(Jesenia)

One of the primary causes of clitoromegaly is hormonal imbalances,
significantly an extra of androgen hormones. Androgens, corresponding to testosterone, play a
crucial function in the improvement of the clitoris throughout fetal
development. When there might be an overproduction of androgens, either because of a medical situation or medicine,
it could result in the enlargement of the clitoris.
Clitoral atrophy is an actual and impactful situation that impacts
many ladies, often silently. Understanding its causes, signs, and available treatments
is important for these affected to seek applicable
care and support. Seeking medical advice, exploring numerous therapy choices, and fostering open communication may
help individuals manage this condition and regain a fulfilling and
satisfying sex life.
That being stated, there have been research that provide some
insights into the common clitoral development skilled by people taking testosterone.

A examine printed in the Journal of Sexual Medicine examined clitoral development in 202 transgender males who acquired testosterone therapy for a imply period of 28 months.
The examine found that, on average, the clitorises of these individuals elevated in size by 1.9 centimeters (cm) and in width by 1.2 cm.
Nonetheless, it is worth noting that the range of clitoral development varied widely amongst members, with some experiencing no change, whereas others had more substantial growth.
It is essential to note that the effects of testosterone on clitoral measurement and look can differ from person to person. Additionally, the period and dosage of
testosterone remedy can even influence the extent of these changes.

Testosterone is a hormone primarily answerable for the event and
maintenance of male secondary sexual traits, but it is also discovered naturally in females at decrease ranges.

The FTM pump operates by drawing blood to the
intimate area via suction, resulting in increased dimension and
sensitivity. This methodology can be used each before and
through testosterone therapy, but it goes to be more effective after beginning the therapy.
Alizai et al. (58) in their report of 14 youngsters at
a imply age of 13 years found that four had skilled atrophy of the glans clitoris.

One additional approach that serves to preserve the tunica albuginea is the Girth-reduction clitoroplasty.
This procedure was first devised by Robert Fowler within the early Seventies and
later popularized by Hutson et al. (47). The initial degloving of the clitoris,
launch of the ventral plate, and identification of the
corporal bifurcation are just like that described above.
It is also necessary to acknowledge that not everyone who takes testosterone will desire or expertise
all of these adjustments. Some people may expertise
just a few, while others could not discover any vital variations
within the appearance of their vagina. Utilizing sexual stimulants like warming lotions or specially designed massage oils can enhance clitoral sensation, corresponding to CBD lube.
CBD has been shown to extend blood circulate to the genitals making them extra delicate.
By making use of CBD lube earlier than and during sex there's the potential for the clit to turn out to be more sensitive to pleasure.
Nevertheless, it is important to grasp that pleasure is not limited to orgasms alone.
The complete sexual expertise, including foreplay and arousal, contributes to general sexual satisfaction.
Contrary to some beliefs, this physical change does not affect a woman’s femininity
or sexuality negatively. As An Alternative, it highlights the body’s exceptional ability to
adapt and grow stronger. Having an enlarged clitoris doesn’t put you in danger for other ailments, infections, or disorders.

Kids born with CAH, for example, grow as much as reside physically wholesome lives.

Certain types of ovarian tumors, similar to Sertoli-Leydig cell tumor and steroid cell tumor, can produce androgen.
"The half you see is the clitoral glans, however there's another 10 centimeters that surrounds the vagina,"
she tells SELF. "It branches into 'legs'?it nearly looks like a wishbone." In fact,
a small examine within the Journal of Sexual Drugs utilizing
ultrasound means that the G-spot is definitely part of the
clitoris. I Am not in need of care any longer since all went well with my surgical procedure.

I would not hesitate to refer different girls for analysis (and care) of feminine pelvic issues with Dr.
Shashoua and his team. If you resolve to
see him, you may experience what clinically competent, patient-centered care really looks like.
This might happen as the results of certain well being points like polycystic
ovarian syndrome (PCOS). When your ovaries produce extra androgens,
this will likely lead to an enlarged clitoral hood.

Nonetheless, you will want to notice that this improve in clitoral dimension is often short-term and can revert back
to its original measurement once testosterone use is discontinued.
It can additionally be value mentioning that the increase in clitoral dimension is typically not substantial
and is probably not noticeable to the naked eye.
Rising proof helps using physiologic testosterone doses for sexual function, bone health, brain protection and breast
protection. If testosterone ranges are stored throughout
the vary of feminine physiological requirements,
adverse effects are rare. Due to our tradition's distaste for discussing sexual
matters, women may really feel embarrassed asking easy questions about their clitoris.

