The Relationships between Sex Hormones and Sexual Function in Middle-Aged and Older European Men

O’Connor, Daryl B.; Lee, David M.; Corona, Giovanni; Forti, Gianni; Tajar, Abdelouahid; O'Neill, Terence W; Pendleton, Neil; Bártfai, György; Boonen, Steven; Casanueva, Felipe F.; Finn, Joseph D.; Giwercman, Aleksander; Han, Thang S.; Huhtaniemi, Ilpo; Kula, Krzysztof; Labrie, Fernand; Lean, Michael E. J.; Punab, Margus; Silman, Alan J.; Vanderschueren, Dirk; Wu, Frederick C. W.

doi:10.1210/jc.2010-2216

Cited by 102 publications

(64 citation statements)

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“…Hypoandrogenism in men is manifested, among other things, by a lack of interest in sex (no sexual fantasies), lack of spontaneous, morning erections, ED during sexual stimulation and difficulty in achieving orgasm [12,13]. EMAS revealed that among men above 40, those with the lowest levels of total and free testosterone reported significantly lower sexual function compared to men with the highest testosterone levels [14]. Androgen deficiency in older men creates a clinical syndrome called late onset hypogonadism (LOH), which is associated with multiple end-organ deficits [15].…”

Section: Introductionmentioning

confidence: 99%

Zależność pomiędzy funkcją seksualną a wskaźnikiem masy ciała i stężeniem hormonów steroidowych u młodych mężczyzn

Jastrzebska¹,

Walczak-Jędrzejowska²,

Kramek³

et al. 2014

Endokrynologia Polska

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Introduction: In older men, sexual disorders may be the result of a decrease in testosterone and an increase in sex hormone binding globulin (SHBG) serum levels. Although obesity may enhance the decline of testosterone, it is also the cause of metabolic disorders, which are additional risk factors of erectile dysfunction. The purpose of this study was to investigate whether elevated body weight is associated with decreased serum testosterone concentrations and reduced sexual function in young men. Material and methods: Data on general health, medication, depressive symptomatology and sexual life was obtained from 136 men aged 20-49 years. Blood levels of LH, total testosterone (TT), dehydroepiandrosterone sulfate (DHEA-S), oestradiol, SHBG, total cholesterol, LDL-and HDL-cholesterol, and triglycerides were determined. Body mass index (BMI), waist to hip ratio (WHR) and free testosterone index (FTI) were calculated. Results: A significantly reduced occurrence of sexual fantasies, morning erections and erectile function scores was observed in the oldest group compared to the youngest men with normal BMI, although orgasmic function was unchanged. A significant decrease in TT serum levels was observed in obese 30-year-olds compared to men with normal BMI, while in obese 40-year-olds decreased LH and SHBG levels were also found. No differences in the levels of lipids and sexual achievements were found among men with different BMI. However, erectile function and morning erections significantly negatively correlated with age, BMI and WHR, and positively with FTI, but not with other studied hormones and lipids.

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Section: Introductionmentioning

confidence: 99%

Zależność pomiędzy funkcją seksualną a wskaźnikiem masy ciała i stężeniem hormonów steroidowych u młodych mężczyzn

Jastrzebska¹,

Walczak-Jędrzejowska²,

Kramek³

et al. 2014

Endokrynologia Polska

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“…E 2 was the only hormone associated with sexual function-related distress, such that higher levels were related to greater distress. 20 Although several interesting studies have elucidated the role of E 2 in male reproduction, data on the peripheral levels of sex steroids are lacking. Huhtaniemi et al 21 reported that increased oestrogen activity rather than decreased androgen activity is associated with longer androgen receptor CAG repeats.…”

Section: Discussionmentioning

confidence: 99%

“…Cronbach's alpha coefficient has also indicated a high internal consistency. 12,13 Scoring the IIEF domain of erectile function allowed the classification of each patient as having no (26)(27)(28)(29)(30), mild (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate (11)(12)(13)(14)(15)(16) or severe (0-10) ED. At the same visits during which they were assessed for ED, all patients were also interviewed to gather their sociodemographic characteristics and relevant medical history.…”

Section: Ed Assessmentmentioning

confidence: 99%

Impact of the association between elevated oestradiol and low testosterone levels on erectile dysfunction severity

