What were your first thoughts, waking up after the orchiectomy?
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No. How did you re-establish ownership of your body following the orchiectomy?
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That leads to denials when, say, a doctor seeks reimbursement for a transgender woman's orchiectomy.
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She hadn't received gender-affirming surgeries such as breast augmentation, orchiectomy (removal of testicles), or vaginoplasty.
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My workday began with a 20-year-old man undergoing an orchiectomy: the removal of one or both testicles.
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Even in the event of a double (bilateral) orchiectomy, testosterone therapy can help restore a man's sex-drive and function.
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Within days he had an orchiectomy — the surgical removal of the testicles — which confirmed that the leukemia had recurred, in his testes.
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The clinic, "affirming" as ever, recommended and provided the referral letters for him to have an orchiectomy, a removal of his testicles, which he underwent.
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Though the patients who seek a radical penectomy and orchiectomy vary, Dr. Curtis Crane says that they're "kind of their own category" within our classifications of known gender identities.
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As it's a reproductive organ, it's generally very hard to imagine having an orchiectomy and being 100 percent after, but it really doesn't matter if you have one testicle or two.
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In April, she had an orchiectomy or the removal of her testes, which stops the production of testosterone, which makes hormone management easier and curbs the growth of body and facial hair.
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I'd wound up there only because Mom had insisted that I get a second opinion after my first operation, an orchiectomy to remove my cancerous testicle, at a hospital on the opposite coast.
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I spoke to four men who have all survived testicular cancer and an orchiectomy, along with a mother whose son chose to wait—hoping that the lump he'd found on his testicle was benign.
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The clinic, 'affirming' as ever, provided the referral letters for him to have an orchiectomy, a removal of his testicles When I first detransitioned, my community consisted of online groups of fewer than 100 women.
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After my orchiectomy and CT scans were completed, my cancer was found to have spread, so I went through three months of complete misery getting chemotherapy, and then had to get a retroperitoneal lymph node dissection surgery.
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A mastectomy for trans men and nonbinary people, known as top surgery, can range from about $3,143 to $10,000, while what's known as bottom surgery for trans women, often a combination of orchiectomy and vaginoplasty, can cost up to $30,240.
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Those novel thoughts weren't chiefly about worst case scenarios—I quickly learned that the odds of surviving testicular cancer are around 95 percent—but about whether I would, should, or even could get a get a testicular prosthesis installed in the event that one of my own balls needed to be removed in a procedure called an orchiectomy.
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A subcapsular orchiectomy is also commonly performed for treatment of prostate cancer. The operation is similar to that of a simple orchiectomy, with the exception that the glandular tissue that surrounds each testicle is removed rather than the entire gland itself. This type of orchiectomy is done primarily to keep the appearance of an ordinary scrotum.
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Unilateral orchiectomy results in decreased sperm count but does not reduce testosterone levels. Bilateral orchiectomy causes infertility and greatly reduced testosterone levels leading to loss of sexual interest, erectile dysfunction, hot flashes, breast enlargement (gynecomastia), weight gain, loss of muscle mass and osteoporosis. The administration of hormone replacement therapy after orchiectomy can help to mitigate the negative side effects.
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The scrotum of a transgender female patient six months after receiving simple bilateral orchiectomy without other genital surgery. A simple orchiectomy is commonly performed as part of sex reassignment surgery (SRS) for transgender women, or as palliative treatment for advanced cases of prostate cancer. Orchiectomy may be required in the event of a testicular torsion as well. The patient lies flat on an operating table with the penis taped against the abdomen.
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Spermatocytic tumors are diagnosed based on tissue from orchiectomy (or partial orchiectomy), done for a lesion suspicious for cancer on medical imaging. The macroscopic appearance of the tumour is of a mutinodular grey-white to tan coloured mass with gelatinous, haemorrhagic and necrotic areas. The tumour may extend beyond the testis.
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An inguinal orchiectomy is sometimes done under general anesthesia, and takes from 30 minutes to an hour to complete.
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In contrast to GnRH agonists, GnRH antagonists don't cause an initial androgen surge, and are gradually replacing GnRH agonists in clinical use. There have been studies to investigate the benefit of adding an antiandrogen to surgical orchiectomy or its continued use with a GnRH analogue (combined androgen blockade (CAB)). Adding antiandrogens to orchiectomy showed no benefit, while a small benefit was shown with adding antiandrogens to GnRH analogues. Unfortunately, therapies which lower testosterone levels, such as orchiectomy or GnRH analogue administration, also have significant side effects.
