Stroke-related erectile dysfunction: Impact of the cerebrovascular stroke site on the degree of erectile dysfunction, total testosterone and prolactin levels

Increased cardiovascular risk has been associated with reduced response to proerectile drugs. The Italian Society of Andrology and Sexual Medicine (SIAMS) promoted an independent, multicenter study performed in 604 men (55 ± 12 yrs) suffering from erectile dysfunction (ED) to assess multiple health outcomes and response to 6-month vardenafil challenge in a real-life setting. Overall, 30.8% men had metabolic syndrome. Cardiovascular risk stratification revealed a greater number of ED subjects with moderate risk of a major adverse cardiovascular event than the general population (P<0.01). Age-adjusted pulse pressure was positively correlated with ED severity and negatively with androgens and waist circumference (P<0.01). A decline in total testosterone was observed with increasing arterial pulse pressure (P<0.05), which was not accompanied by compensatory LH rise. Follow-up on 185 men treated with vardenafil in an nonrandomized, open, single-arm trial documented a significant rise in IIEF-5 (delta = 6.1 ± 4.8) that was maintained in men with high cardiovascular risk. Mild adverse events occurred in <5%, with no differences between cardiovascular risk classes. In summary, ED is a frequent symptom in patients with an elevated, but often unknown, risk of future cardiovascular events. Androgens predict vascular resistance in ED patients. Vardenafil’s response and safety profile were preserved in subjects with higher cardiovascular risk.

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Correlation between Serum Total Testosterone and the AMS and IIEF Questionnaires in Patients with Erectile Dysfunction with Testosterone Deficiency Syndrome

Korean Journal of Urology ◽

10.4111/kju.2011.52.6.416 ◽

2011 ◽

Vol 52 (6) ◽

pp. 416 ◽

Cited By ~ 17

Author(s):

Jae Il Kang ◽

Byeong Kuk Ham ◽

Mi Mi Oh ◽

Je Jong Kim ◽

Du Geon Moon

Keyword(s):

Erectile Dysfunction ◽

Deficiency Syndrome ◽

Total Testosterone ◽

Testosterone Deficiency ◽

Testosterone Deficiency Syndrome

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Androgen Deficiency and Erectile Dysfunction in Patients with Type 2 Diabetes

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s27700 ◽

2015 ◽

Vol 8 ◽

pp. CMED.S27700 ◽

Cited By ~ 12

Author(s):

Entesar O.A. El Saghier ◽

Salah E. Shebl ◽

Olfat A. Fawzy ◽

lhab M. Eltayeb ◽

Lamya M.A. Bekhet ◽

...

Keyword(s):

Type 2 Diabetes ◽

Erectile Dysfunction ◽

Hypogonadotropic Hypogonadism ◽

Multivariate Logistic Regression Analysis ◽

Serum Testosterone ◽

Total Serum ◽

Total Testosterone ◽

Androgen Deficiency ◽

Cross Sectional

Background The association between type 2 diabetes mellitus (T2DM) and low total serum testosterone (LST) has been identified in several cross-sectional studies. Objectives To assess the prevalence of androgen deficiency and erectile dysfunction (ED) and their relation to glycemic control within a sample of Egyptian men with T2DM. Research Design and Methods A cross-sectional study including 70 men having T2DM. Their ages ranged from 30 to 50 years. They were evaluated for symptoms of androgen deficiency and ED, using a validated Arabic-translated Androgen Deficiency in Aging Males questionnaire and five-items version of the International Index of Erectile Function-5, respectively. Total testosterone (TT), glycated hemoglobin (HbA1c), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin were measured for all study subjects. Penile hemodynamics was assessed using penile duplex study for subjects who gave history of ED. Results LST was found in 40% of studied men, and 92.9% of them reported overt symptoms of androgen deficiency. ED was detected in 85.7% of those with LST, as opposed to 31.0% of those with normal TT ( P < 0.000). TT was lower in diabetic men with ED compared to those without ED (12.04 ± 5.36 vs 17.11 ± 7.11 nmol/L, P < 0.001). Significant negative correlation was found between TT and age, body mass index, waist circumference, systolic and diastolic blood pressures, and HBA1c ( P < 0.00). FSH, LH, and prolactin levels were within the normal reference range in all subjects. HbA1c was higher in patients who had LST with ED, compared to those with normal TT and without ED. However, multivariate logistic regression analysis did not reveal a significant association between HBA1c and LST levels. Conclusion LST, symptoms of androgen deficiency, and ED are common in the studied sample of Egyptian men with T2DM. Inappropriately normal FSH and LH in face of LST may denote a state of hypogonadotropic hypogonadism. HBA1c was found to be more significantly associated with ED than with LST.