El‐Sakka¹

2013

Asian J Androl

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Our aim was to assess the impact of the association between elevated oestradiol (E 2 ) and low testosterone (T) levels on erectile dysfunction (ED) severity. A total of 614 male patients with ED and a normal or low T level in association with normal or elevated E 2 levels were enrolled. Patients underwent routine laboratory investigations in addition to measurements of total T, total E 2 , follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. We compared the responses to the erectile function domain, Q3 (achieving erection) and Q4 (maintaining erection) of the International Index for Erectile Function (IIEF) score in patients with the following: normal T and E 2 levels; low T level; low T level and elevated E 2 level; and elevated E 2 level. Of the patients included, 449 (73.1%) had normal T and E 2 levels, 110 (17.9%) had a low T level, 36 (5.9%) had a low T level and an elevated E 2 level, and 19 (3.1%) had an elevated E 2 level. Increased ED severity was significantly associated with low T levels, elevated E 2 levels, and both a low T level and an elevated E 2 level. Additionally, the mean values of the EF-domain, Q3 and Q4 were significantly lower in patients with both a low T level and an elevated E 2 level compared to patients with any condition alone.In conclusion, a low T level had the primary effect on erectile function; however, a concomitantly elevated E 2 level had an additive impairment effect. Keywords: erectile dysfunction (ED); hypogonadism; testosterone; oestradiol INTRODUCTION A diminution in testicular function with a consequence of testosterone (T) depletion is a common occurrence in older men. 1,2 The multi-factorial mechanisms of this phenomenon, which involve the hypothalamic-pituitary-testicular axis, have been reported. 3 Several studies have demonstrated that T has substantial effects on cavernosal tissues and that T deficiency impairs the anatomic and physiological substrates of erectile capacity that could be partly reversed upon androgen replacement. 4,5 Oestradiol (E 2 ) possesses an opposing functional role of T; therefore, a decline in the T level will affect its physiological balance with E 2 in men. 6 As a consequence, a high E 2 level, which has a strong gonadotropin suppressive effect, may lead to secondary hypogonadism in the ageing male. 7 Despite the concomitant elevation of E 2 in hypogonadal men, the information available on the physiological role of E 2 in erectile function is insufficient to correlate the aetiology of erectile dysfunction (ED) to a high E 2 level. 8 The likelihood of E 2 affecting the T balance and the independent effect of E 2 on erectile function have not been well evaluated. 9 Furthermore, although the association between ED severity and the prospective decrease in testosterone has been investigated, 10 the impact of an elevated E 2 level on ED severity has not been well addressed. The current study was designed to assess the impact of an association between an elevated E 2 level and a low T level on ED severity.

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“…In particular, total serum T concentrations lower than or equal to 230 ng/ dL (8 nmol/L) have been associated with worse sexual functioning and higher rates of erectile dysfunction. 92 …”

Section: Consequences Of Hormonal Changes Related To Male Agingmentioning

confidence: 99%

“…47 In particular, in the EMAS study lower serum free T levels have been more strongly associated with severe sexual dysfunction (such as increased erectile dysfunction and lower masturbation frequency). 83,92 Less data are available on sexual function in the BLSA and MrOS studies 97 (Table 3). Overweight and obesity are strongly associated to the decline of both total serum T and SHBG in several studies such as the MMAS, 37 and diabetes 107 (Table 3).…”

Section: Main Outcomes Of Cohort Studiesmentioning

confidence: 99%

Aging and sex hormones in males

2016

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Several large cohort studies have disclosed the trajectories of sex steroids changes overtime in men and their clinical significance. In men the slow, physiological decline of serum testosterone (T) with advancing age overlaps with the clinical condition of overt, pathological hypogonadism. In addition, the increasing number of comorbidities, together with the high prevalence of chronic diseases, all further contribute to the decrease of serum T concentrations in the aging male. For all these reasons both the diagnosis of late-onset hypogonadism (LOH) in men and the decision about starting or not T replacement treatment remain challenging. At present, the biochemical finding of T deficiency alone is not sufficient for diagnosing hypogonadism in older men. Coupling hypogonadal symptoms with documented low serum T represents the best strategy to refine the diagnosis of hypogonadism in older men and to avoid unnecessary treatments.

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The Relationships between Sex Hormones and Sexual Function in Middle-Aged and Older European Men

Cited by 102 publications

References 50 publications

Zależność pomiędzy funkcją seksualną a wskaźnikiem masy ciała i stężeniem hormonów steroidowych u młodych mężczyzn

Zależność pomiędzy funkcją seksualną a wskaźnikiem masy ciała i stężeniem hormonów steroidowych u młodych mężczyzn

Impact of the association between elevated oestradiol and low testosterone levels on erectile dysfunction severity

Aging and sex hormones in males

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