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. 2021 Nov;44(11):2465-2474.
doi: 10.1007/s40618-021-01561-0. Epub 2021 Apr 3.

Serum concentrations of dihydrotestosterone are associated with symptoms of hypogonadism in biochemically eugonadal men

A Sansone  1   2 , S Kliesch  3 , M Dugas  4 , R Sandhowe-Klaverkamp  3 , A M Isidori  5 , S Schlatt  3 , M Zitzmann  3
Affiliations

Serum concentrations of dihydrotestosterone are associated with symptoms of hypogonadism in biochemically eugonadal men

A Sansone et al. J Endocrinol Invest. 2021 Nov.

Abstract

Purpose: Symptoms of hypogonadism are often reported by subjects with normal serum testosterone (T) levels. We aimed to assess the association between clinical symptoms in andrological outpatients and sex steroids levels.

Methods: This is a retrospective cross-sectional cohort study in an Academic clinic and research unit. International Index of Erectile Function (IIEF, EF domain) and Aging Males Symptoms scale (AMS) questionnaires were completed by 635 and 574 men, respectively (mean age: 47.3 ± 13.9 and 47.4 ± 13.8 years, p = 0.829), free of interfering medications with complaints possibly related to hypogonadism.

Results: Serum total/free T as well as dihydro-T (DHT) was associated with IIEF-EF and AMS scores in the overall population using univariate analyses. Multivariate approaches revealed DHT concentrations in subjects with normal T levels (n = 416, Total T > 12 nmol/L) to be significant predictors of AMS scores. A 0.1 nmol/l serum DHT increase within the eugonadal range was associated with a 4.67% decrease in odds of having worse symptoms (p = 0.011). In men with biochemical hypogonadism (Total T < 12 nmol/L), total and free T rather than DHT were associated with AMS results. This association was not found for IIEF-EF scores. Indirect effects of age and BMI were seen for relations with hormone concentrations but not questionnaire scores.

Conclusion: DHT can be associated with symptoms of hypogonadism in biochemically eugonadal men. Serum DHT measurement might be helpful once the diagnosis of hypogonadism has been ruled out but should not be routinely included in the primary diagnostic process.

Keywords: Aging Males Symptoms scale; Dihydrotestosterone; Erectile dysfunction; International Index of Erectile Function; Male hypogonadism; Testosterone.

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Conflict of interest statement

The Authors report no conflict of interest for the present study.

Figures

Fig. 1
Fig. 1
Spearman’s correlation matrix for parameters included in analysis of symptoms of male aging. Upper panel: rho coefficients for single bivariate correlation. Lower panel: negative correlation depicted in shades of red; positive correlation depicted in shades of blue
Fig. 2
Fig. 2
Spearman’s correlation matrix for parameters included in analysis of erectile function. Upper panel: rho coefficients for single bivariate correlation. Lower panel: negative correlation depicted in shades of red; positive correlation depicted in shades of blue
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References

    1. Sansone A, Sansone M, Lenzi A, Romanelli F. Testosterone replacement therapy: the Emperor’s new clothes. Rejuvenation Res. 2017;20:9–14. doi: 10.1089/rej.2016.1818. - DOI - PubMed
    1. Snyder PJ, Bhasin S, Cunningham GR, et al. Lessons from the testosterone trials. Endocr Rev. 2018;39:369–386. doi: 10.1210/er.2017-00234. - DOI - PMC - PubMed
    1. Corona G, Goulis DG, Huhtaniemi I, et al. European Academy of Andrology (EAA) guidelines on investigation, treatment and monitoring of functional hypogonadism in males: Endorsing organization: European Society of Endocrinology. Andrology. 2020;8:970–987. doi: 10.1111/andr.12770. - DOI - PubMed
    1. Wang C, Nieschlag E, Swerdloff R, et al. ISA, ISSAM, EAU, EAA and ASA recommendations: Investigation, treatment and monitoring of late-onset hypogonadism in males. Int J Impot Res. 2009;21:1–8. doi: 10.1038/ijir.2008.41. - DOI - PubMed
    1. Basaria S. Male hypogonadism. Lancet. 2014;383(9924):1250–1263. doi: 10.1016/S0140-6736(13)61126-5. - DOI - PubMed

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