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Opinions differ on the need for histological proof, with reports of limited biopsy and frozen section, radical orchiectomy in unilateral disease and unilateral orchiectomy in bilateral disease. The peak incidence of sarcoidosis and testicular neoplasia coincide at 20–40 years and this is why most patients end up having an orchiectomy. However, testicular tumours are much more common in white men, less than 3.5% of all testicular tumours being found in black men. These racial variations justify a more conservative approach in patients of Afro-Caribbean descent with proven sarcoidosis elsewhere.
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Orchiectomy (also named orchidectomy, and sometimes shortened as orchi) is a surgical procedure in which one or both testicles are removed (bilateral orchiectomy), as a form of castration. The surgery is typically performed as treatment for testicular cancer, in some cases of testicular torsion, as a gender-affirming procedure for trans women, and is sometimes used in the management of advanced prostate cancer. There are three main types of orchiectomy: simple, subcapsular, and inguinal. The first two types can be done under general, local, or epidural anesthesia, and take about 30 minutes to perform.
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Inguinal orchiectomy (named from the Latin inguen for "groin," and also called radical orchiectomy), is performed when an onset of testicular cancer is suspected, in order to prevent a possible spread of cancer from the spermatic cord into the lymph nodes near the kidneys. An inguinal orchiectomy can be either unilateral or bilateral. The surgeon makes an incision in the patient's groin area (in contrast to an incision in the scrotum, as is done in both simple and subcapsular orchiectomies). The entire spermatic cord is removed, as well as the testicle(s).
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GCNIS is generally treated by radiation therapy and/or orchiectomy. Chemotherapy used for metastatic germ cell tumours may also eradicate GCNIS.
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Fertility is also a factor considered in SRS, as patients are typically informed that if an orchiectomy or oöphoro-hysterectomy is performed, it will make them irreversibly infertile.
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In rare instances, botched circumcisions have also resulted in full or partial penectomies, as with David Reimer. Fournier gangrene can also be a reason for penectomy and/or orchiectomy.
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In metastatic disease, where cancer has spread beyond the prostate, removal of the testicles (called orchiectomy) may be done to decrease testosterone levels and control cancer growth. (See hormonal therapy, below).
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Inguinal orchiectomy (also named orchidectomy) is a specific method of orchiectomy whereby one or both testicles and the full spermatic cord are surgically removed through an incision in the lower lateral abdomen (the "inguinal region"). The procedure is generally performed by a urologist, typically if testicular cancer is suspected. Often it is performed as same-day surgery, with the patient returning home within hours of the procedure. Some patients elect to have a prosthetic testicle inserted into their scrotum.
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In addition, gynecomastia caused by estrogens can be prevented with prophylactic irradiation of the breasts or can be remediated with mastectomy. PEP has been studied for the treatment of prostate cancer at dosages of 160 mg/month (three studies) and 240 mg/month (four studies). At a dosage of 160 mg/month, PEP incompletely suppresses testosterone levels, failing to reach the castrate range, and is significantly inferior to orchiectomy in slowing disease progression. Conversely, PEP at a dosage of 240 mg/month results in greater testosterone suppression, into the castrate range similarly to orchiectomy, and is equivalent to orchiectomy in effectiveness. For prostate cancer in men, PEP is usually given at a dosage of 80 to 320 mg every 4 weeks for the first 2 to 3 months to rapidly build up estradiol levels.
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MAB has been found to produce higher rates of gynecomastia (7 to 28%) than orchiectomy and GnRH analogues alone (1 to 16%), but lower rates than nonsteroidal antiandrogen monotherapy such as with bicalutamide (30 to 85%).
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Careful follow-up and ultrasonic surveillance may be preferable in certain clinical settings to biopsy and surgery, especially in patients with bilateral testicular disease. Two main approaches to genitourinary sarcoidosis have been proposed. Based on the marked relationship between testicular cancer and sarcoidosis, orchiectomy is recommended, even if evidence of sarcoidosis in other organs is present. By contrast, others consider immediate orchiectomy as being quite aggressive because of several factors associated with a benign diagnosis, as well as the involvement of the epididymis or vas deferens and bilateral testicular involvement.
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In fact, potential beneficial effects on cardiovascular mortality have been observed at this dosage. However, PEP at a higher dosage of 240 mg/month has subsequently been found in large studies to significantly increase cardiovascular morbidity relative to GnRH modulators and orchiectomy in men treated with it for prostate cancer. The increase in cardiovascular morbidity with PEP therapy is due to an increase in non-fatal cardiovascular events, including ischemic heart disease and heart decompensation, specifically heart failure. Conversely, PEP has not been found to significantly increase cardiovascular mortality relative to GnRH modulators and orchiectomy.
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A low testosterone level (hypogonadism) in men may be treated with testosterone administration. Prostate cancer may be treated by removing the major source of testosterone: testicle removal (orchiectomy); or agents which block androgens from accessing their receptor: antiandrogens.
