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PubMed2006

Assessment of feminization of male fish in English rivers by the Environment Agency of England and Wales.

In recent years there has been considerable concern over the ability of substances discharged into the environment to disrupt the normal endocrine function of wildlife. In particular, the apparent widespread feminization of male fish in rivers has received significant attention from regulators in the United Kingdom, the United States, Europe, and Japan. The U.K. and European epidemiological data sets have demonstrated that the occurrence of feminized fish is associated with effluent discharges and that the incidence and severity is positively correlated with the proportion of treated sewage effluent in receiving waters. Although weakly estrogenic substances may contribute to the overall effect, studies have concluded that steroid estrogens are the principal and most potent estrogenic components of domestic sewage. Extensive laboratory data sets confirm that steroid estrogens are capable of eliciting the effects observed in wild fish at concentrations that have been measured in effluents and in the environment. Based on evaluation of the available information, the Environment Agency (England and Wales) has concluded that the weight of evidence for endocrine disruption in fish is sufficient to develop a risk management strategy for estrogenically active effluents that discharge to the aquatic environment.

Animals↗

PubMed2004

The feminization of psychiatry? Some ruminations.

This article considers the position of women in psychiatry today from the historical perspective of feminism. Feminism in medicine demands the inclusion of the traditional priorities of women: collaboration and cooperation over competition and hierarchy, compassionate care over technology and automation, flexible care for the individual in a social context over the study of units of diseased organs. These themes, in addition to the care of women and children, were prominent in the lives of early women physicians and again in the 1970s and 1980s. The number of women in psychiatry has increased. However, their influence is scant and feminist goals are again submerged. At the same time psychiatry has become increasingly interested in the organ (brain) at the expense of the individual person. Women need a new awakening. They must use their new presence to assert feminine values in patient care and protect themselves from becoming provider units on the assembly line.

Female↗

PubMed1997

Feminism: a path to clinical knowledge development.

Nurses are under increasing pressure to defend the efficacy, value and cost benefits of professional nursing care. Now more than ever, there is a need for nurses to undertake quality clinical research, through which practice may be shaped and guided. Feminist theory can provide a lens through which nurses may explore clinical issues. It also provides a framework by which socially constructed differences, such as gender and culture, may be incorporated into the design of clinical research projects. Because feminism is an openly political and transformative process, feminist concepts are suitable for use where the aim of the research is to catalyse practice change. This paper explores the use of feminism as a theoretical framework for nursing research.

Clinical Competence↗

PubMed2001

Feminization as a critical component of the changing hydrosocial contract.

The Dublin Principles recognize the role that women play in water resources management. The South African Minister of Water Affairs, Prof. Kader Asmal, coined a new expression by referring to the "feminization of water". The article explores some of the ramifications of this and shows that the two aspects are not necessarily the same thing. Feminization does not necessarily mean bringing more women into management processes as it is often depicted. This is the quantitative aspect that is often referred to by male managers and it has been given a negative implication as a result. The more important issue is the qualitative aspect that involves processes such as stakeholder participation, viewing alternatives before a decision is made and accountability.

Female↗

PubMed2005

Opioids are responsible for neurochemical feminization of the brain in prenatally stressed male rats.

OBJECTIVES: To study the role of opioids in early postnatal changes of the hypothalamic testosterone metabolism and catecholamine content underlying feminizing effect of prenatal stress on male sexual behavior in rats. MATERIAL AND METHODS: 10 day-old male and female offspring from mothers given naltrexone prior to daily 1-hour restraint during the last gestational week were used in the study. Aromatase and 5 alpha-reductase activities, noradrenaline and dopamine contents in the brain preoptic area and medial basal hypothalamus were studied by thin layer chromatography, radiometric and spectrofluorimetric techniques. RESULTS: Sexual dimorphism of testosterone metabolism enzymes activity and catecholamine content in discrete brain regions of 10 day-old rat pups was found. Prenatal stress attenuated these gender-related differences. Naltrexone pre-treatment of stressed dams prevented modifying effect of prenatal stress on aromatase activity and noradrenaline content in the male preoptic area. CONCLUSIONS: The results of the study demonstrate preventive effect of naltrexone on stress-induced alterations of testosterone aromatization and noradrenaline concentration in the developing brain preoptic area associated with neuroendocrine control of the male sexual behavior in adult rats. These findings indicate that endogenic opioids mediate detrimental effect of prenatal stress on neurochemical determinants of the brain sexual differentiation that may underlie feminization of the male sexual behavior.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

PubMed1991

[Feminizing adrenocortical tumor].

