reduction of body mass index? Effect of weight loss, with or without exercise, on body composition and sex hormones in postmenopausal women: the SHAPE-2 trial Sex hormones and sexual function in obese men losing weight. Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men. Effect of testosterone treatment on bone remodelling markers and mineral density in obese dieting men in a randomized clinical trial Reduced-calorie dietary weight loss, exercise, and sex hormones in postmenopausal women: randomized controlled trial. Testosterone dose-response relationships in hysterectomized women with or without oophorectomy: effects on sexual function, body composition, muscle performance and physical function in a randomized trial Sex hormone changes during weight loss and maintenance in overweight and obese postmenopausal African-American and non-African-American women Testosterone supplementation of megestrol therapy does not enhance lean tissue accrual in men with human immunodeficiency virus-associated weight loss: a randomized, double-blind, placebo-controlled, multicenter trial. Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency Design of the SHAPE-2 study: the effect of physical activity, in addition to weight loss, on biomarkers of postmenopausal breast cancer risk Sex hormone-binding globulin levels and cardiovascular risk factors in morbidly obese subjects before and after weight reduction induced by diet or malabsorptive surgery. Effects of risedronate and low-dose transdermal testosterone on bone mineral density in women with anorexia nervosa: a randomized, placebo-controlled study.
Background and aim : Male hypogonadism has been linked to obesity and diabetes . We aim ed to study the association of changes in insulin sensitivity and testosterone levels in severe obese patients su bmi tted to bariatric surgery .  Subjects and methods : Prospect i ve intervention study with twenty consecutive patients who underwent bariatric surgery studied before and after significant weight loss .  Serum testosterone , SHBG , fasting glucose , and insulin were measured among others . Free testosterone was calculated with the Vermeulen formula and insulin sensitivity with the homeostatic model assessment ( HOMA ) . Results : At baseline , thirteen patients had low total testosterone levels  , whereas eight of these patients also had free testosterone levels below the reference range obtained from the control group . After bariatric surgery  total testosterone , SHBG , and free testosterone significantly increased and achieved normal values in all evaluated patients . Insulin sensitivity improved in all of them . Multivariate linear regression showed that changes in fasting glucose ( β=−1.868 , p= 0.001 ) , insulin ( β=−3.782 , p= 0.001 ) , weight ( β=−0.622 , p= 0.002 ) , and SHBG ( β=−0.635 , p= 0.022 ) were associated with changes in free testosterone ( adjusted R2 = 0.936 , F=26.613 , p= 0.001 ) . When insulin resistance calculated by HOMA was in the model instead of insulin and glucose , it also was associated ( β=−3.488 , p= 0.008 ) with free testosterone ( adjusted R2 = 0.821 , F=11.111 , p= 0.005 ) . Conclusion : Circulating testosterone in obese men increases after bariatric surgery in parallel with an improvement in insulin sensitivity Objective . Obesity is a risk factor for hypogonadotropic hypogonadism in men . Weight loss has been shown to improve hypogonadism in obese men . This study evaluated the early changes in sex hormones profile after bariatric surgery . Methods . This is a prospect i ve study including 29 morbidly obese men . Main outcomes were changes in serum levels of total testosterone ( TT ) , free testosterone ( cFT ) , SHBG , estradiol , adiponectin , and leptin at 1 and 6 months after surgery . Results . The mean age of patients was 31 ± 8 years and the mean BMI was 56.8 ± 11.7 kg/m2 . Fifteen patients underwent Roux-en-Y gastric bypass and 14 patients underwent sleeve gastrectomy .  