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In males, due to the difficulty in identifying the tumour using imaging techniques, an orchiectomy is often performed. The majority of Sertoli cell tumours are benign, so this is sufficient. There is no documented benefit of chemotherapy or radiotherapy.
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Rather than a real- life person, Dr. Evans turned out to be a doctor who once performed an unnecessary orchiectomy on Bert Cooper. The episode ends with the song "Bleecker Street" from Simon & Garfunkel's 1964 album Wednesday Morning, 3 A.M..
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The initial treatment for testicular cancer is surgery to remove the affected testicle (orchiectomy). While it may be possible, in some cases, to remove testicular cancer tumors from a testis while leaving the testis functional, this is almost never done, as the affected testicle usually contains pre-cancerous cells spread throughout the entire testicle. Thus removing the tumor alone without additional treatment greatly increases the risk that another cancer will form in that testicle. Since only one testis is typically required to maintain fertility, hormone production, and other male functions, the afflicted testis is almost always removed completely in a procedure called inguinal orchiectomy.
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Potential surgical problems: The most complicated aspect of closure involves moving the urethra to the phallus if it is not already there (i.e., repairing a perineal hypospadias). Fistulas, scarring, and loss of sensation are the main risks. Gonadectomy (also referred to as "orchiectomy") removal of the gonads.
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A single such injection results in estradiol levels of about 1,250 pg/mL at peak and levels of around 200 pg/mL after 7 days. Dosages of estrogens can be reduced after an orchiectomy or sex reassignment surgery, when gonadal testosterone suppression is no longer needed.
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Curtis is a member of The Church of Jesus Christ of Latter-day Saints also known as the Mormon faith; after high school, he served a two-year Mormon mission in London, England. On September 23, 2010, Curtis received an orchiectomy due to testicular cancer, at the Huntsman Cancer Institute.
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Estradiol is used as part of feminizing hormone therapy for transgender women. The drug is used in higher dosages prior to sex reassignment surgery or orchiectomy to help suppress testosterone levels; after this procedure, estradiol continues to be used at lower dosages to maintain estradiol levels in the normal premenopausal female range.
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Jorgensen stayed in Denmark and underwent hormone replacement therapy under Hamburger's direction. She chose the name Christine in honor of Hamburger. She obtained special permission from the Danish Minister of Justice to undergo a series of operations in that country. On September 24, 1951, surgeons at Gentofte Hospital in Copenhagen performed an orchiectomy on Jorgensen.
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Demasculinization refers to the reversal of virilization. Some but not all aspects of virilization are reversible. Demasculinization occurs naturally with andropause, pathologically with hypogonadism, and artificially or medically with antiandrogens, estrogens, and orchiectomy. It is desired by transgender women who have undergone the changes of pubertal masculinization, to restore & induce feminine physical traits that would otherwise be masked or never occur.
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Apalutamide is used in conjunction with castration, either via bilateral orchiectomy or gonadotropin-releasing hormone analogue (GnRH analogue) therapy, as a method of androgen deprivation therapy in the treatment of NM-CRPC. It is also a promising potential treatment for metastatic castration-resistant prostate cancer (mCRPC), which the NSAA enzalutamide and the androgen synthesis inhibitor abiraterone acetate are used to treat.
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As the growth of hormone dependent cancer is driven by sex hormones, surgical removal of the organs that synthesizes the sex hormone is sometimes performed. In the case of prostate cancer, orchiectomy (surgical castration) of the testes is sometimes performed while oophorectomy (surgical removal of the ovaries) is sometimes performed to prevent breast cancer in high risk women with BRCA1 or BRCA2 mutations.
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For malignant tumours, the surgery may be radical and usually is followed by adjuvant chemotherapy, sometimes by radiation therapy. In all cases, initial treatment is followed by surveillance. Because in many cases Leydig cell tumour does not produce elevated tumour markers, the focus of surveillance is on repeated physical examination and imaging. In males, a radical inguinal orchiectomy is typically performed.
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A potential testicular rupture should be evaluated with ultrasound imaging. Testicular rupture is treated with surgery, though the procedure performed depends on the magnitude of the injury and the salvageability of the tissue. An orchiectomy – removal of the affected testis – is done when the testis is not salvageable and leads to reduced semen quality and higher rates of endocrine dysfunction than repair of salvageable tissue.
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These surgeries include vaginoplasty, feminizing augmentation mammoplasty, orchiectomy, facial feminization surgery, reduction thyrochondroplasty (tracheal shave), and voice feminization surgery among others. Masculinization surgeries are surgeries that result in anatomy that is typically gendered male. These surgeries include chest masculinization surgery (top surgery), metoidioplasty, phalloplasty, scrotoplasty, and hysterectomy. In addition to SRS, patients may need to follow a lifelong course of masculinizing or feminizing hormone replacement therapy.
