The Associations Between Serum Sex Hormones, Erectile Function, and Sex Drive: The Olmsted County Study of Urinary Symptoms and Health Status Among Men

Abstract

Few studies have examined the association between sex hormone serum levels, erectile function, and sex drive. Using data from the Olmsted County Study of Urinary Symptoms and Health Status among Men we examined the associations between sex hormone serum levels, erectile function, and sex drive. During 1989-1991, Caucasian men ages 40-79 years were randomly selected from Olmsted County, MN, and in the sixth year of follow-up questions on sexual function from the Brief Male Sexual Function Inventory were added and included biennially thereafter with assays for estradiol, testosterone, and bioavailable testosterone levels. Out of 414 men, 294 had a regular sexual partner and androgen measurements at the fourteenth year of follow-up. These cross-sectional results suggest the relationship between sex hormones and sexual function is complex. Total testosterone and erectile function were significantly correlated even after adjustment for age (r = 0.12, p = 0.04). Conversely, total testosterone was not significantly correlated with sex drive (r = 0.08, p = 0.17). Bioavailable testosterone was significantly correlated with both erectile function and sex drive (r = 0.16, p = 0.01 and r = 0.20, p = 0.001, respectively). However, these associations disappeared after age-adjustment (r = 0.04 and r = 0.09). This suggests that the age-related decline in sexual function may be due to age-related declines in levels of bioavailable testosterone rather than total testosterone levels.

Predictors of Sexual Dysfunction Incidence and Remission in Men

“…The ages of the men in these studies ranged from 26 to 83 years of age, and higher rates were seen in older cohorts; for instance, 66 cases per 1,000 person‐years were observed in the Brazilian Men's Health Study (age range 60–83 years [26]). Lower incidence rates were also observed in studies that used only two questions to assess ED [27].…”

“…By contrast, low solitary and dyadic desire remitted in 21.8% and 15.3% of men, respectively. Previous prospective studies [24,27] have also found that sexual desire was relatively well preserved into old age, although these studies did not distinguish between dyadic and solitary desire (the MMAS did, however, report a decreased masturbatory frequency in older men). Data from the present study concur with our previous cross‐sectional observations [15] and others [13], showing a marked preference for partnering that is maintained well into older age.…”

“…The examination of explanatory variables in previous longitudinal studies of changes in sexual desire in men has been limited. In separate analyses of men from the Olmsted County Study of Urinary Symptoms and Health Status, both diabetes [47] and lower testosterone [27] were found to predict lower sexual desire at follow‐up. The relationship between testosterone and sexual desire in men has been well‐established in cross‐sectional [48] and clinical studies [49].…”

The Relationship between Testosterone Deficiency and Men's Health

“…A longitudinal study also showed a close relationship between the serum testosterone level and sexual desire 27. The Olmsted County Study, with its large number of subjects, showed an association between a higher testosterone level and an increase in sexual desire 28. When reduced sexual desire is primarily due to hypogonadism, two meta-analyses of RCTs demonstrated a significant improvement in sexual desire after TRT 25,26.…”

Translational Perspective on the Role of Testosterone in Sexual Function and Dysfunction

“…Testosterone is widely accepted as playing a role in male sexual anatomy and function [15, 16]. However, its physiological role in human erectile function remains a matter of some controversy [17–20].…”