At baseline , 22 patients ( 75.9 % ) had either low TT levels ( < 10.4 nmol/L ) or low cFT levels ( < 225 pmol/L ) . Total testosterone and SHBG levels increased significantly at 1 month after surgery ( p ≤ 0.001 ) . At 6 months after surgery , TT and cFT increased significantly ( p ≤ 0.001 ) and 22 patients ( 75.9 % ) had normalized TT and cFT levels . There were no changes in estradiol levels at either 1 month or 6 months after surgery . Conclusions . Increases in TT and SHBG levels occurred early at 1 month after bariatric surgery while improvements in cFT levels were observed at 6 months after bariatric surgery Background The relative contribution of anthropometric , hormonal , and metabolic changes after  bariatric surgery ( BS ) on sexual function ( SF ) in severely obese subjects is not well established . Methods Prospect i ve observational case series study of 39 men undergoing BS .  SF was assessed by means of the international index of erectile function ( IIEF ) before and at 1 year after surgery . At the same time points , anthropometric ( body mass index , waist circumference ) , hormonal ( testosterone , sex hormone binding globulin , estradiol , gonadotropins , inhibin B , prolactin , leptin ) , and metabolic parameters ( insulin sensitivity , C-reactive protein , lipid profile , hemoglobin A1c , presence of hypertension or sleep apnea ) were assessed . Results BS was associated with marked weight loss ( 77.18 % excess weight loss ) , improved IIEF score ( baseline : 54.85 ± 16.59 , 1 year : 61.21 ± 14.10 ; p < 0.01 ) , gonadal function ( testosterone : baseline 256.36 ± 120.98 , 1 year : 508.01 ± 161.90 ; p < 0.001 ) , and improved metabolic profile . However , on multivariate regression analysis whereas changes in body mass index ( beta : −0.677 , p = 0.001 ) , and baseline IIEF score ( beta : −0.397 , p = 0.023 ) , were independent predictors of the changes in the IIEF score at 1 year after surgery , changes in hormonal and metabolic factors were not . Variables in the model accounted for 66 % of the postsurgical variation in the IIEF score . Similar results were found when the different IIEF-sexual domains were evaluated , except for intercourse satisfaction for which no independent predictor was identified . Conclusions Weight loss ’s beneficial effects on SF occurring after BS are beyond the parallel improvement in gonadal and metabolic profiles OBJECTIVE To explore the correlation models between body mass index ( BMI ) and sex hormones constructed from a male cross-sectional survey and evaluate the effects of surgery-induced weight loss on sex hormones in morbidly obese subjects that are not predicted by the constructed BMI correlation models . DESIGN Cross-sectional population and longitudinal studies . SETTING Bariatric surgery center in a university hospital . PATIENT(S ) A cross-sectional survey of a male general population of 161 patients ( BMI median [ interquartile range ] = 29.2 [ 24.8 - 41.9 ] kg/m(2 ) ) in addition to 24 morbidly obese subjects ( BMI = 43.9 [ 40.8 - 53.8 ] kg/m(2 ) ) who were undergoing bariatric surgery  were prospect ively studied for 6 and 12 months . INTERVENTION(S )  Bariatric surgery on 24 morbidly obese men . MAIN OUTCOME MEASURE(S ) Cross-sectional population : construction of the best-fitting models describing the relationship between baseline BMI with total ( TT ) and calculated free ( cFT ) testosterone , E2 , sex hormone-binding globulin ( SHBG ) , FSH , and LH levels . Longitudinal study deviation between the observed sex hormone levels at 6- and 12-month follow-up and those expected on BMI bases . RESULT ( S ) The correlation of BMI with sex hormones was not univocally linear ( E2 ) , but the best-fitting model was exponential for TT , cFT , FSH , LH , and TT/E2 and power for SHBG . In addition to the significant improvement of all parameters observed after surgery in the longitudinal cohort , the increase in TT and SHBG , but not in cFT , was significantly higher than expected from the corresponding weight loss at 6 months from surgery ( 14.80 [ 12.30 - 19.00 ] nM vs. 12.77 [ 10.92 - 13.64 ] nM and 40.0 [ 28.9 - 54.5 ] nM vs. 24.7 [ 22.5 - 25.8 ] nM for TT and SHBG , respectively ) , remaining rather stable at 12 months . CONCLUSION ( S ) The increase in TT and SHBG , but not the increase in cFT , after bariatric surgery is greater than expected based on weight loss Introduction Physical inactivity and overweight are risk factors for postmenopausal