Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic

Abstract

Patients with diabetes mellitus (DM) were more often hypogonadal than normal fasting glucose subjects. The aim of this investigation is the assessment of characteristics and psychobiological correlates of DM associated with hypogonadism (DMAH). The Structured Interview SIEDY r was used along with several biochemical, psychological and instrumental investigations in a series of more than 1200 patients with erectile dysfunction (ED); 16% of whom with type II DM. Hypogonadism was defined as circulating total testosterone (T) below 10.4 nmol/l. The prevalence of hypogonadism was 24.5% in DM versus 12.6% in the rest of the sample (Po0.0001); differences in the prevalence of hypogonadism retained significance after adjustment for age and BMI. DMAH was associated with typical hypogonadism-related symptoms, such as reduction in sexual desire, leading to a decreased number of sexual attempts, and with higher depressive symptomatology. In DMAH, testis size and LH concentrations were significantly reduced, suggesting a central origin of the disease. At penile Duplex ultrasound examination, diabetic patients and in particular hypogonadal type II diabetic patients showed lower levels of basal and dynamic (after PGE 1 injection) peak systolic velocity and acceleration, when compared to the rest of the sample, even after adjustment for age and BMI. Our results show that hypogonadism is frequently associated with type II DM, at least in the 6th decade. DMAH might exacerbate sexual dysfunction by reducing libido and mood and further compromising penile vascular reactivity.

Endothelial dysfunction in diabetic erectile dysfunction

“…Endocrine disorders such as low testosterone and changes in hormone receptors may also be associated with diabetes-associated ED. 10,[115][116][117] This broad and complex area of research is, however, beyond the scope of the present review. Figure 1 Mechanisms of endothelial dysfunction in diabetesassociated ED.…”

Obesity, low testosterone levels and erectile dysfunction

“…53 Diabetes is clearly related to hypogonadism, and studies have shown that 20-50% of men with type 2 diabetes mellitus have low serum total or free testosterone. [54][55][56][57] The low serum testosterone levels are associated with lower serum LH and FSH levels, suggesting that the lower serum testosterone levels is due to hypogonadotropic hypogonadism in type 2…”

“…Patients with Obesity, low testosterone levels and ED M Diaz-Arjonilla et al diabetes mellitus and low testosterone levels had symptoms of reduced libido and mood in addition to ED. 91 In a cross-sectional cohort study, ED was related to metabolic factors, smoking and depression, but only to very low testosterone levels (below 8 nmol l À1 or 230 ng per 100 ml), 92 suggesting that ED is related to serum testosterone levels only when it is significantly below the adult range. 93 A recent study in type 2 diabetes mellitus showed that overt hypogonadism (total serum testosterone o8 nmol l À1 and bioavailable testosterone o2.5 nmol l À1 with clinical symptoms) was present in 17 and 14% of men and that the incidence increases with age.…”

Effects of Partners' Age, Marriage Duration and Monthly Coitus Number on Mean Intravaginal Ejaculation Latency Time on Premature Ejaculation Patients

“…9 PE ve/veya erektil disfonksiyon (ED) şikâyeti ile başvuran 822 kişilik bir çalışmada, eşler arasında sorun, iş yerinde hoşnutsuzluk gibi stres altında olanlarda PE ve ED arasında anlamlı korelasyon saptanmıştır. 10 Etiyolojiye yönelik yapılan çalışmalarda; ■ Genetik yatkınlık.…”

“…10 ■ Düşük 5-hidroksitriptamin seviyesi ve/veya 5-hidroksitriptamin 2c reseptör hiposensitivitesi olanlarda ejekülasyon eşiği belki de genetik olarak düşük olmakta ve sonuçta daha çabuk sürede ejekülasyon gerçekleşmektedir. Selektif serotonin gerialım inhibitör (SSRI)'lerinin PE'yi inhibe etmesi de bu teoriyi desteklemektedir.…”