It is important to begin with a low suction setting and
gradually enhance the intensity to avoid discomfort or
injury. Using suction gadgets persistently and following manufacturer tips can lead
to a gradual enhance in clitoral measurement. The PROMIS SexFS
assesses self-reported sexual perform and satisfaction over the past 30 days.
Once you orgasm, the scale of your clitoris will decrease, and your genitals will go back to their unaroused state more quickly.

[2025-05-19 08:13:13.727392] URL

(Kristan)

Common exercise not only boosts testosterone manufacturing but in addition helps
preserve a healthy physique composition, which is essential
for hormonal balance. One notable study printed in the Journal of Zhejiang College SCIENCE A in 2003
examined the consequences of abstinence on serum testosterone levels in wholesome younger men. The researchers discovered
that abstaining from ejaculation for seven days led to a peak in serum testosterone levels on the seventh day, followed by a decline.
This examine has usually been cited as proof
for the advantages of short-term abstinence, but it’s necessary to note that
the observed enhance was temporary and not sustained over longer periods.
In phrases of how often men should masturbate to take care of optimum testosterone levels, there isn't any specific frequency that applies to all people.

In conclusion, the current scientific proof on the hyperlink
between common masturbation and testosterone ranges is
proscribed and contradictory. While some research have discovered no important change in testosterone ranges after masturbation, others counsel that abstinence may very well increase testosterone ranges.

It is necessary to approach this subject with warning and
rely on scientific evidence quite than anecdotal reports
or particular person experiences. Scientific research
suggests that there's a momentary improve in testosterone levels immediately after ejaculation, adopted by a brief
lived decrease. Frequent masturbation might lead to slightly decrease testosterone levels instantly after every orgasm, but these levels usually return to regular within a short interval.
It is necessary to notice that these fluctuations are thought-about a
part of the body's pure hormonal regulation and aren't indicative of long-term
declines. Masturbation is a pure and common activity that often raises questions regarding its impact on various aspects of health,
particularly testosterone levels.
Ejaculation can briefly improve testosterone ranges, but these levels return to baseline comparatively rapidly.

Prolonged intervals of abstinence could result in a gradual enhance in testosterone ranges,
but ejaculating during this time may momentarily lower testosterone levels.
Additionally, frequency of ejaculation could have
an impact on testosterone levels, with more frequent ejaculation doubtlessly leading to higher testosterone levels.
It is important to note that these findings are based on scientific research and will differ from particular person to individual.

Data revealed that testosterone ranges have been larger after the 3-week abstinence
interval. The researchers in contrast the
salivary testosterone levels in males who participated in sexual exercise
with these in men who solely noticed. While
testosterone levels elevated in all the boys who visited the sex club, the increase
was considerably higher in those that participated. A 2021 examine on healthy younger males advised that masturbation might have an result on free testosterone
levels but not hormonal ratios. This type of testosterone can act on physique tissues, whereas the physique
can not instantly use testosterone that's attached to proteins.

Due To This Fact, any potential effect of masturbation on testosterone levels could also be overshadowed by these different factors.
Masturbation, the act of self-stimulation to attain sexual
pleasure, is a normal and wholesome part of
human sexuality. It is a common follow that the majority adults engage in sooner or later of their lives.
However, there are various misconceptions surrounding masturbation and its
effects on the physique, particularly in relation to testosterone ranges.
A balanced food plan wealthy in vitamins and minerals helps healthy testosterone
ranges. Foods high in zinc, vitamin D, and omega-3
fatty acids are notably helpful.
However, whether or not intercourse decreases or
increases testosterone levels really isn’t known, says James
Hotaling, M.D., a urologist and male fertility professional on the College
of Utah in Salt Lake Metropolis. You may also really feel uncomfortable masturbating, especially if you masturbate extra often than you have interaction in sexual activity along with your companion. This can cause difficulties in your relationship, and these difficulties may have an result on your T levels in the event that
they lead to despair or anxiety. Masturbation and
ejaculation haven’t been shown to have
any long-term or adverse results on testosterone ranges, also called T levels.
Understanding how testosterone ranges fluctuate and what influences them is crucial for sustaining overall well being
and well-being. The dopamine response during sexual activity,
together with masturbation, is part of the brain’s reward system.