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A 7.4 x 5.5-cm seminoma in a radical orchiectomy specimen from a 27-year-old man Seminoma is the second-most common testicular cancer; the most common is mixed, which may contain seminoma. Abnormal gonads (due to gonadal dysgenesis and androgen insensitivity syndrome) have a high risk of developing a dysgerminoma.Sadler, T.W. 2006. Langman's Medical Embryology, 10th Edition, Chapter 15, pp. 251-252.
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On October 2, 1996, at age 25, Armstrong was diagnosed with stage three (advanced) testicular cancer (embryonal carcinoma). The cancer had spread to his lymph nodes, lungs, brain, and abdomen. He visited urologist Jim Reeves in Austin, Texas for diagnosis of his symptoms, including a headache, blurred vision, coughing up blood and a swollen testicle. On October 3, Armstrong had an orchiectomy to remove the diseased testicle.
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One study reported that denervation of the spermatic cord provided complete relief at the first follow-up visit in 13 of 17 cases, and that the other four patients reported improvement. As nerves may regrow, long-term studies are needed. One study found that epididymectomy provided relief for 50% of patients with post-vasectomy pain syndrome. Orchiectomy is recommended usually only after other surgeries have failed.
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Intratesticular masses that appear suspicious on an ultrasound should be treated with an inguinal orchiectomy. The pathology of the removed testicle and spermatic cord indicate the presence of the seminoma and assist in the staging. Tumors with both seminoma and nonseminoma elements or that occur with the presence of AFP should be treated as nonseminomas. Abdominal CT or MRI scans as well as chest imaging are done to detect for metastasis.
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Orchiopexy can also be performed to resolve a testicular torsion. If caught early enough and the blood supply can be restored to the testicle, this operation can be performed to prevent further occurrence of torsion. If the blood supply has been interrupted for too long, an orchiectomy must be performed. Sometimes orchiopexy is also done preventively in adults in cases in which the patient has the bell-clapper deformity, retractile testicles.
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3 The two developed a close friendship. Dillon subsequently carried out an inguinal orchiectomy on Cowell. Secrecy was necessary for this as the procedure was then illegal in the United Kingdom under so-called "mayhem" laws and no surgeon would agree to perform it openly. Cowell then presented herself to a private Harley Street gynaecologist and was able to obtain from him a document stating she was intersex.
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Orchiectomy may be performed as part of a more general sex reassignment surgery, either before or during other procedures. It may also be performed on someone who does not desire, or cannot afford, further surgery. Involuntary castration appears in the history of warfare, sometimes used by one side to torture or demoralize their enemies. It was practiced to extinguish opposing male lineages and thus allow the victor to sexually possess the defeated group's women.
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However, a legal gender change is difficult to obtain. The criteria to change one's legal gender includes written diagnoses of transsexualism from two or more psychiatrists, sterilization, and genital reconstruction. The average costs for orchiectomy and vaginoplasty are about 2 million won (USD 1,900) and 12 million won (USD 11,500), and these procedures are not covered by insurance. As a result, most trans women cannot obtain exemption by way of a legal gender change.
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As such, EMP therapy results in considerably stronger androgen deprivation than orchiectomy. Metabolites of EMP, including estramustine, estromustine, estradiol, and estrone, have been found to act as weak antagonists of the androgen receptor ( = 0.5–3.1 μM), although the clinical significance of this is unknown. Extremely high levels of estradiol and estrone occur during EMP therapy. The estrogenic metabolites of EMP are responsible for its most common adverse effects and its cardiovascular toxicity.
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Sharaf ad-Din depicting an operation for castration, c. 1466 Castration (also known as orchiectomy or orchidectomy) is any action, surgical, chemical, or otherwise, by which an individual loses use of the testicles: the male gonad. Surgical castration is bilateral orchidectomy (excision of both testicles), and chemical castration uses pharmaceutical drugs to deactivate the testes. Castration causes sterilization (preventing the castrated person or animal from reproducing); it also greatly reduces the production of certain hormones, such as testosterone.
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She is touched to discover Bailey's drawings on their map, and her mother rejects her attempt to discuss addiction. Arriving in Atlanta, Bailey realizes that he and Elizabeth have outgrown their relationship, and they amicably part ways. Darla makes peace with her mother, who fixes her car, and she arrives at Bailey's support group just as he is describing his appreciation for her. They reconcile, and he undergoes his second orchiectomy, while she commits to treating her sex addiction.
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The reported cases have occurred in patients with a history of cryptorchidism, which is associated with an elevated risk of neoplasm. Splenogonadal fusion occurs with a male-to-female ratio of 16:1, and is seen nearly exclusively on the left side. The condition remains a diagnostic challenge, but preoperative consideration of the diagnosis may help avoid unnecessary orchiectomy. On scrotal ultrasound, ectopic splenic tissue may appear as an encapsulated homogeneous extratesticular mass, isoechoic with the normal testis.