Feminizing adrenocortical tumor is rare. Three patients with feminizing adrenocortical tumor (2 males and 1 female) were treated surgically. The age of the patients was 11, 21 and 32 years old respectively. The removed tumors weighing 70 g, 250g and 31g respectively and they all were adrenocortical adenoma. The chief symptoms of the patients were gynecomastia, orchiatrophy and sexual inadequacy. The results of follow-up for 1-11 years showed no recurrence in all 3 patients. We consider that the tumor should be resected as soon as the diagnosis was established and long-term follow-up should be made after operation.

Adenoma↗

PubMedDate not supplied

Gynaecomastia and azoospermia as sole presenting symptoms of feminizing adrenal tumor.

Adrenal feminizing tumours are rare but frequently malignant. A case of adrenal feminizing tumour in a 35-year-old man, which presented with gynaecomastia and infertility due to azoospermia, without loss of libido and sexual potency is reported in this paper. Our patient represents a relatively unusual case. The long free interval from the excision allows us to consider the patient cured as despite the pathological malignant features of the neoplasm.

Adrenal Cortex Hormones↗

PubMed1979

Mechanisms of hypogonadism and feminization in alcholic liver disease.

Based upon studies in man and animals it is proposed that: 1. Alcohol-induced hypogonadism is primarily due to a direct testicular toxicity of ethanol manifested by alcohol-induced reduced testosterone levels. 2. In addition, an alcohol-induced central defect also may contribute to the observed hypogonadism. 3. In contrast to the ease with which hypogonadism can be ascribed to androgen deficiency per se, the observed feminization can not be ascribed to altered estrogen levels alone. Rather, we would propose, that feminization of such men is due to the combined effects of estrogen excess and androgen deficiency upon the patter of estrogen-binding proteins in hepatic cytosol.

Animals↗

PubMed1982

Clinical feminization and serum testosterone levels in male patients with chronic African endomyocardial fibrosis.

Thirteen out of 19 male patients aged sixteen years and above who had clinically diagnosed chronic African endomyocardial fibrosis (E.M.F.) had some clinical evidence of feminization. Serum was obtained from ten patients and assayed together with serum of ten age- and sex-matched normal controls for testosterone. The serum testosterone level in the 10 E.M.F. patients was uniformly below the lowest normal level, and the mean serum level for E.M.F. was significantly lower than the mean for the controls. Persistent and severe hepatic congestion in E.M.F. may lead to feminization long before cardiac cirrhosis occurs.

Adolescent↗

PubMed1997

[Feminizing syndrome and gynecomastia in males].

Gynecomastia is one of the common symptoms of feminizing syndrome in males. Causes of feminizing syndrome are considered the increase of serum level of estrogen, prolactin, LH and hCG and testosterone deficiency. The condition of gynecomastia was commonly silent. Gynecomastia is classified three groups those are physiological, pathological and ideopathic gynecomastia. Physiological gynecomastia was reported to break out healthy males. Ideopathic gynecomastia is the main cause in medicine. Characterization of pathological gynecomastia are known side effect of drugs, testosterone deficiency and increased estrogen production. Gynecomastia is making satisfactory progress by treatment of the causes, but long term of the history merely have need resection.

Adolescent↗

PubMed1975

Feminizing interstitial cell tumor of the testis: personal observations and a review of the literature.

A 28-year-old man with evidence of feminization was demonstrated after 4 years of investigation to have a estrogen-secreting interstitial cell tumor. Such feminizing neoplasms are uncommon, only 37 having been described. They are usually benign and are characterized by gynecomastia, a testicular mass and, with lesser frequency, by decreased libido and potency and poor semen quality. The urinary excretion and plasma levels of estrogen are increased and, by selective testicular catheterization, the site of increased estrogen production can be localized. Secondary histologic changes occur in the nontumorous portions of the testis as well as in the contralateral testis; they are most marked in the area immediately adjacent to the tumor. Postoperatively, the gynecomastia regresses, the excessive levels of estrogen return to normal, libido improves, and the sperm count increases to normal.

