A Relationship of Sex Hormone Levels and Erectile Dysfunction: Which Tests Should Be Done Routinely?

Department of Urology, Celal Bayar University, Medical Faculty, 45010 Manisa, Turkey.
Yonsei Medical Journal (Impact Factor: 1.29). 12/2007; 48(6):1015-9. DOI: 10.3349/ymj.2007.48.6.1015
Source: PubMed


In this study, the relationship between sex hormone levels and erectile dysfunction (ED), as well as the necessity of routinely measuring sex hormone levels were evaluated.
This study included one hundred patients admitted to a urology clinic for sexual dysfunction. To determine the hormone levels, following the history (included IIEF-5 score) and physical examination, triple blood samples were collected at intervals of 15 minutes between 08:00 and 10:00 am. Total and free testosterone, prolactin, follicle stimulating hormone and luteinizing hormone levels were studied.
Mean age was 43 (23-80) years. IIEF-5 score was less than 21 [9.8-4.3 (3-19)] in all study groups. There was a statistically significant correlation between tT and FSH, as well as between LH and FSH in Pearson (r =-0.513, p < 0.001, respectively) and also in Spearman tests (r=-0.224, p=0.042 and r=-0.459, p < 0.001, respectively). However, there was no correlation between age and serum hormone levels (p > 0.05). Of the 100 patients, 18 (18%) had low tT, 77 (77%) had normal and 5 (5%) had high tT levels. No statistically significant correlation was found between decreased libido and tT levels (p > 0.05). Twelve (66.6%) of the 18 patients with low tT had normal libido.
Analyzing the medical history in detail and performing a thorough physical examination can reduce the need for excessive studies and consultations, and enables patients to save time and costs.

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    • "In the last several years various studies have also underlined a role of sex hormones in ED. From them it is obvious that androgens are important for the penis growth and for its erectile regulation (Müezzinoğu et al. 2007; Traish et al. 2007), but in fact no significant correlation was ascertained between serum testosterone levels and ED, while a relationship was found between serum testosterone and FSH as well as between serum FSH and LH in patients with ED (Müezzinoğu et al. 2007). In contrast to the male patients, women with MTHFR 677CC genotype showed higher serum estradiol levels than heterozygous or homozygous carriers of the 677T allele (Thaler et al. 2006) and recurrent pregnancy loss (Ozdemir et al. 2012; Wu et al. 2012). "
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    ABSTRACT: Objectives: The methylenetetrahydrofolate reductase (MTHFR) enzyme activity plays an important role in the metabolism of folate within methionine-homocysteine pathway and, consequently, in the development of vascular diseases. The C677T polymorphism (rs1801133) of the MTHFR gene affects the MTHFR activity, modifies the homocysteine plasma concentration and, among others, increases the risks for idiopathic male infertility, including erectile dysfunction (ED). As this sexual dysfunction is related to sex hormone levels, we investigated a possible relationship between the C677T polymorphism of the MTHFR gene and plasma concentrations of follicle-stimulating hormone (FSH) as well as luteinizing hormone (LH) in male patients with ED. Methods: We conducted our study on 90 healthy men with ED between the age of 32 and 61 (mean age was 51.1 ± 11.5) years. The subjects were genotyped and their FSH and LH plasma levels were analysed. Results: The analysis results of ED patients and their genotypes of the MTHFR gene did not provide evidence supporting any causal association of T allele in CT and TT genotypes with studied clinical parameters. However, we found that patients with the CC genotype had significantly higher plasma levels of LH than patients with the CT and/or TT genotypes. Conclusions: Our observations suggest that the C677T polymorphism of MTHFR gene has no direct relationship to erectile dysfunction, but does exhibit a relationship between this rs1801133 polymorphism and plasma LH concentrations.
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    ABSTRACT: Descripción: El American College of Physicians desarrolló estas guías clínicas para presentar la evidencia disponible sobre la evaluación hormonal y el tratamiento farmacológico de la disfunción eréctil. Las terapéutica farmacológica actual incluye a los inhibidores de la 5-fosfodiesterasa (PDE-5) como el sildenafil, vardenafil, tadalafil, mirodenafil y udenafil, así como el tratamiento hormonal. Métodos: La literatura publicada sobre este tema fue identificada usando MEDLINE (1966 a mayo del 2007), EMBASE (1980 a la semana 22 del 2007), el Registro Central de Estudios Controlados Cochrane (segunda trimestre del 2007), PsycINFO (1985 a junio del 2007), AMED (1985 a junio del 2007), y SCOPUS (2006). La búsqueda bibligráfica fue actualizada buscando artículos en MEDLINE y EMBASE publicados entre mayo 2007 y abril 2009. Las búsquedas se limitaron a publicaciones en idioma inglés. Esta guía clínica establece el nivel de evidencia y el grado de recomendación utilizando el sistema de graduación de las guías clínicas del American College of Physicians.
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    ABSTRACT: DESCRIPTION: The American College of Physicians developed this guideline to present the available evidence on hormonal testing in and pharmacologic management of erectile dysfunction. Current pharmacologic therapies include phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil, and hormonal treatment. METHODS: Published literature on this topic was identified by using MEDLINE (1966 to May 2007), EMBASE (1980 to week 22 of 2007), Cochrane Central Register of Controlled Trials (second quarter of 2007), PsycINFO (1985 to June 2007), AMED (1985 to June 2007), and SCOPUS (2006). The literature search was updated by searching for articles in MEDLINE and EMBASE published between May 2007 and April 2009. Searches were limited to English-language publications. This guideline grades the evidence and recommendations by using the American College of Physicians' clinical practice guidelines grading system. RECOMMENDATION 1: The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use (Grade: strong recommendation; high-quality evidence). RECOMMENDATION 2: The American College of Physicians recommends that clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile (Grade: weak recommendation; low-quality evidence). RECOMMENDATION 3: The American College of Physicians does not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with erectile dysfunction (Grade: insufficient evidence to determine net benefits and harms).
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