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Lili Elbe was the first known recipient of male-to-female sex reassignment surgery, in Germany in 1930. She was the subject of four surgeries: one for orchiectomy, one to transplant an ovary, one for penectomy, and one for vaginoplasty and a uterus transplant. However, she died three months after her last operation. Christine Jorgensen was likely the most famous recipient of sex reassignment surgery, having her surgery done in Denmark in late 1952 and being outed right afterwards.
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The inguinal orchiectomy is a necessary procedure if testicular cancer is suspected. While it is possible to remove a testicle through an incision in the scrotum, this is not done when cancer is suspected because it disrupts the natural lymphatic drainage patterns. Testicular cancer usually spreads into the lymph nodes inside the abdomen in a predictable manner. Cutting the skin in the scrotum may disrupt this and cancer may spread to the inguinal lymph nodes, making surveillance and subsequent operations more difficult.
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This was followed by Lili Elbe in Dresden during 1930–1931. She started with the removal of her original sex organs, the operation supervised by Dr. Magnus Hirschfeld. Lili went on to have four more subsequent operations that included an orchiectomy, an ovary transplant, a penectomy, and ultimately an unsuccessful uterine transplant, the rejection of which resulted in death. An earlier known recipient of this was Magnus Hirschfeld's housekeeper,Magnus Hirschfeld, Zeitschrift für Sexualwissenschaft, 1908 but their identity is unclear at this time.
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Oral estradiol often has difficulty adequately suppressing testosterone levels, due to the relatively low estradiol levels achieved with it. Prior to orchiectomy (surgical removal of the gonads) or sex reassignment surgery, the doses of estrogens used in transgender women are often higher than replacement doses used in cisgender women. This is to help suppress testosterone levels. The Endocrine Society (2017) recommends maintaining estradiol levels roughly within the normal average range for premenopausal women of about 100 to 200 pg/mL.
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Exemption can also be granted when there is extensive medical proof of gender identity disorder and "treatment". One other way of exemption is the irreversible orchiectomy surgery, which is the removal of the testicles, to achieve objective feminization. Irreversible surgery as a method of exemption is considered unethical and a coercive act of body mutilation. Between 2012 and 2015, 104 transgender women were exempt based on "testicle loss" and only 21 transgender women were exempt from service based on gender identity disorder.
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Either surgical removal of both testicles or chemical castration may be carried out in the case of prostate cancer. Testosterone-depletion treatment (either surgical removal of both testicles or chemical castration) is used to slow down the cancer, greatly reduce sex drive or interest in those with sexual drives, obsessions, or behaviors, or any combination of those that may be considered deviant. Castration has also been used in the United States for sex offenders. Trans women often undergo orchiectomy, as do some other transgender people.
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However, in acute suppurating epididymitis (acute epididymitis with a discharge of pus), an epididymotomy may be recommended; in refractory cases, a full epididymectomy may be required. In cases with unrelenting testicular pain, removal of the entire testicle—orchiectomy—may also be warranted. It is generally believed that most cases of chronic epididymitis will eventually "burn out" of patient's system if left untreated, though this might take years or even decades. However, some prostate-related medications have proven effective in treating chronic epididymitis, including doxazosin.
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Removal of the gland was first described in 1851, and radical perineal prostatectomy was first performed in 1904 by Hugh H. Young at Johns Hopkins Hospital. Surgical removal of the testes (orchiectomy) to treat prostate cancer was first performed in the 1890s, with limited success. Transurethral resection of the prostate (TURP) replaced radical prostatectomy for symptomatic relief of obstruction in the middle of the 20th century because it could better preserve penile erectile function. Radical retropubic prostatectomy was developed in 1983 by Patrick Walsh.
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The suppression of testosterone levels that can be achieved with PEP is equal to that with orchiectomy. However, to achieve such concentrations of testosterone, which are about 15 ng/dL on average, higher concentrations of estradiol of around 500 pg/mL were necessary. This was associated with a dosage of intramuscular 320 mg PEP every four weeks and occurred by 90 days of treatment. However, 240 mg PEP every four weeks has also been reported to eventually suppress testosterone levels in the castrate range.
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The Act on Sterilisation and Castration (), adopted in June 1929, was one of the first gender change laws in the world. The first person to successfully undertake a legal gender change in Denmark, which required undergoing sex reassignment surgery, was American Christine Jorgensen in the early 1950s. She underwent an orchiectomy and a penectomy in Copenhagen in 1951 and 1952, respectively. Danish transgender woman Lili Elbe, who inspired the 2015 movie The Danish Girl, was one of the first identifiable recipients of sex reassignment surgery.