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P2644Coronary atherosclerotic burden and risk of major adverse cardiac events in hypertensive patients with erectile dysfunction

European Heart Journal ◽

10.1093/eurheartj/ehz748.0965 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

N Ioakeimidis ◽

C Vlachopoulos ◽

D Terentes-Printzios ◽

C Georgakopoulos ◽

E Oikonomou ◽

...

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Coronary Artery ◽

Comprehensive Evaluation ◽

Bypass Graft ◽

Peak Systolic Velocity ◽

Sexual Life ◽

Total Testosterone ◽

Risk Category

Abstract Purpose Aim of the study is to assess the prevalence of angiographically coronary artery disease (CAD) and the incidence of future cardiovascular (CV) events among hypertensive males with erectile dysfunction (ED) on the basis of calculated total CV risk at first presentation. Methods A total of 392 hypertensive ED patients without diabetes or known cardiovascular disease underwent a comprehensive evaluation for presence of target organ damage (TOD) and stratified into three total CV risk categories based on blood pressure (BP) category, CV risk factors, TOD and presence of chronic kidney disease. Total testosterone (TT) and peak systolic velocity (PSV) at penile arteries were measured as markers of ED severity and predictors of CV risk. All patients underwent exercise treadmill test and stress echocardiography to reveal myocardial ischemia. Men with positive one or both of the two tests were referred for coronary angiography in order to document CAD. Our primary outcome was a composite measure which included acute myocardial infarction (AMI), stroke, congestive heart failure, revascularization with either percutaneous coronary intervention or coronary artery bypass graft surgery. All patients were followed from cohort entry until major CV event, or end of study period (December 2018), whichever occurred first. Results The whole population was divided into high (n=176), intermediate (n=120) and low (n=96) total CV risk groups. The three groups had similar mean age (57 yrs). The prevalence of angiographically documented CAD was significantly higher among patients in the high risk group (n=32, 18%), compared to intermediate (n=15, 12.5%) and low risk (n=4, 4.1%) (overall P<0.05). Furthermore, there was a progressive decrease in penile PSV and TT levels from low to moderate and high total CV risk (35 vs 31 vs 28 cm/s and 5.1 vs 4.3 vs 3.8 ng/ml, respectively, overall P<0.001), indicating significant microvascular damage and androgen deficiency in men with a higher CV risk category. Interestingly, Kaplan-Meier analysis revealed a comparable incidence of major CV events in patients who were at high and intermediate total CV risk at entry (12.5% vs. 11%, respectively, log-rank =0.57) and a greater incidence of major CV events compared to that of low CV risk patients (3.2%), (log-rank P=0.004, for all comparisons) during a 9-year follow-up period (figure). CV events during a 9-year follow-up Conclusion The incidence of future CV events is considerably high among hypertensive ED patients with a intermediate total CV risk at first evaluation. Such patients may require a comprehensive evaluation to reveal occult CAD and they need an aggressive management of BP and concomitant risk factors to reduce their CV risk and improve their sexual life.

