Hormonal modulation in aging patients with erectile dysfunction and metabolic syndrome
Costa IC1, Carvalho HN1, Pacheco-Figueiredo L2, Tomada I3, Tomada N4. Int J Endocrinol. 2013;2013:107869. doi: 10.1155/2013/107869. Epub 2013 Dec 28.

Author information

1Faculty of Medicine, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal. 2Department of Urology, São João Central Hospital, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal ; School of Health Sciences, Life and Health Sciences Research Institute (ICVS), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal. 3Department of Experimental Biology, Faculty of Medicine, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal ; Institute for Molecular Cell Biology, Universidade do Porto (IBMC), Rua do Campo Alegre 823, 4150-180 Porto, Portugal ; Faculty of Biotechnology, Catholic University of Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal. 4Faculty of Medicine, Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal ; Department of Urology, São João Central Hospital, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal ; Institute for Molecular Cell Biology, Universidade do Porto (IBMC), Rua do Campo Alegre 823, 4150-180 Porto, Portugal.

Abstract

Erectile dysfunction (ED), metabolic syndrome (MetS), and hypogonadism are closely related, often coexisting in the aging male. Obesity was shown to raise the risk of ED and hypogonadism, as well as other endocrinological disturbances with impact on erectile function. We selected 179 patients referred for ED to our andrology unit, aiming to evaluate gonadotropins and estradiol interplay in context of ED, MetS, and hypogonadism. Patients were stratified into groups in accordance with the presence (or not) of MetS and/or hypogonadism. Noticeable differences in total testosterone (TT) and free testosterone (FT) levels were found between patients with and without MetS. Men with MetS evidenced lower TT circulating levels with an increasing number of MetS parameters, for which hypertriglyceridemia and waist circumference strongly contributed. Regarding the hypothalamic-pituitary-gonadal axis, patients with hypogonadism did not exhibit raised LH levels. Interestingly, among those with higher LH levels, estradiol values were also increased. Possible explanations for this unexpected profile of estradiol may be the age-related adiposity, other estrogen-raising pathways, or even unknown mechanisms. Estradiol is possibly a molecule with further interactions beyond the currently described. Our results further enlighten this still unclear multidisciplinary and complex subject, raising new investigational opportunities.