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Cortisol levels were unchanged in the other groups (e.g., orchiectomy, GnRH agonist therapy, and parenteral estrogen therapy) in this study, but increased by 300 to 400% in the oral and synthetic estrogen groups, likely secondary to increases in hepatic corticosteroid-binding globulin (CBG) production and compensatory upregulation of adrenal corticosteroid synthesis. Changes in levels of weak adrenal androgens are of relevance as these androgens serve as circulating reservoir of precursors that are transformed in tissues into potent androgens like testosterone and dihydrotestosterone and into estrogens.
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Complications from this procedure include bleeding and infection. The ilioinguinal nerve which runs anterior to the spermatic cord may be damaged during the operation and cause numbness over the inner thigh or chronic groin and scrotal pain. Other symptoms also include intermittent and chronic back pain and sudden loss of mobility in the lower back. If the orchiectomy is performed to diagnose cancer, the testicle and spermatic cord are then sent to a pathologist to determine the makeup of the tumor, and the extent of spread within the testicle and cord.
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If the genitals become diseased, as in the case of cancer, sometimes the diseased areas are surgically removed. Females may undergo vaginectomy or vulvectomy (to the vagina and vulva, respectively), while males may undergo penectomy or orchiectomy (removal of the penis and testicles, respectively). Reconstructive surgery may be performed to restore what was lost, often with techniques similar to those used in sex reassignment surgery. During childbirth, an episiotomy (cutting part of the tissue between the vagina and the anus) is sometimes performed to increase the amount of space through which the baby may emerge.
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Gestonorone caproate, a closely related progestin to OHPC with about 5- to 10-fold greater potency in humans, was found to suppress testosterone levels by 75% at a dosage of 400 mg/week in men with prostate cancer. For comparison, orchiectomy decreased testosterone levels by 91%. In general, progestins are able to maximally suppress testosterone levels by about 70 to 80%. The antigonadotropic effects of OHPC and hence its testosterone suppression are the basis of the use of OHPC in the treatment of benign prostatic hyperplasia and prostate cancer in men.
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In modern times, pseudopregnancy is rarely used. However, studies in the mid-1990s were conducted and found it to be rapidly effective for increasing bone mineral density in women with osteopenia due to hypoestrogenism. HDE has also commonly been used in transgender women since the 1960s. Oral HDE for prostate cancer with diethylstilbestrol was used widely in men with prostate cancer until the mid-1960s, when it was compared directly to orchiectomy and was associated with improved cancer-related mortality but worse overall survival, mainly due to previously unrecognized cardiovascular side effects.
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The purpose of the use of antiandrogens in transgender women is to block or suppress residual testosterone that is not suppressed by estrogens alone. Additional antiandrogen therapy is not necessarily required if testosterone levels are in the normal female range or if the person has undergone orchiectomy. However, individuals with testosterone levels in the normal female range and with persisting androgen-dependent skin and/or hair symptoms, such as acne, seborrhea, oily skin, or scalp hair loss, can potentially still benefit from the addition of an antiandrogen, as antiandrogens can reduce or eliminate such symptoms.
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Others do not medically require hysterectomy, phalloplasty, metoidioplasty, penectomy, orchiectomy, or vaginoplasty to treat their gender dysphoria. In these cases, surgery is considered medically unnecessary and, for that reason, medically unethical. Additionally, surgery is generally the final series of medical procedures in a complete sex transition, and is financially prohibitive for many people.The Right to (Trans) Parent , William & Mary Law School There is also advocacy for transgender people to have a legal right to access assisted reproduction technology services and preservation of reproductive tissue prior to having surgery that would render them infertile.
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As a celebrity, Kaba-chan was open with her sexuality. While she was already known for her flamboyant character in Dos, she came out as a gay man publicly on television on a 2002 episode of the Japanese variety show Dancing Sanma Palace. In October 2014, when appearing on the talk show Uchi Kuru!? with drag queen Mitz Mangrove and transvestite LGBT activist Matsuko Deluxe, Kaba-chan revealed that she had undergone orchiectomy that past June, in addition to having had plastic surgery and begun hormone therapy, and intended to have her gender officially changed in the koseki.
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The array of medically indicated surgeries differs between trans women (male to female) and trans men (female to male). For trans women, genital reconstruction usually involves the surgical construction of a vagina, by means of penile inversion or the sigmoid colon neovagina technique; or, more recently, non-penile inversion techniques that make use of scrotal tissue to construct the vaginal canal. For trans men, genital reconstruction may involve construction of a penis through either phalloplasty or metoidioplasty. For both trans women and trans men, genital surgery may also involve other medically necessary ancillary procedures, such as orchiectomy, penectomy, mastectomy or vaginectomy.
