The Harvard Medical School Guide To Men’S Health

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The Harvard Medical School Guide To Men’S Health

  1. 1. The Harvard Medical School Guide to Men’s Health Harvey B. Simon,M.D.
  2. 2. Chapter 1 <ul><li>44 autosomes (22 pairs) </li></ul><ul><li>2 sex chromosomes </li></ul><ul><li>( 1 pair, XX or XY) </li></ul><ul><ul><li>DNA in these 46 chromosomes has 30,000 genes </li></ul></ul><ul><ul><li>with genetic information </li></ul></ul><ul><li>Y chromosome small </li></ul><ul><li>40 genes </li></ul><ul><li>SRY gene makes the man </li></ul><ul><li>“ sex –determined region y” </li></ul>
  3. 3. SRY 1) MIS 2) T during fetal development Gnrh ( hypothalamus)  FSH and LH (pituitary)  LH goes to testicle and makes “T” which with FSH initiates sperm production
  4. 4. In Testicle, Leydig cells use cholesterol  androstenedione  T T  DHT  prostate, skin, scalp, body hair follicles …. High LDL Low HDL Primary characteristics Sexual function Behavior RBCs T  secondary sex characteristics
  5. 5. T production <ul><li>Testicles 95% of T </li></ul><ul><li>Adrenals 5% T –independent of FSH or LH and precursor is DHEA </li></ul><ul><li>T finally  Estradiol in fat cells. </li></ul>
  6. 6. T in Life Cycle <ul><li>Week 7 in embryo </li></ul><ul><li>Rest of embryo life </li></ul><ul><li>3-6 months of age </li></ul><ul><li>6-8 years ( adrenal androgens) </li></ul><ul><li>Puberty, Gnrh  LH  T till 16 years old </li></ul><ul><li>Decline after 40 at 1% per year </li></ul>
  7. 7. Reproductive Cells in testicles Nurture sperm Sertoli cells Make sperm Germ cells Make T Leydig cells
  8. 8. Movin ‘em out! <ul><li>Sperm cells within 2 months  </li></ul><ul><li>epididymis  within 2 weeks  to vas </li></ul><ul><li>deferens  ampulla  ejaculatory duct. </li></ul><ul><li>Sperm fluid(10%) gets joined by fluid from prostate (20%) and seminal fluid(70%). </li></ul><ul><li>Semen = 10% +20%+70%. </li></ul>
  9. 9. Sexual Arousal <ul><li>Erotic (CNS) sensory </li></ul><ul><li>( autonomic nerves) </li></ul><ul><li>Nerves Penile artery widening </li></ul><ul><li>Vein compression erection </li></ul>
  10. 10. Ejaculation <ul><li>Under control of autonomic nervous system : </li></ul><ul><li>Fluids move into ejaculatory duct </li></ul><ul><li>Muscles at bladder neck contract </li></ul><ul><li>Pelvis, prostate and penis muscular contractions  ejaculation </li></ul><ul><li>Penile arteries recontract  flacidity </li></ul>

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