17-Hydroxycorticosteroids↗

PubMed1994

Partial demasculinization and feminization of sex behavior in male rats by in utero and lactational exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin is not associated with alterations in estrogen receptor binding or volumes of sexually differentiated brain nuclei.

In utero and lactational 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure partially demasculinizes and feminizes sexual behavior in adult male rats, presumably by causing incomplete sexual differentiation of the central nervous system (CNS). Our objective was to determine if TCDD exposure affects other aspects of sexual differentiation of the CNS. Because sex differences in the estrogen receptor system are thought to play a role in sexually dimorphic estrogen-mediated responses, and because estrogen is an important activator of both male and female sex behavior, the possible effect of TCDD exposure on estrogen binding in specific brain nuclei was examined. In addition, we investigated effects of in utero and lactational TCDD exposure on sex differences in the volumes of brain nuclei which are dependent on steroid hormone stimulation during the period of CNS sexual differentiation. Pregnant Holtzman rats were given TCDD (0.7 microgram/kg, po) or vehicle (control) on gestation Day 15. Offspring were exposed to TCDD in utero and via lactation and then assessed in adulthood. Demasculinized sexual behavior was evidenced in the TCDD-exposed males by increased intromission latencies and a greater number of intromissions prior to ejaculation. These males were then castrated, primed with ovarian steroids, and tested for feminine sexual behavior. In utero and lactational TCDD exposure increased both the frequency and intensity of lordotic behavior, indicating that the males were partially feminized. To determine if TCDD exposure had a generalized effect on estrogen receptor concentrations the arcuate nucleus, cortical and medical amygdala and the bed nucleus of the stria terminalis, previously found to have equivalent numbers of estrogen receptors in males and females, were evaluated in littermates of the rats whose sexual behavior had been assessed. TCDD had no effect in either sex. To determine if TCDD exposure had an effect specific to sexual differentiation of the brain, estrogen receptor concentrations in the medial preoptic nucleus (MPO), ventrolateral aspect of the ventro-medial nucleus, and periventricular preoptic area were assessed. As expected, females had higher estrogen receptor concentrations in these nuclei than did males, but TCDD exposure did not affect estrogen receptor concentrations in any of these sexually dimorphic brain nuclei. The volumes of sexually dimorphic brain nuclei were examined in additional littermates. In control rats, the volume of the sexually dimorphic nucleus of the preoptic area (SDN-POA) is larger in males than in females whereas the MPO is larger in females than in males. TCDD exposure had no effect on the volume of either the SDN-POA or MPO in either males or females.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1978

Cell death in the mosaic epididymis of sex reversed mice, heterozygous for testicular feminization.

Sex reversed mice heterozygous for testicular feminization are genetic females which are converted to males by the autosomal Sxr ("sex reversed") mutation, thus imitating the Y-chromosome. They carry on one of their X-chromosomes the mutation for testicular feminization. Then, X-inactivation leads to the formation of a mosaic of androgen insensitive XTfm and androgen sensitive X+ cells. In the epididymis the Tfm cells are maintained into adulthood as undifferentiated flat cells. There are however, always less Tfm cells than expected from random X-inactivation. Therefore, in the present study the role of cell death in the modification of the original mosaic is investigated before and after castration. It is shown that survival or elimination of Tfm cells depends on the structure of the smooth muscle layers around the epididymal duct. In addition to elimination of whole Tfm sections, a steady loss of single cells, not only in the Tfm but also in the wild-type fraction occurs. In the connective tissue distinct necrotic areas are present. After castration massive necroses appear in both cell types. In Tfm sections disintegration of the wall layers again leads to elimination of Tfm cells and to protrusion of epithelial cells in the interstitium which later on may be organized as abnormal sprouts and ducts. The observations indicate that the testosterone dependent trophic principle is based on short-range intercellular interactions and presumably arises in the connective tissue component of the epididymis.

Androgen-Insensitivity Syndrome↗

PubMed1979

Sexual differentiation of the hypothalamus in gonadal agenesis and testicular feminization.

Cyclical hypothalamic function was investigated in three patients with an XY karyotype and female external genitalia; in one of them we diagnosed gonadal agenesis, and in the other two testicular feminization. We studied the effect of estradiol and progesterone on gonadotropin release. The patient with gonadal agenesis had cyclical hypothalamic function, but this cyclical function was suppressed in the patients with testicular feminization in whom no LH secretion could be provoked by steroid stimulation. These observations support the concept that hypothalamic sexual differentiation is due to testosterone (which is locally converted to estradiol in the hypothalamus).