breast cancer . The effect of physical activity may be partially mediated by concordant weight loss . We studied the effect on serum sex hormones , which are known to be associated with postmenopausal breast cancer risk , that is attributable to exercise by comparing r and omly obtained equivalent weight loss by following a hypocaloric diet only or mainly by exercise . Methods Overweight , insufficiently active women were r and omised to a diet ( N = 97 ) , mainly exercise ( N = 98 ) or control group ( N = 48 ) . The goal of both interventions was to achieve 5–6 kg of weight loss by following a calorie-restricted diet or an intensive exercise programme combined with only a small caloric restriction . Primary outcomes after 16 weeks were serum sex hormones and sex hormone-binding globulin ( SHBG ) . Body fat and lean mass were measured by dual-energy X-ray absorptiometry . Results Both the diet ( −4.9 kg ) and mainly exercise ( −5.5 kg ) groups achieved the target weight loss . Loss of body fat was significantly greater with exercise versus diet ( difference −1.4 kg , P < 0.001 ) . In the mainly exercise arm , the reduction in free testosterone was statistically significantly greater than that of the diet arm ( treatment effect ratio [ TER ] 0.92 , P = 0.043 ) , and the results were suggestive of a difference for and rostenedione ( TER 0.90 , P = 0.064 ) and SHBG ( TER 1.05 , P = 0.070 ) . Compared with the control arm , beneficial effects were seen with both interventions , diet and mainly exercise , respectively , on oestradiol ( TER 0.86 , P = 0.025 ; TER 0.83 , P = 0.007 ) , free oestradiol ( TER 0.80 , P = 0.002 ; TER 0.77 , P < 0.001 ) , SHBG ( TER 1.14 ; TER 1.21 , both P < 0.001 ) and free testosterone ( TER 0.91 , P = 0.069 ; TER = 0.84 , P = 0.001 ) . After adjustment for changes in body fat , intervention effects attenuated or disappeared . Conclusions Weight loss with both interventions result ed in favourable effects on serum sex hormones , which have been shown to be associated with a decrease in postmenopausal breast cancer risk . Weight loss induced mainly by exercise additionally result ed in maintenance of lean mass , greater fitness , greater fat loss and a larger effect on ( some ) sex hormones . The greater fat loss likely explains the observed larger effects on sex hormones . Trial registration Clinical Trials.gov identifier : NCT01511276 . Registered on 12 January 2012 OBJECTIVE To study the impact of a weight-loss program on sex hormones and sexual function among 38 middle-aged obese men ( BMI > or=35 kg/m(2 ) ) . RESEARCH METHODS AND PROCEDURES A r and omized controlled clinical trial was conducted . The treatment group ( n = 19 ) participated in a 4-month weight-loss program including 10 weeks on a very-low-energy diet ( VLED ) and 17 behavior modification visits . There was no intervention in the control  group ( n = 19 ) . Both groups were followed for 8 months , i.e. , 22 weeks after the active weight loss in the treatment group . The outcome measures ( weight , sex hormones , sexual function , leptin , and metabolic variables ) were obtained at baseline and at three time-points during follow-up . RESULTS The mean weight loss in the treatment group was 21 kg at the end of the 10-week VLED . At the end of follow-up , the maintained weight loss was 17 kg of baseline weight . The control group was weight stable throughout the study . In the treatment group , increases in sex hormone-binding globulin , testosterone , and high-density lipoprotein-cholesterol , as well as decreases in insulin and leptin , were maintained until the end of follow-up , although with VLED , the level of several hormones and metabolic variables improved transiently during the rapid weight loss . There were no significant changes in the question naire scores on sexual function in either group . DISCUSSION We conclude that obese men lose weight and increase their serum testosterone level on a weight-loss program with VLED and behavior modification . However , they do not change their sexual function scores INTRODUCTION Obesity and inactivity are associated with erectile dysfunction and hypogonadism . AIM To compare the effects of low volume ( LV ) and high