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Erectile dysfunction in cerebrovascular stroke patients

Journal of Current Medical Research and Practice ◽

10.4103/jcmrp.jcmrp_150_18 ◽

2018 ◽

Vol 3 (3) ◽

pp. 127

Author(s):

DoaaA Sayed Mahdy ◽

EmadE.K. Ali ◽

TarekA Sayed Rageh ◽

AhmedA. A Abdel Mageed

Keyword(s):

Erectile Dysfunction ◽

Stroke Patients ◽

Cerebrovascular Stroke

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Prevalence and Risk Factors of Testosterone Deficiency in Aging Thai Male Outpatients

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.11391 ◽

2021 ◽

Vol 104 (6) ◽

pp. 921-926

Keyword(s):

Risk Factors ◽

Erectile Dysfunction ◽

Potential Risk ◽

Testosterone Level ◽

Serum Testosterone ◽

Serum Testosterone Level ◽

Total Testosterone ◽

Testosterone Deficiency ◽

Factors Associated ◽

Potential Risk Factors

Background: Testosterone deficiency in men, characterized by a reduced concentration of serum testosterone, causes a constellation of signs and symptoms that may include decreased libido, erectile dysfunction, increased body fat, fatigue, and psychological problem. Testosterone deficiency in adult men is often overlooked, because they ignore their symptoms or attribute them to alternate causes, including aging and underlying diseases that made them lose the opportunity for treatment. The present study aimed to describe the prevalence of testosterone deficiency and to study potential risk factors associated with testosterone deficiency among Thai men in Phramongutklao Hospital. Objective: To determine the prevalence of testosterone deficiency and potential risk factors associated with testosterone deficiency in Thai men. Materials and Methods: Thai male older than 40 years old who visited in urological outpatient unit at Phramongkutklao Hospital between July and October 2018 were included. Demographic data, medical information, and the androgen deficiency in the aging male (ADAM) questionnaires were collected. The participants having symptoms of testosterone deficiency from ADAM questionnaires were requested to measure serum total testosterone levels and were repeated if serum testosterone level was less than 300 ng/dL. Results: Data from 156 men were collected. The mean age of the participants was 67±8.73 years. Prevalence of testosterone deficiency was 5.8%. Obesity, waist circumference at or greater than 90 cm, diabetes mellitus, and dyslipidemia were identified as risk factors of testosterone deficiency. There was an association between three symptoms of ADAM questionnaires, which were decreased libido, erectile dysfunction, and decreased enjoyment of life, with testosterone deficiency. Conclusion: Prevalence of testosterone deficiency among Thai men at Phramongkutklao Hospital is about 5.8%. Clarification of the underlying causes for the changes in testosterone level may provide helpful information so that preventive action can be taken. Low libido, erectile dysfunction, and decreased enjoyment of life may be specific symptoms of testosterone deficiency and should be the questions to ask the suspected patients. Keywords: Testosterone deficiency; Total testosterone; Prevalence; ADAM questionnaires

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Correlation of Adiponectin With Testosterone in Patients With and Without Type 2 Diabetes and Erectile Dysfunction

American Journal of Men s Health ◽

10.1177/1557988318807049 ◽

2018 ◽

Vol 13 (1) ◽

pp. 155798831880704

Author(s):

Moustafa A. Elsaied ◽

Doaa Masallat ◽

Ibrahim A. Abdel-Hamid

Keyword(s):

Insulin Resistance ◽

Erectile Dysfunction ◽

Fasting Blood Glucose ◽

Total Testosterone ◽

Diabetic Patients ◽

Fasting Insulin ◽

Type 2 Diabetic Patients ◽

Testosterone Levels ◽

Type 2 Diabetic

The aim of this study was to evaluate the levels of adiponectin in diabetic patients with and without erectile dysfunction (ED). In addition, the correlations of adiponectin with the scores of international index of erectile function (IIEF) and total testosterone levels were explored in diabetic and nondiabetic patients with ED. The study included three groups: Type 2 Diabetic patients (T2DM) with and without ED and a third nondiabetics with ED group, each of 29 patients. Fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR index), testosterone and adiponectin levels were evaluated. IIEF was applied to diabetic and nondiabetic patients with ED. The results showed that adiponectin was lower in diabetic patients with ED than in both nondiabetics with ED and diabetics without ED groups (5.23 ± 1.05 vs. 11.38 ± 10.08 and 6.5 ± 2.13; p = .003 and .006 respectively). Testosterone was lower in diabetic patients with ED than in diabetics without ED group (2.52 ± 1.15 vs. 4.1 ± 1.46; p = .024). Testosterone had a direct correlation with adiponectin ( r = .371; p = .001). Both adiponectin and testosterone levels did not correlate with IIEF. In conclusion, the decreased adiponectin and testosterone are associated with ED in T2DM. Testosterone has a direct correlation with circulating adiponectin while both have no correlation with IIEF.

