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. 2022 Aug;45(8):1527-1534.
doi: 10.1007/s40618-022-01788-5. Epub 2022 Apr 2.

Erectile dysfunction as a marker of endocrine and glycemic disorders

R Mazzilli  1 , V Zamponi  2 , S Olana  2 , N Mikovic  2 , D Cimadomo  3 , G Defeudis  4 , A Faggiano  2
Affiliations

Erectile dysfunction as a marker of endocrine and glycemic disorders

R Mazzilli et al. J Endocrinol Invest. 2022 Aug.

Abstract

Purpose: The aim of this study was to evaluate in a population of patients with erectile dysfunction (ED): (a) the prevalence of a previously unknown endocrine/glycemic disorders; (b) the correlation between ED severity and endocrine/glycemic disorders.

Methods: 1332 patients referred for ED from 2013 to 2020 were included. The ED diagnosis was made using the International-Erectile-Function-Index-5 questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency. All patients were subjected to search for sociodemographic and clinical characteristics: age, ethnicity, marital status, previous use of PDE5i, previous prostatectomy, diabetes mellitus (DM), prediabetes, endocrine dysfunctions.

Results: The mean ± SD age was 54.3 ± 13.7 years. The 19.1% (255/1332) of patients were already in treatment for prediabetes/diabetes or endocrine dysfunctions. Among the remaining 1077, the prevalence of previously unknown endocrine and glycemic disorders was 30% (323/1077). Among them, 190/323 subjects (58.8%) were affected by hypogonadism, with high estradiol level observed in 8/190 (4.2%). The prevalence of new glycemic alterations was 17.3% (56/323) [specifically, 32/56 (57.1%) DM, and 24/56 (42.9%) prediabetes]. A thyroid dysfunction was observed in 40/323 subjects (12.3%) and hyperprolactinemia in 37/323 (11.5%). Patients with new diagnosis of DM showed more severe form of ED compared to the total group {difficulty in the achievement of erection: 46/56 [82.2%, vs 265/1332 (19.9%), p < 0.05]; absence of spontaneous erection 23/56 [41.1%, vs 321/1332 (24.1%), p < 0.05]}.

Conclusion: ED is an early marker of endocrine/glycemic disorder, and a previously unknown dysfunction was found in more than a quarter of patients. A newly diagnosed DM is associated with ED severity, especially in elderly man and in presence of hypertension.

Keywords: Diabetes mellitus (DM); Erectile dysfunction; Hypogonadism; Prolactin; Sexual function; Thyroid dysfunction.

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Conflict of interest statement

All authors declare no conflict of interest.

Figures

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Fig. 1
Flowchart of patient enrollment
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