volume ( HV ) of moderate-intensity exercise  on sexual function , testosterone , lower urinary tract symptoms ( LUTS ) , endothelial function , and quality of life ( QoL ) in obese men . MAIN OUTCOME MEASURES Weight , waist circumference ( WC ) , body composition , International Index of Erectile Function 5-item ( IIEF-5 ) , International Prostate Symptom Scale ( IPSS ) ( for LUTS ) , and 36-item Short Form Survey version 2 Instrument ( SF-36 ) ( for QoL ) scores , plasma testosterone , sex-hormone binding globulin , glucose , insulin and lipids , and endothelial function ( by Reactive Hyperaemia Index [ RHI ] using finger plethysmography ) were measured at baseline and 24 weeks . METHODS Ninety abdominally obese ( body mass index > 27.5 kg/m(2 ) , WC > 90 cm ) , sedentary ( exercise ≈ 80 minutes/week ) Asian men ( mean age 43.6 years , range 30 - 60 ) were prescribed a diet to reduce daily intake by ≈ 400 kcal below calculated requirement and r and omized to perform moderate-intensity exercise of LV ( < 150 minutes/week ) or HV ( 200 - 300 minutes/week ) ( n = 45 each ) for 24 weeks . Seventy-five men ( 83.3 % ) completed the study .  RESULTS Weekly exercise volume was significantly greater in the HV ( 236 ± 9 minutes ) than the LV ( 105 ± 9 minutes ) group . The HV group had significantly greater increases in IIEF-5 score ( 2.6 ± 0.5 points ) and testosterone ( 2.06 ± 0.46 nmol/L ) and reductions in weight ( -5.9 ± 0.7 kg , -6.2 % ) , WC ( -4.9 ± 0.8 cm , -4.9 % ) , and fat mass ( -4.7 ± 1.0 kg , -14.5 % ) than the LV group ( -2.9 ± 0.7 kg , -3.0 % ; -2.7 ± 0.7 cm , -2.5 % ; -1.1 ± 0.8 kg , -3.2 % ; 0.79 ± 0.46 nmol/L ; and 1.8 ± 0.5 points ) . Improvements in IPSS and SF-36 scores , and RHI , were similar . CONCLUSIONS Moderate-intensity HV aerobic exercise > 200 minutes/week produces greater improvements in sexual function , testosterone , weight , WC , and fat mass than smaller exercise volume To assess the effect of testosterone treatment on bone remodelling and density in dieting obese men , 100 obese men aged 53 years ( interquartile range 47–60 ) with a total testosterone level < 12 nmol/L receiving 10 weeks of a very low energy diet ( VLED ) followed by 46 weeks of weight maintenance were r and omly assigned at baseline to 56 weeks of intramuscular testosterone undecanoate ( n = 49 , cases ) or matching placebo ( n = 51 , controls ) . Pre-specified outcomes were between-group differences ( mean adjusted difference , MAD ) in serum c-telopeptide ( CTx ) , N-terminal propeptide of type 1 procollagen ( P1NP ) and bone mineral density ( BMD ) . At trial end , CTx was significantly reduced in men receiving testosterone compared to placebo , MAD −66 ng/L ( 95 % CI −113 , −18 ) , p = 0.018 , and this was apparent already after the 10 week VLED phase , MAD −63 ng/L ( 95 % CI −108 , −18 ) , p = 0.018 . P1NP was marginally increased after VLED , MAD + 4.2 ug/L ( 95 % CI −0.01 , + 8.4 ) , p = 0.05 but lower at study end , MAD −5.6 ug/L ( 95 % CI −10.1 , −1.1 ) , p = 0.03 . No significant changes in sclerostin , lumbar spine BMD or femoral BMD were seen . We conclude that in obese men with low testosterone levels  undergoing weight loss , bone remodelling markers are modulated in a way that may have favourable effects on bone mass PURPOSE Estrogens and and rogens are elevated in obesity and associated with increased postmenopausal breast cancer risk , but the effect of weight loss on these biomarkers is unknown . We evaluated the individual and combined effects of a reduced-calorie weight loss diet and exercise on serum sex hormones in overweight and obese postmenopausal women . PATIENTS AND METHODS We conducted a single-blind , 12-month , r and omized controlled trial from 2005 to 2009 . Participants ( age 50 to 75 years ; body mass index > 25.0 kg/m(2 ) , exercising < 100 minutes/wk ) were r and omly assigned using a computer-generated sequence to ( 1 ) reduced-calorie weight loss diet ( " diet " ; n = 118 ) , ( 2 ) moderate- to vigorous-intensity aerobic exercise ( " exercise " ; n = 117 ) , ( 3 ) combined reduced-calorie weight loss diet and moderate- to vigorous-intensity aerobic exercise ( " diet + exercise " ; n = 117 ) , or ( 4 ) control ( n = 87 ) . Outcomes were estrone concentration ( primary ) and estradiol , free estradiol , total testosterone , free testosterone , and rostenedione , and sex hormone-binding globulin ( SHBG ) concentrations ( secondary ) . RESULTS Mean age and body mass index were 58 years and 30.9 kg/m(2 ) , respectively . Compared with controls , estrone decreased 9.6 % ( P = .001 ) with diet , 5.5 % ( P = .01 ) with exercise , and 11.1 % ( P < .001 ) with diet + exercise . Estradiol decreased 16.2 % ( P < .001 ) with diet , 4.9 % ( P = .10 ) with exercise , and 20.3 % ( P < .001 ) with diet + exercise . SHBG increased 22.4 % ( P < .001 ) with diet and 25.8 % ( P < .001 ) with diet + exercise . Free estradiol decreased 21.4 % ( P < .001 ) with diet and 26.0 % ( P < .001 ) with diet + exercise . Free testosterone decreased 10.0 % ( P < .001 ) with diet and 15.6 % ( P < .001 ) with diet + exercise . Greater weight loss produced stronger effects on estrogens and SHBG . CONCLUSION Weight loss significantly lowered serum estrogens and free testosterone , supporting weight loss for risk reduction through lowering exposure to breast cancer biomarkers Objective This study aims to determine the dose-dependent effects of testosterone on sexual function , body composition , muscle performance , and physical function in hysterectomized women with or without oophorectomy . Methods Seventy-one postmenopausal women who previously underwent hysterectomy with or without oophorectomy and had total testosterone levels less than 31 ng/dL or free testosterone levels less than 3.5 pg/mL received a st and ardized transdermal estradiol regimen during the 12-week run-in period and were r and omized to receive weekly intramuscular injections of placebo or 3 , 6.25 , 12.5 , or 25 mg of testosterone enanthate for 24 weeks .  Total and free testosterone levels were measured by liquid chromatography – t and em mass spectrometry and equilibrium dialysis , respectively . The primary outcome was change in sexual function measured by the Brief Index of Sexual Functioning for Women . Secondary outcomes included changes in sexual activity , sexual distress , Derogatis Interview for Sexual Functioning , lean body mass , fat mass , muscle strength and power , and physical function .  Results Seventy-one women were r and omized ; five groups were similar at baseline . Sixty-two women with analyzable data for the primary outcome were included in the final analysis . The mean on-treatment total testosterone concentrations were 19 , 78 , 102 , 128 , and 210 ng/dL in the placebo , 3-mg , 6.25-mg , 12.5-mg , and 25-mg groups , respectively . Changes in composite Brief Index of Sexual Functioning for Women scores , thoughts/desire , arousal , frequency of sexual activity , lean body mass , chest-press power , and loaded stair-climb power were significantly related to increases in free testosterone concentrations ; compared with placebo , changes were significantly greater in women assigned to the 25-mg group , but not in women in the lower-dose groups . Sexual activity increased by 2.7 encounters per week in the 25-mg group . The frequency of and rogenic adverse events was low . Conclusions Testosterone administration in hysterectomized women with or without oophorectomy for 24 weeks was associated with dose and concentration-dependent gains in several domains of sexual function , lean body mass , chest-press power , and loaded stair-climb power . Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects Introduction Changes in sex hormones with weight loss might have implication s for breast cancer prevention but have not been examined extensively , particularly in African-American ( AA ) women . Methods We conducted a prospect i ve study of 278 overweight/obese postmenopausal women ( 38 % AA ) not taking hormone therapy within the Weight Loss Maintenance Trial . All participants lost at least 4 kg after a 6-month weight-loss phase and attempted to maintain weight loss during the subsequent 12 months . We evaluated the percentage changes in estrone , estradiol , free estradiol , testosterone , free testosterone , and rostenedione , dehydroepi and rosterone sulfate and sex hormone-binding globulin ( SHBG ) using generalized