Libido, development

Secondly, androgenic characteristics or effects which are commonly referred to as secondary male characteristics that promote sexual behavior, libido, development and maturing of the penis, body hair, beard growth, deeper voice, aggressiveness, and formation and maturation of sperm. And of course, as any pubescent boy will tell you, increased production of the sebaceous gland and pimples. 

Changes in steroidal hormone production, conversion, and handling are also prominent features of cirrhosis. These changes can result in decreased libido, gynecomastia (development of breast tissue in men), testicular atrophy, and features of... 

Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse. The definition is very subjective due to differences in desired or needed rigidity in patients of different ages and in different types of relationships. Patients may refer to their dysfunction as impotence, but the National Institutes of Health Consensus Development Conference recommends that the term erectile dysfunction replace the term impotence due to confusion with other forms of sexual dysfunction and the negative connotation associated with the term impotence.1 Patients may also develop libido or ejaculatory disorders, but these are not considered erectile dysfunction. 

In theface of a decreased libido, a secondary erectile dysfunction develops. 

Adverse effects. Disorders of extra-pyramidal motor function with development of pseudo-Parkinsonism(p. 88), sedation, depression, stuffy nose, impaired libido, and impotence increased appetite. These adverse effects have rendered the drug practically obsolete. 

Testicular failure may occur before puberty and present as delayed puberty and the eunuchoid phenotype, or after puberty, with the development of infertility, impotence, or decreased libido in otherwise fully virilized males. The source of hypogonadism can be testicular, as occurs in primary hypogonadism, or it may result from abnormalities of the hypothalamic-pituitary axis, as in secondary hypogonadism. 

SSRIs and venlafaxine can cause of variety of sexual dysfunctions including delayed ejaculation, anorgasmia, and decreased libido ( Table 7-24). For two reasons, the adverse effect of these medications on sexual function was underestimated during the early clinical trials. First, such trials rely on spontaneous reporting by participants. Second, these adverse effects appear to take several weeks to develop. These adverse effects develop in approximately 30% to 40% of patients on adequate doses of SSRIs and venlafaxine. Although all manufacturers of these medications endeavor to suggest that their product is less likely to cause these effects, there is no compelling evidence to indicate that is true. Comparisons of rates across studies are not fair comparisons because they may differ based on how these problems were assessed. 

The notion that an oral contraceptive closely similar to that used in women might be developed for men has been discussed for about 45 years, but the concept has not yet found wide acceptance. Delays in putting the concept into practice have related variously to difficulties in finding an effective combination, complaints of reduced libido or potency, and the long delay between the start of treatment and the attainment of azoospermia. 

Megestrol acetate has also proved of value in patients with metastatic prostatic cancer, epithelial ovarian cancer, or malignant melanoma and is therefore used in both sexes. The adverse effects are very similar in men to those seen with oncological doses in women loss of libido and potency is likely to occur in male patients. In one clinical study of 43 men with recurrent and metastatic cancer of the prostate given megestrol acetate 160 mg/ day orally, five developed a symptomatic rise in liver... 

The aim of the study, often called fertility study , is to assess adverse effects of the test compound on maturation of gametes, mating behavior, fertility, preimplantation stages of the embryo and implantation. Adverse effects can be detected at the estrus cycle, tubal transport, implantation, and development of the pre-implantation stages of the embryo. In males, functional effects on libido and epididymal sperm maturation may be detected which cannot be observed by histological examination of the male reproductive organs. 

FUNCTION Development of male genitalia, male secondary sex characteristics, spermatogenesis, and libido. Androgens also promote skeletal and muscular development. 

After several months of treatment, patients taking SSRIs can develop a syndrome including loss of energy, passivity, decreased pleasure, and decreased libido which resembles, but is not the same as, the depression for which they are being treated. This may, with close patient monitoring, respond to the addition of buproprion or methylphenidate. 

Androgens are a group of Cit, steroids (Figure 53-2) that cause masculinization of the genital tract and the development and maintenance of male secondary sex characteris-tics. They also contribute to muscle bulk, bone mass, libido, and sexual performance in men. Testosterone is the main androgen secreted by the Leydig cells of the testes, and its production increases during puberty. Women produce about 5% to 10% as much testosterone as do men. 

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