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Spontaneous and morning erections decrease significantly in frequency, although some patients who have had an orchiectomy still experience morning erections. Voluntary erections may or may not be possible, depending on the amount of hormones and/or antiandrogens being taken. Managing long-term hormonal regimens have not been studied and are difficult to estimate because research on the long-term use of hormonal therapy has not been noted. However, it is possible to speculate the outcomes of these therapies on transgender people based on the knowledge of the current effects of gonadal hormones on sexual functioning in cisgender men and women.
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The SOC state: With respect to mastectomy/chest reconstruction and breast augmentation, the seventh version of the SOC do not require an RLE for these procedures; nor is an RLE required for hysterectomy, salpingo-oophorectomy, or orchiectomy, or for other procedures such as facial feminization surgery and voice feminization surgery. However, for GRS, including metoidioplasty, phalloplasty, and vaginoplasty, one year of continuous RLE is a listed requirement. Previous versions of the SOC stated that an RLE for GRS was an absolute requirement that could not be skipped or ignored. However, the seventh version of the SOC appears to be less stringent, and does not contain any such statements.
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To castrate (medical term: orchiectomy) is to remove the testicles of a male animal. Different techniques are used depending on the type of animal, including ligation of the spermatic cord with suture material, placing a rubber band around the cord to restrict blood flow to the testes, or crushing the cord with a specialized instrument like the Burdizzo. Pyometra surgery Neutering is usually performed to prevent breeding, prevent unwanted behavior, or decrease risk of future medical problems. Neutering is also performed as an emergency procedure to treat certain reproductive diseases, like pyometra and testicular torsion, and it is used to treat ovarian, uterine, and testicular cancer.
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Darolutamide is approved for use concurrently with a gonadotropin-releasing hormone (GnRH) agonist or antagonist or bilateral orchiectomy in the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC) in men. It is used at a dosage of 600 mg orally twice per day (1,200 mg/day total) with food. In individuals with severe renal impairment or moderate hepatic impairment, darolutamide is used at a dosage of 300 mg orally twice per day (600 mg/day total) with food. No dosage adjustment is needed for mild to moderate renal impairment or mild hepatic impairment, whereas appropriate dosage adjustment for end-stage kidney disease and severe hepatic impairment is unknown.
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If the malignant diagnosis is established by exploration and intraoperative ultrasound-guided biopsy, orchiectomy is performed in cases of diffuse involvement of a testis. Spontaneous resolution has been reported in 50% to 70% of patients with active sarcoidosis. If the diagnosis is not established unequivocally, immunosuppressive agents (frequently steroids) will resolve the inflammation in patients who wish to salvage their fertility; and in those with severely advanced disease, after careful consideration. A new approach has been proposed recently, based on the absence of evidence for malignant transformation in pathologically confirmed benign diagnosed testicular sarcoidosis, and it involves the open exploration of both testes, with resection of the largest lesion (on the right tunica).
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On August 23, 2009, Hirschbeck was diagnosed with a form of testicular cancer described as treatable by Dr. Stephen Jones of the Cleveland Clinic, causing Hirschbeck, who had missed the entire 2008 season following back surgery, to miss the remainder of the 2009 season as well. After the tumor was removed via orchiectomy, the cancer was given a 10 percent chance of recurrence, and Hirschbeck returned for the 2010 season. After working a reduced schedule in 2011 due to back pain, Hirschbeck's cancer returned and he missed the 2012 MLB season. His last contest before returning to umpiring's disabled list was Game 162 of the 2011 regular season between the Boston Red Sox and Baltimore Orioles.
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Hormonal therapy in oncology is hormone therapy for cancer and is one of the major modalities of medical oncology (pharmacotherapy for cancer), others being cytotoxic chemotherapy and targeted therapy (biotherapeutics). It involves the manipulation of the endocrine system through exogenous or external administration of specific hormones, particularly steroid hormones, or drugs which inhibit the production or activity of such hormones (hormone antagonists). Because steroid hormones are powerful drivers of gene expression in certain cancer cells, changing the levels or activity of certain hormones can cause certain cancers to cease growing, or even undergo cell death. Surgical removal of endocrine organs, such as orchiectomy and oophorectomy can also be employed as a form of hormonal therapy.
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Estrogens are powerful antigonadotropins at sufficiently high concentrations. By exerting negative feedback on the hypothalamic–pituitary–gonadal axis (HPG axis), they are able to suppress the secretion of the gonadotropins, LH and FSH, and thereby inhibit gonadal sex hormone production and circulating sex hormone levels as well as fertility (ovulation in women and spermatogenesis in men). Clinical studies have found that in men treated with them, estrogens can maximally suppress testosterone levels by about 95% or well into the castrate/female range (<50 ng/dL). This is equivalent to the reduction in testosterone levels achieved by orchiectomy and gonadotropin-releasing hormone analogue (GnRH analogue) therapy, corresponding to a complete shutdown of gonadal testosterone production.
