Hormonal variations during sleep in men with erectile dysfunction and normal controls

Abstract

Five physically healthy young males suffering from erectile impotence and five normal controls of similar age are the subjects of this preliminary report. All were studied in the sleep laboratory during 3 to 5 nights with the last two devoted to sequential hormonal sampling by means of an indwelling venous catheter. Electroencephalogram, eye movements, and penile tumescence were monitored continually through the night. Plasma LH, FSH, and testosterone were measured every 20 minutes by radioimmunoassay. There were no differences between the patients with erectile impotence and normal controls in all sleep parameters investigated, including mean tumescent time, time in simultaneous REM and tumescence, and number of full and partial tumescent episodes. Marked fluctuations in plasma LH, FSH, and testosterone were observed during sleep without differences noted between the two groups. Mean plasma LH, but not FSH or testosterone, was significantly lower in the impotent men. There were no significant differences in mean plasma gonadotrophins and testosterone between tumescent episodes and nontumescent periods in either group. A significant relation was found in normals, but not in the men with erectile dysfunction, between the occurrence of REM sleep and abrupt elevations in testosterone. Testosterone levels during REM sleep with tumescence were also consistently higher than during the condition of non-REM without tumescence in the normal, but not in the impotent, group.

Pituitary-Gonadal Function During Sleep in Men with Erectile Impotence and Normal Controls

“…We replicated our previous finding that testosterone levels during REM with tumescence were significantly higher than during periods free from REM and tumescence (15,20). Although penile tumescent episodes are usually associated with REM activity, REM may occur without tumescence, and occasional tumescent episodes take place during non-REM sleep.…”

“…There was a pattern of irregularly occurring abrupt rises in LH and testosterone concentrations in normal men, consistent with the results of our earlier work (15,20) and that of other investigators (21)(22)(23)(24). Quantitative characterization of testosterone and LH changes in terms of number of peaks, amount, and percentage of peak hormonal increases based on a mean of 44 determinations per subject did not reveal significant differences between the primary-and secondary-impotent groups and normal controls.…”

“…Primary-impotent men exhibited half as many full tumescent episodes as did secondary-impotent men and controls, and they spent significantly less time above 80% of full tumescence (Kruskal-Wallistestp < 0.02). It should be noted that some secondary-impotent men did exhibit markedly reduced time above 80% of full tumescence (Table 3, code numbers 15,17,24,26) and that one primary-impotent man ( Table 2, code number 25) did not exhibit a single full tumescent episode during the 5 study nights.…”

“…Seventeen men with erectile impotence and 12 sexually nondysfunctional controls were studied; 5 of the impotent subjects were included in the preliminary report (15). Selection criteria were ages 23-36, and no evidence of organic disease, significant psychopathology or current or recent history of drug or medication use.…”

“…In a preliminary investigation (15), we compared sequential variations in LH, FSH, and testosterone during 2 sleep nights in a small mixed group of primaryand secondary-impotent men (n=5) and matched controls. There were no differences in sleep and penile tumescent parameters and in the pattern of marked fluctuations in LH, FSH, and testosterone.…”