Serum concentrations of dihydrotestosterone are associated with symptoms of hypogonadism in biochemically eugonadal men

Abstract

Purpose Symptoms of hypogonadism are often reported by subjects with normal serum testosterone (T) levels. We aimed to assess the association between clinical symptoms in andrological outpatients and sex steroids levels. Methods This is a retrospective cross-sectional cohort study in an Academic clinic and research unit. International Index of Erectile Function (IIEF, EF domain) and Aging Males Symptoms scale (AMS) questionnaires were completed by 635 and 574 men, respectively (mean age: 47.3 ± 13.9 and 47.4 ± 13.8 years, p = 0.829), free of interfering medications with complaints possibly related to hypogonadism. Results Serum total/free T as well as dihydro-T (DHT) was associated with IIEF-EF and AMS scores in the overall population using univariate analyses. Multivariate approaches revealed DHT concentrations in subjects with normal T levels (n = 416, Total T > 12 nmol/L) to be significant predictors of AMS scores. A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011). In men with biochemical hypogonadism (Total T < 12 nmol/L), total and free T rather than DHT were associated with AMS results. This association was not found for IIEF-EF scores. Indirect effects of age and BMI were seen for relations with hormone concentrations but not questionnaire scores. Conclusion DHT can be associated with symptoms of hypogonadism in biochemically eugonadal men. Serum DHT measurement might be helpful once the diagnosis of hypogonadism has been ruled out but should not be routinely included in the primary diagnostic process.

Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience

“…on hypogonadism patients, sexual functions were evaluated using IIEF and Aging Male’s Symptoms (AMS) questionnaire, and the relationship between the results and dihydrotestosterone was investigated. According to the study results, the dihydrotestosterone level was associated with hypogonadism symptoms in hypogonadism patients ( 24 ). A study conducted by Rosen and cols., which aimed to show the effect of TRT on the quality of life and sexual functions, reported that TRT increases the quality of life and improves the sexual functions of patients.…”

Facing Counterfeit Medications in Sexual Medicine. A Systematic Scoping Review on Social Strategies and Technological Solutions

“…144 Some websites only provide high dosages of PDE5i, without mentioning the suggested "starting" dose for any naïve patient. 57 Additionally, first-line treatments for ED include pursuing a healthier lifestyle, such as by limiting alcohol intake, reducing harm from tobacco smoking and performing physical exercise 112,145,146 : individuals buying "sexual enhancers" online, or getting them from friends without any prior clinical evaluation, are generally less aware of the pathophysiology of sexual dysfunctions 115 and thus less likely to investigate for any underlying condition, such as endocrine dysfunctions including hypogonadism 147,148 and diabetes, 138,149,150 or metabolic and cardiovascular diseases, 150 −152 possibly resulting in ED. 136,153 The unsupervised use of PDE5i might therefore reduce the rate of diagnosis for ED-associated diseases.…”