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- Title
The role of male hypogonadism, aging, and chronic diseases in characterizing adult and elderly men with erectile dysfunction: a cross-sectional study.
- Authors
Lisco, Giuseppe; Triggiani, Vincenzo; Bartolomeo, Nicola; Ramunni, Maria Isabella; Pelusi, Carla; De Pergola, Giovanni; Guastamacchia, Edoardo; Jirillo, Emilio; Giagulli, Vito Angelo
- Abstract
Background: Erectile function depends on a complex interaction between demographic, metabolic, vascular, hormonal, and psychological factors that trigger erectile dysfunction (ED). In the present study we carried out a cross-sectional study assessing the impact of non-communicable chronic diseases (NCDs), male hypogonadism, and demographic factors in characterizing men with ED. Four hundred thirty-three consecutive outpatients with ED were extracted from the electronic database from January 2017 to December 2019. The International Index of Erectile Function (IIEF) 5 score was used to diagnose ED and stratify its severity, standardized values of serum testosterone (10.5 nM/L) and luteinizing hormone (LH 9.4 IU/L) to diagnose and classify male hypogonadism and the Charlson Comorbidity Index (CCI) to weigh the role of each NCD on ED. Results: Forty-six percent of participants were eugonadal (EuG), 13% had organic hypogonadism (OrH), and the remaining 41% had functional hypogonadism (FuH). Hypogonadal men had a significantly lower IIEF 5 score (p <.0001) than EuG. FuH had a higher CCI than OrH and EuG (all p <.0001). In a multivariable model, only free T (FT) and Sex Hormone Binding Globulin (SHBG) showed a direct correlation with the IIEF 5 score (all p <.0001). Age and CCI had an inverse correlation with IIEF 5 score (all p <.0001). Conclusion: Serum FT, SHBG, and CCI are the leading determinants of ED severity. Besides overt hypogonadism, a relevant burden of severe NTCDs in middle-aged or older adults features the patient's characteristics who will suffer from severe ED. Appropriate clinical approaches and, when necessary, treatments are required in these clusters of patients.
- Subjects
OLDER men; HYPOGONADISM; IMPOTENCE; CHRONIC diseases; MIDDLE-aged persons; CROSS-sectional method; MALE infertility
- Publication
Basic & Clinical Andrology, 2023, Vol 33, Issue 1, p1
- ISSN
2051-4190
- Publication type
Article
- DOI
10.1186/s12610-022-00182-8