estimating equations . Results In all study phases , AA women had higher levels of estrogen and testosterone concentrations , independent of adiposity . On average , participants lost 7.7 kg during the weight-loss phase , and concentrations of estrone ( -5.7 % , P = 0.006 ) , estradiol ( -9.9 % , P < 0.001 ) , free estradiol ( -13.4 % , P < 0.0001 ) , and free testosterone ( -9.9 % , P < 0.0001 ) decreased , while the SHBG concentration ( 16.2 % , P < 0.001 ) increased . Weight change did not significantly affect total testosterone or other and rogen concentrations . Compared with non-AA women , AA women experienced less change in estrogens per kilogram of weight change ( that is , per 1 kg weight loss : estrone , -0.6 % vs. -1.2 % , P-interaction = 0.10 ; estradiol , -1.1 % vs. -1.9 % , P-interaction = 0.04 ; SHBG , 0.9 % vs. 1.6 % , P-interaction = 0.006 ; free estradiol , -1.4 % vs. -2.1 % , P-interaction = 0.01 ) . Conclusion To the best of our knowledge this is the first study to examine and compare the effects of intentional weight loss and maintenance on a panel of sex hormones in AA women and non-AA women . Although speculative , these data suggest hormonal differences may contribute to different racial patterns of breast cancer incidence and mortality and encourage further investigations to underst and the long-term effects of weight loss on sex hormones in obese postmenopausal women . Trial Registration Clinical Trials.gov : CONTEXT Reduced energy intake is a primary factor in HIV-associated wasting .  Megestrol acetate ( MA ) stimulates appetite and weight gain . However , much of the weight gained is fat , possibly as a result of MA-induced hypogonadism . OBJECTIVE The objective of the study was to determine whether coadministration of testosterone with MA could enhance lean body mass ( LBM ) accrual and evaluate the effects of MA , alone or combined with testosterone , on sexual functioning and the hypothalamic-pituitary-adrenal axis . DESIGN This was a r and omized , double-blind , placebo-controlled , multicenter trial . SETTING Fourteen AIDS Clinical Trials Units in the United States participated in the study . SUBJECTS Seventy-nine HIV-positive men with 5 % or more weight loss or body mass index less than 20 kg/m2 took part in the study . INTERVENTION Subjects were r and omized to receive MA ( 800 mg daily ) plus testosterone enanthate ( 200 mg ; MA/TE ; n = 41 ) or placebo ( MA/PL ; n = 38 ) biweekly for 12 wk . MAIN OUTCOME MEASURES Weight , body composition ( bioelectric impedance analysis ) , adrenal and gonadal hormones , and sexual functioning ( question naire ) were measured . RESULTS Both groups experienced robust increases in weight ( median 5.3 and 7.3 kg in MA/TE and MA/PL , respectively ) , LBM ( 3.3 and 3.3 kg ) , and fat ( 3.0 and 3.8 kg ) . There were no significant differences between groups in the magnitude or composition of weight gain ( P = 0.44 , 0.90 , and 0.11 for weight , LBM , and fat , respectively ) . Trough testosterone concentrations decreased to a greater extent in MA/PL ( -12.3 vs. -6.1 nmol/liter in MA/TE ; P = 0.04 ) . Cortisol levels became nearly undetectable in subjects with plasma MA levels greater than 150 ng/ml . Sexual functioning was preserved with MA/TE but worsened in MA/PL . CONCLUSIONS MA produced robust weight gain . Coadministration of testosterone preserved sexual functioning but did not enhance LBM accrual This open-label nonr and omized study evaluated the effect of intramuscular testosterone enanthate administration on body composition , protein dynamics , and serum hormone concentrations in seven healthy hypogonadal adults 19 to 47 years old . The subjects had been previously treated with and rogen replacement therapy ( testosterone or gonadotropins )  but underwent a 12-week washout period off all and rogenic therapy prior to study . During the 10-week treatment period , testosterone enanthate ( 100 mg IM ) was administered weekly in the Clinical Research Center . Subjects were instructed to refrain from moderate to heavy exercise for 4 weeks before study and during the treatment period . All were instructed to consume a st and ardized daily diet of 36 kcal/kg/d and 1.5 g/ kg/d protein and 100 % of the recommended dietary allowance for vitamins . Study endpoints were determined before and after testosterone therapy . The primary outcome measure was fat-free mass determined by underwater weighing . Body composition ( fat-free m The objective of this study was to assess the effects of oral testosterone supplementation therapy on glucose homeostasis , obesity and sexual function in middle-aged men with type 2 diabetes and mild and rogen deficiency . Forty-eight middle-aged men , with type 2 diabetes , ( visceral ) obesity and symptoms of and rogen deficiency , were included in this open-label study . Twenty-four subjects received testosterone undecanoate ( TU ; 120 mg daily , for 3 months ) ; 24 subjects received no treatment .  Body composition was analyzed by bio-impedance . Parameters of metabolic control were determined . Symptoms of and rogen deficiency and erectile dysfunction were scored by self-administered question naires . TU had a positive effect on ( visceral ) obesity : statistically significant reduction in body weight ( 2.66 % ) , waist-hip ratio ( -3.96 % ) and body fat ( -5.65 % ) ; negligible changes were found in the control group . TU significantly improved metabolic control : decrease in blood glucose values and mean glycated hemoglobin ( HbA1c ) ( from 10.4 to 8.6 % ) . TU treatment significantly improved symptoms of and rogen deficiency ( including erectile dysfunction ) , with virtually no change in the control group . There were no adverse effects on blood pressure or hematological , biochemical and lipid parameters , and no adverse events . Oral TU treatment of type 2 diabetic men with and rogen deficiency  improves glucose homeostasis and body composition ( decrease in visceral obesity ) , and improves symptoms of and rogen deficiency ( including erectile dysfunction ) . In these men , the benefit of testosterone supplementation therapy exceeds the correction of symptoms of and rogen deficiency and also includes glucose homeostasis and metabolic control Background Physical inactivity and overweight are two known risk factors for postmenopausal breast cancer . Former exercise intervention studies showed that physical activity influences sex hormone levels , known to be related to postmenopausal breast cancer , mainly when concordant loss of body weight was achieved . The question remains whether there is an additional beneficial effect of physical activity when weight loss is reached . The aim of this study is to investigate the effect attributable to exercise on postmenopausal breast cancer risk biomarkers , when equivalent weight loss is achieved compared with diet-induced weight loss . Design The SHAPE-2 study is a three-armed , multicentre trial . 243 sedentary , postmenopausal women who are overweight or obese ( BMI 25–35 kg/m2 ) are enrolled . After a 4 - 6 week run-in period , wherein a baseline diet is prescribed , women are r and omly allocated to ( 1 ) a diet group , ( 2 ) an exercise group or ( 3 ) a control group . The aim of both intervention groups is to lose an amount of 5–6 kg body weight in 10–14 weeks . The diet group follows an energy restricted diet and maintains the habitual physical activity level . The exercise group participates in a 16-week endurance and strength training programme of 4 hours per week . Furthermore , they are prescribed a moderate caloric restriction . The control group is asked to maintain body weight and continue the run-in baseline diet . Measurements include blood sampling , question naires , anthropometrics ( weight , height , waist and hip circumference ) , maximal cycle exercise test ( VO2peak ) , DEXA-scan ( body composition ) and abdominal MRI ( subcutaneous and visceral fat ) . Primary outcomes are serum levels of oestradiol , oestrone , testosterone and sex hormone binding globulin ( SHBG ) . Discussion This study will give insight in the potential attributable effect of physical activity on breast cancer risk biomarkers and whether this effect is mediated by changes in body composition , in postmenopausal women . Eventually this may lead to the design of specific lifestyle guidelines for prevention of breast cancer . Trial registration The SHAPE-2 study is registered in the register of clinical trials.gov , Identifier : NCT01511276 One of the main goals of weight reduction in morbidly obese subjects is its benefit on coronary heart disease ( CHD ) risk . A cross-sectional study was design ed to r and omly assign 79 morbidly obese subjects ( 27 men and 52 women ; age : 30 - 45 years ) either to a diet protocol ( 20 kcal per kg fat-free mass ( FFM ) ; 55 % carbohydrates , 30 % fat , and 15 % proteins ) or to malabsorptive surgery ( biliopancreatic diversion ) .  