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SUMMARYAn estimated 20-30% of adult men have at least one manifestation of sexual dysfunction, the most common of which are premature ejaculation (PE) and erectile dysfunction (ED). Emerging evidence has suggested an association between the regulation of hormones with the processes of erection and ejaculation. In this study, we aim to investigate the relationship between sexual dysfunction, namely, PE and ED, and the levels and ratios of estradiol to testosterone in Chinese men. A retrospective case-control study was performed involving 878 male patients aged from 18 to 74 years (mean: 36 years). The ratio of estradiol to testosterone was significantly higher for subjects with ED (7.45 AE 3.09 9 10 À3 ; p < 0.001), and combined PE and ED (6.66 AE 3.05 9 10 À3 ; p = 0.032) compared with that of the control group (6.01 AE 2.61 9 10 À3 ). The ratio was also significantly higher for ED patients when compared with PE patients (5.26 AE 2.18 9 10 À3 ; p < 0.001). Furthermore, compared with the control group, subjects with PE had