This system reinforces behaviors that are helpful for survival and copy, which explains why sexual activity may be so rewarding and doubtlessly addictive for some individuals.

A small research discovered that complete testosterone levels
might barely decrease after ejaculation. Nonetheless, the
levels of "free testosterone" ? the biologically active testosterone ? may very well
enhance in some circumstances. One of the most common myths is that
masturbation results in a major drop in testosterone levels.
Have you ever wondered if that solo session might be shrinking your muscle tissue or sabotaging your intercourse drive?
Many people have questions concerning the link between masturbation and testosterone.

A widespread query that arises is whether or not ejaculation lowers
dopamine levels. Whereas there's a natural decrease in dopamine following orgasm, this
is sometimes a brief impact and a half of the normal sexual
response cycle. Dopamine and sex are crucially linked, with this neurotransmitter
playing a significant function in sexual perform and pleasure.
Most research signifies that masturbation doesn't have a major long-term
impact on testosterone levels.

[2025-05-19 01:55:24.886881] URL

(Lucinda)

Labordiagnostisch zeigt sich das Bild einer Polyglobulie, das jedoch nur vorgetäuscht ist, da in Wirklichkeit ein Flüssigkeitsmangel und damit eine Dehydratation vorliegt.
Eine Polyglobulie ist eine Erhöhung der Zahl der roten Blutkörperchen (Erythrozyten) über den physiologischen Normwert.
Sie macht sich labordiagnostisch durch einen erhöhten Hämatokrit bemerkbar.
Prof. Dr. Petrides hat Vortragshonorare von den Firmen Shire und AOP
erhalten. Herr Siegel erklärt, dass kein Interessenkonflikt
im Sinne des International Committee of Medical Journal Editors besteht.
Der wasserinduzierte Juckreiz ist das chronische Symptom der PV, welches die Lebensqualität am stärksten beeinträchtigt.

Steht die alleinige Senkung der Thrombozyten zur Diskussion, ist Anagrelid
das Medikament der Wahl (mittlere Dosierung 2 mg täglich).

Dieses Präparat wirkt selektiv auf Megakaryozyten und ist nicht leukämogen.
Nebenwirkungen können Kopfschmerzen und Palpitationen sein (23), die
im Allgemeinen nach 4 Wochen wieder abklingen. Aufgrund der oralen Verfügbarkeit, der besseren Verträglichkeit, des geringen Preises
und der Zulassung wird im Allgemeinen die Gabe von Hydroxyharnstoff gegenüber der von Interferon-a
bevorzugt. Konventionelles Interferon-a und pegyliertes Interferon-a (kovalent an einen Polyethylenrest gekoppeltes Interferon-a) verbinden hohe Wirksamkeit mit fehlendem leukämogenen und tumorogenen Risiko.
IE Interferon-a subkutan (beziehungsweise 40 ?g pegyliertes Interferon-a) pro Woche reduziert es
Erythrozytose, Splenomegalie und Pruritus.
Um eine im Vergleich flachere Testosteron-Wirkungskurve zu erreichen, stellten die Baseler Internisten auf das intramuskulär zu applizierende und länger wirksame Präparat Testosteronundecanoat um.

In Zukunft soll sich der Zeitpunkt der Testosteron-Substitution am klinischen Allgemeinzustand des Patienten sowie am peripheren Androgenspiegel orientieren. Zu
beachten ist außerdem das erhöhte Prostatakarzinom-Risiko unter
der Substitutionstherapie, dem Affected Person wurde empfohlen, sich regelmäßig klinisch und sonografisch untersuchen lassen. Inzwischen lagen die Ergebnisse
der Knochenmarkspunktion vor, wonach ein normo- bis leicht
hyperzelluläres Knochenmark mit leichter Hyperplasie der Erythropoese bestand.
Es fanden sich kein morphologischer Anhalt für eine myeloproliferative Erkrankung und keine genetischen Aberrationen.
"Die initial geschilderte abdominale Symptomatik interpretierten wir im Rahmen der Testosteronüberdosierung bei Regredienz im Verlauf als potenzielle Nebenwirkung", so Kofler und
Mitarbeiter.
Eine seltene, aber bei Männern wichtige Differenzialdiagnose der Polyglobulie ist die testosteronbedingte Polyglobulie.
Die Therapie der primären Polyglobulie wird im Artikel Polycythaemia vera besprochen. Bei sekundären Polyglobulien muss die Grunderkrankung behandelt
werden.
Die JAK2 (Januskinase 2) ist eine zytoplasmatische Tyrosinkinase, die an der Signaltransduktion verschiedener Zytokine (unter anderem am EPO-Rezeptor) beteiligt ist.
Die Mutation verstärkt die Aktivität der JAK2 und
führt damit zu EPO-unabhängigem Wachstum (Grafik 3).
Diese Mutation ist erworben, weil sie nicht in der Keimbahn nachweisbar ist.