Fatness parameters , measured by dual-energy X-ray absorptiometry , lipid profile , insulin , leptin , sex steroid hormones and sex hormone-binding globulin ( SHBG ) levels were compared at baseline and 1 year after the beginning of the study . The data showed that plasma SHBG levels , but not testosterone levels , correlated negatively to fasting insulin levels and positively to HDL-cholesterol in both men and women . Total leptin levels were significantly lower ( P<0.0001 ) in post-BPD subjects of both sexes compared to dietary treated obese subjects . The logarithm of plasma leptin correlated significantly and positively with insulin but negatively with SHBG.A step-down regression analysis showed that FFM and SHBG , but not insulin levels , were the most powerful independent variables for predicting HDL-cholesterol levels in morbidly obese patients . The negative relationship between SHBG levels and CHD risk appears to be mediated by a concomitant variation in body fatness . Finally , in obese patients , SHBG levels seem to be an indicator of total adiposity rather than an index of an altered insulin/glucose homeostasis CONTEXT Anorexia nervosa is complicated by severe bone loss and clinical fractures . Mechanisms underlying bone loss in adults with anorexia nervosa include increased bone resorption and decreased formation . Estrogen administration has not been shown to prevent bone loss in this population , and to date , there are no approved , effective therapies for this comorbidity . OBJECTIVE To determine whether antiresorptive therapy with a bisphosphonate alone or in combination with low-dose transdermal testosterone replacement would increase bone mineral density ( BMD ) in women with anorexia nervosa . DESIGN AND SETTING We conducted a12-month , r and omized , placebo-controlled study at a clinical research center . STUDY PARTICIPANTS Participants included 77 ambulatory women with anorexia nervosa . INTERVENTION Subjects were r and omized to risedronate 35 mg weekly , low-dose transdermal testosterone replacement therapy , combination therapy or double placebo . MAIN OUTCOME MEASURES BMD at the spine ( primary endpoint ) , hip , and radius and body composition were measured by dual-energy x-ray absorptiometry . RESULTS Risedronate  increased posteroanterior spine BMD 3 % , lateral spine BMD 4 % , and hip BMD 2 % in women with anorexia nervosa compared with placebo in a 12-month clinical trial . Testosterone administration did not improve BMD but increased lean body mass . There were few side effects associated with either therapy . CONCLUSIONS Risedronate administration for 1 yr increased spinal BMD , the primary site of bone loss in women with anorexia nervosa . Low-dose testosterone did not change BMD but increased lean body mass
And rogen rise is greater in those patients who lose more weight as well as in younger , non-diabetic subjects with a greater degree of obesity .
Body weight loss is also associated with a decrease in estradiol and an increase in gonadotropins levels .
These data show that weight loss is associated with an increase in both bound and unbound testosterone levels .
The normalization of sex hormones induced by body weight loss is a possible mechanism contributing to the beneficial effects of surgery in morbid obesity
OBJECTIVE Few r and omized clinical studies have evaluated the impact of diet and physical activity on testosterone levels in obese men with conflicting results .
Conversely , studies on bariatric surgery in men generally have shown an increase in testosterone levels .
The aim of this study is to perform a systematic review and meta- analysis of available trials on the effect of body weight loss on sex hormones levels .