Androgen-Insensitivity Syndrome↗

PubMed1993

Feminizing genital reconstruction for male pseudohermaphroditism.

The ambiguous genital structures of Male Pseudo-hermaphrodites may be reconstructed either in a masculinizing or feminizing manner. This decision is made attempting to maximize body image and function. Early assignment of an appropriate sex of rearing is important. Feminizing genitoplasty for Male Pseudo-hermaphroditism may be done at any age, once accurate diagnosis of the underlying condition is reached. Clitoroplasty, labioplasty, and exteriorization vaginoplasty may be done simultaneously in selected cases where an adequate vagina is already present, with excellent functional and cosmetic results anticipated.

Disorders of Sex Development↗

PubMed2006

Congenital adrenal hyperplasia: long-term evaluation of feminizing genitoplasty and psychosocial aspects.

Analyzing the long-term outcome in females with congenital adrenal hyperplasia (CAH) is crucial to evaluate effectiveness of treatment strategies. The aim of the study was to evaluate the long-term results in patients with CAH after feminizing surgery from the pediatric intersex clinic. Of 163 patients of CAH being followed (1980-2005), 50 responded for review. The patients had undergone feminizing genitoplasty and hormonal therapy. Evaluation included filling a detailed questionnaire along with physical examination and a structured interview in privacy. Assessment was performed for cosmetic results (50), psychosocial adjustment (42) above 5-year age, and functional outcome in 19 cases above 14-year age. Mean age at clitoroplasty was 3.6 years (1-16 years) and at time of the study was 14.6 years (4-23 years), with a mean post-op follow up of 6 years after the final surgery (6 months-17 years). The cosmetic outcome of clitoroplasty was excellent in 37, satisfactory in 10, and poor in 3. Gender identity was female, male, and mixed in 45, 4, and 1, respectively. The attitude to self and life was positive in 36 and negative in 6. The functional outcome of vaginoplasty was satisfactory, unsatisfactory, and undetermined in 11, 4, and 4, respectively. Endocrine control was satisfactory in 36/50. A novel assessment system has been adopted for analyzing the results of clitoroplasty and vaginoplasty. Endocrine control and surgical treatment are complimentary to each other to achieve satisfactory results in majority of CAH patients.

Adolescent↗

PubMed2003

Irreducible inguinal hernia, bowel obstruction, and torsion of testis in a patient with testicular feminization syndrome.

Testicular feminization syndrome, irreducible inguinal hernia, bowel obstruction, and testicular torsion were diagnosed and treated in a 13-year-old girl. Diagnosis of this case in such a complex form in an emergency room is a rare occurrence. Through this case, we want to emphasize the coincidence of inguinal hernia and testicular feminization and the X-linked recessive transmission character of the disease.

Androgen-Insensitivity Syndrome↗

PubMed1991

Corpus callosum: ovarian hormones and feminization.

The rat's corpus callosum is sexually dimorphic with the male's being larger. This difference appears to depend in part on the neonatal presence of testosterone in the male and ovarian hormones in the female. To further investigate the possibility that ovarian hormones participate in the differentiation of the rat's callosum, females received one of the following treatments on postnatal day 8, 12 or 16: (1) ovariectomy (Ovx); (2) 1 mg of testosterone propionate (TP); or (3) sham surgery. All animals were handled daily from birth until weaning. They were sacrificed at 110 days and a mid-sagittal section of the callosum was obtained. From this section measures of callosal area, perimeter, length, and 99 widths were derived. Widths were averaged into 7 factors as defined by prior factor analysis. Ovariectomy, whether on day 8, 12 or 16, enlarged callosal area and 3 of the callosal width factors. TP had no effect on any callosal variable when administered on day 8, 12 or 16. A comparison of control males and females replicated our prior findings of sexual dimorphism. We conclude that ovarian hormones act to feminize the female callosum, and that their removal results in defeminization. Furthermore, the fact that ovariectomy was effective as late as day 16, while TP treatment on day 8 or later had no effect, suggests that masculinization and feminization of this structure constitute separate processes with distinct sensitive periods.

Aging↗