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Moreover, numerically more patients with preexisting cardiovascular disease were randomized to the PEP group in one large study (17.1% vs. 14.5%; significance not reported), and this may have contributed to the increased incidence of cardiovascular morbidity observed with PEP. In any case, some studies have found that the increased cardiovascular morbidity with PEP is confined mainly to the first one or two years of therapy, whereas one study found consistently increased cardiovascular morbidity across three years of therapy. A longitudinal risk analysis that projected over 10 years suggested that the cardiovascular risks of PEP may be reversed with long-term treatment and that the therapy may eventually result in significantly decreased cardiovascular risk relative to GnRH modulators and orchiectomy, although this has not been confirmed.
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Abiraterone acetate is available in the form of 250 mg and 500 mg film-coated oral tablets and 250 mg uncoated oral tablets. It is used at a dosage of 1,000 mg by mouth once per day an empty stomach, in conjunction with castration (via GnRH analogue therapy or orchiectomy) and in combination with 5 mg prednisone orally twice per day. Abiraterone acetate is also available in the form of micronized 125mg tablets used once per day at 500mg in combination with methylprednisolone 4mg taken twice per day with or without food. Abiraterone acetate is marketed widely throughout the world, including in the United States, Canada, the United Kingdom, Ireland, elsewhere in Europe, Australia, New Zealand, Latin America, Asia, and Israel.
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Burdizzos have also been used by some human males as a means of self- castration , often by those seeking a remedy for a high libido, or those who, for religious, friends' influence, fun or personal reasons, seek to become eunuchs. The burdizzo has also been used by some transsexual women and other male-to-female transgender persons, as an alternative to the surgical procedure known as an orchiectomy. Because an incision is not required, castration by burdizzo is usually bloodless and, according to some research, has a lower risk of infection, compared with traditional methods. Since the burdizzo was not originally designed for human use, and fairly little research has been done on burdizzo castrations in humans, many physicians and others do not consider the burdizzo to be a safe castration method for humans.
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High-dose CPA has been found to achieve prostatic levels that are at least 30-fold those of DHT. One study found that levels of CPA in the prostate gland in men being treated with 200 mg/day oral CPA were about 28 times those of DHT. In accordance with the preceding findings, it has been stated that oral doses of CPA of at least 300 mg/day may achieve a combined androgen blockade action in the treatment of prostate cancer. At a dosage of CPA of 100 mg/day in men with prostate cancer, circulating levels of CPA (e.g., 350 ng/mL) are on the order of 200-fold higher than circulating levels of testosterone (e.g., 100 ng/dL). In men who have undergone orchiectomy, 50 mg/day oral CPA results in a 500-fold excess of circulating CPA relative to circulating testosterone.
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In addition to their antigonadotropic effects, estrogens at high concentrations can significantly decrease androgen production by the adrenal glands. A study found that treatment with a high dosage of ethinylestradiol (100 µg/day) reduced circulating adrenal androgen levels by 27 to 48% in transgender women. Another study found similar effects in men with prostate cancer, with levels of the adrenal androgens dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA-S), and androstenedione (A4) all decreasing significantly more with high-dose estrogen therapy (oral ethinylestradiol plus intramuscular polyestradiol phosphate) than with orchiectomy (by 33–39% and 10–26%, respectively). However, a study found that these effects occurred with high- dose oral and synthetic estrogens such as ethinylestradiol and estramustine phosphate but not with the parenteral estrogen polyestradiol phosphate, suggesting that decreases in adrenal androgen levels are secondary to changes in liver protein synthesis rather than due to a direct action in the adrenal cortex, and that such changes will only occur in the context of strong hepatic impact.
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But when Bert discovers PPL will be selling Sterling Cooper to a rival agency and that he will be forced to retire as a result, Cooper goes on to co-found the new agency Sterling Cooper Draper Pryce. During Season 4, Don Draper finds a taped recording of Roger's memoirs "Sterling's Gold" in a drawer by accident, from which it is revealed that a younger Cooper was given an unnecessary orchiectomy during the "height of his sexual prime". Don and Peggy also learn that when Roger was a young man, he was sexually involved with Cooper's much older, very eccentric, long-time secretary, Ida Blankenship. Later in the Season 4 episode "Blowing Smoke", when the agency is forced to radically downsize its staff following the loss of the Lucky Strike account, an angered Cooper tells the other partners he is quitting, partially in response to Don Draper's ad in The New York Times, which he feels is a needlessly reckless career move, and he does not want to be associated with Draper's "stunt".
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