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Total Testosterone Levels and the Effect of Sildenafil on Type 2 Diabetics with Erectile Dysfunction

Oman Medical Journal ◽

10.5001/omj.2014.10 ◽

2014 ◽

Vol 29 (1) ◽

pp. 46-50 ◽

Cited By ~ 3

Author(s):

Nabeel Najib Fadhil Hadeed ◽

Imad Abdul-Jabar Thanoon ◽

Samir Burhanaldin Al-Mukhtar

Keyword(s):

Erectile Dysfunction ◽

Total Testosterone ◽

Testosterone Levels ◽

Type 2 Diabetics

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Prevalence of Symptomatic Androgen Deficiency in Men

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-1245 ◽

2007 ◽

Vol 92 (11) ◽

pp. 4241-4247 ◽

Cited By ~ 393

Author(s):

Andre B. Araujo ◽

Gretchen R. Esche ◽

Varant Kupelian ◽

Amy B. O’Donnell ◽

Thomas G. Travison ◽

...

Keyword(s):

Erectile Dysfunction ◽

Free Testosterone ◽

Population Based ◽

Total Testosterone ◽

Androgen Deficiency ◽

Male Population ◽

Clinical Criteria ◽

Testosterone Levels ◽

Low Testosterone ◽

Osteoporosis Fracture

Abstract Context: Despite recognition that androgen deficiency in men should be defined according to biochemical and clinical criteria, most prevalence estimates are based on low testosterone levels alone. Objective: The objective of this study was to examine the association between symptoms of androgen deficiency and low total and calculated free testosterone levels and estimate the prevalence of symptomatic androgen deficiency in men. Design: This study was a population-based, observational survey. Participants: A total of 1475 Black, Hispanic, and white men, between the ages of 30–79 yr, with complete data on testosterone, SHBG, and symptoms of androgen deficiency, and who are not taking medications that impact sex steroid levels were randomly selected from the Boston Area Community Health Survey. Outcome: Outcomes were measured as symptomatic androgen deficiency, defined as low total (<300 ng/dl) and free (<5 ng/dl) testosterone plus presence of low libido, erectile dysfunction, osteoporosis or fracture, or two or more of following symptoms: sleep disturbance, depressed mood, lethargy, or diminished physical performance. Results: Mean age of the sample was 47.3 ± 12.5 yr. Approximately 24% of subjects had total testosterone less than 300 ng/dl, and 11% of subjects had free testosterone less than 5 ng/dl. Prevalence of symptoms were as follows: low libido (12%), erectile dysfunction (16%), osteoporosis/fracture (1%), and two or more of the nonspecific symptoms (20%). Low testosterone levels were associated with symptoms, but many men with low testosterone levels were asymptomatic (e.g. in men 50+ yr, 47.6%). Crude prevalence of symptomatic androgen deficiency was 5.6% (95% confidence interval: 3.6%, 8.6%), and was not significantly related to race and ethnic group. Prevalence was low in men less than 70 yr (3.1–7.0%) and increased markedly with age to 18.4% among 70 yr olds. Projection of these estimates to the year 2025 suggests that there will be as many as 6.5 million American men ages 30–79 yr with symptomatic androgen deficiency, an increase of 38% from 2000 population estimates. Conclusions: Prevalence of symptomatic androgen deficiency in men 30 and 79 yr of age is 5.6% and increases substantially with age. The aging of the U.S. male population will cause a large increase in the burden of symptomatic androgen deficiency. Future work should address the clinical significance of low testosterone levels in asymptomatic men.

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