Da Erythrozyten keinen Zellkern mehr besitzen, erfolgt der
Nachweis dieser JAK2V617F-Mutation im peripheren Blut über
Granulozyten-DNA. Verschiedene Nierenfunktionsstörungen können auch
ohne hypoxische Stimuli zu einer Erythrozytose führen.
Das mit den Erythrozyten entfernte Eisen führt zu einem sekundären Eisenmangel,
der die Erythropoese limitiert und zu Müdigkeit und Abnahme der
Leistungsfähigkeit führen kann. Zunächst im
Osten Russlands und später auch in Mitteleuropa fand man eine
besondere Form der erblichen Polyzythämie. Ihr liegt eine autosomal-rezessiv vererbte Mutation im Von-Hippel-Lindau(VHL)-Gen zugrunde.
Das VHL-Protein reguliert in den peritubulären Fibroblasten der Niere den Abbau des Hypoxie-induzierbaren-Faktors (HIF1) (Grafik 2).

Dieser besteht aus 2 Untereinheiten a und b und vermittelt die
Sauerstoffmessung in den Nieren. In Gegenwart von Sauerstoff werden die a-Ketten unter Beteiligung des
VHL-Genproduktes abgebaut (3).
NGS ist eine molekulardiagnostische Methode, die
erlaubt, mehrere Gene gleichzeitig zu untersuchen und auch
vor einer KMP durchgeführt werden kann. Angeborene
sekundäre Erythrozytosen sind selten und werden meist durch Keimbahnmutationen verursacht, einschliesslich Mutationen in Genen,
die am Sauerstoff-Sensorweg und Hb-Bildung beteiligt sind, unter
anderem abnormale Sauerstoffaffinität (4). Es sind mehrere Mutationen bekannt, welche eine kongenitale
Erythrozytose verursachen können (Tab.?4).
Die sekundäre und die idiopathische Polyzythämie benötigen aus hämatologischer Sicht keine Therapie,
da diese Patienten prinzipiell kein klar erhöhtes Risiko für
Thromboembolien oder Transformation in eine andere Erkrankung haben. Eine Knochenmarkpunktion (KMP) ist hilfreich,
um den Typ der MPN zu charakterisieren und das Vorliegen einer Fibrose, die prognostische
Relevanz hat, zu prüfen. Wichtige Aspekte bei
der Beurteilung sind die gesteigerte Zellularität, eine trilinäre Myeloproliferation,
die Morphologie der Megakaryopoese, das Vorhandensein einer Fibrose,
sowie eventuelle Vermehrung der Blasten. Die Flowzytometrie
ist nicht zwingend nötig, könnte aber dazu
beitragen, eine Zunahme der Blasten auszuschliessen.
Beispiele hierfür sind der Wilms-Tumor, polyzystische Nieren, Nierenzellkarzinome und die Posttransplantationserythrozytose.
Die Gabe von Erythropoietin, beispielsweise
zur Behandlung der Tumor- oder renalen Anämie, führt zu
einem Erythrozytenanstieg. Auf welchen Wert das Hämoglobin angehoben werden soll, wird derzeit diskutiert, weil eine zu starke Stimulierung in einzelnen Studien eine sinkende Überlebensrate zeigte (5).
Verschiedene, mit Zyanose einhergehende Herzfehler
(zum Beispiel Septumdefekte, Links-Rechts-Shunt) führen zu chronischer Hypoxämie und damit über eine Erythropoietin-Erhöhung zu einer kompensatorischen Erythrozytose.

[2025-05-18 10:02:13.656646] URL