The role of testosterone and estradiol levels in seminal plasma in the ejaculate microbiota in men

Abstract

Introduction. In recent years, fundamental research has appeared proving the important role of the level of sex hormones on the microbiota of the urogenital tract. Evidence has emerged that the level of testosterone and estradiol not only in the blood but also in the seminal plasma affects the functional parameters of sperm, as well as the course of chronic prostatitis and chronic pelvic pain syndrome. The study objective. To identify the influence of the level of sex hormones in blood serum and seminal plasma on the microbiota of ejaculate in healthy men. Material and methods. A prospective pilot study was conducted on 20 fertile male volunteers who applied for a preventive examination and did not present active complaints. All patients underwent a double study of the ejaculate by PCR real-time (Androflor®) test, as well as determination of the level of hormones in the blood serum: total testosterone, estradiol, progesterone, sex hormone binding globulin, calculation of the free androgen index and testosterone/estradiol ratio, in the seminal plasma of total testosterone and estradiol. Results. In more than half of the cases, anaerobes and opportunistic microorganisms were found in the sperm. In the ejaculate, the levels of total testosterone and estradiol were statistically significantly higher compared to blood serum; the testosterone/estradiol ratio was not statistically different in the blood and seminal plasma. A statistically significant indirect relationship was revealed between the level of testosterone in the blood serum and the value of total bacterial mass in semen (p<0.05). A statistically significant indirect relationship was observed between the level of testosterone in the blood serum and the presence of Atopobium cluster and Sneathia spp./Leptotrichia spp./ Fusobacterium spp. in semen. (р<0.05). A pronounced tendency was revealed for a lower frequency of occurrence of Enterobacteriaceae spp./Enterococcus spp. in the ejaculate at high levels of testosterone/estradiol ratio. Conclusion. The levels of testosterone and estradiol in blood serum and ejaculate are significantly different and do not always correlate with each other. Our study demonstrates the presence of a correlation between the level of testosterone in the blood serum and testosterone/estradiol ratio with the total bacterial mass in the ejaculate, which is evidence of the etiological significance of sex hormones in the development of bacteriospermia in men.