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Hormone Molecular Biology and Clinical Investigation

Editor-in-Chief: Pasqualini, Jorge R.

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Testosterone deficiency in the aging male and its relationship with sexual dysfunction and cardiovascular diseases

Giovanni Corona1, 2 / Giulia Rastrelli1 / Valdo Ricca3 / 1

1Department of Clinical Physiopathology, Andrology Unit and Endocrinology, University of Florence, Florence, Italy

2Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy

3Department of Neurological and Psychiatric Sciences, Psychiatric Unit, University of Florence, Florence, Italy

Corresponding author: Prof. Mario Maggi, Department of Clinical Physiopathology, Andrology Unit, Viale Pieraccini 6, 50139 Florence, Italy Phone: +39-55-4271415, Fax: +39-55-4271413

Citation Information: Hormone Molecular Biology and Clinical Investigation. Volume 4, Issue 1, Pages 509–520, ISSN (Online) 1868-1891, ISSN (Print) 1868-1883, DOI: 10.1515/HMBCI.2010.048, January 2011

Publication History

Received:
2010-09-17
Accepted:
2010-09-24
Published Online:
2011-01-21

Abstract

Background: The relationship between age-associated dec-line of testosterone (T), cardiovascular (CV) risk and sexual dysfunction in males is not completely clear. The aim of the present study was to report our experience in a large series of patients seeking medical care for sexual dysfunction and comparing our results with current evidence.

Materials and methods: Here, we review published data from our laboratory and reported data from a cross-sectional analysis on a consecutive series of 3149 patients seeking medical care at our Unit for sexual dysfunction (between 2000 and 2010). Among them, 1687 (studied between 2000 and 2007) patients were also longitudinally evaluated (mean follow-up 4.3±2.6 years) for forthcoming major cardiovascular events (MACEs). All major findings were discussed in comparison with data reported in the literature.

Results: T levels were associated with a wide array of biological and psychological factors, which substantially differ as a function of age. Some of these associations were more evident in the youngest patients (psychological symptoms), whereas sexual symptoms, including erectile function, sexual desire and the frequency of sexual intercourse, were associated with T levels only in the oldest patients. We did not find any association between T and MACEs, whereas we reported a close link between CV mortality and low T. Both these observations are in line with data obtained in community-dwelling men.

Conclusions: T plays a crucial role in regulating different aspects of male sexual function. The effect of T on CV risk needs to be confirmed in larger epidemiological and interventional studies.

Keywords: cardiovascular diseases; sexual dysfunction; testosterone

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