Abstract

Hyperestrogenism is believed to be harmful to male sexuality. We aimed to investigate the prevalence of and the impact of hyperestrogenism on sexual functioning in a cohort of men seeking medical attention for new onset erectile dysfunction (ED).Data from 547 men seeking first medical help for new-onset ED at a single andrology center were analyzed. Patients were assessed with a thorough medical and sexual history. Comorbidities were scored with the Charlson Comorbidity Index (CCI). All patients completed the International Index of Erectile Function (IIEF); the IIEF-Erectile function (IIEF-EF) domain was categorized according to Cappelleri's criteria. Circulating hormones were measured in every patient. Hyperestrogenism was defined as estradiol (E2 ) levels >42.6 pg/mL (Tan RS, et al. 2015). Descriptive statistics and logistic/linear regression models tested the association between hyperestrogenism and IIEF domains score.Overall, 96 (17.6%) participants had serum estrogen levels suggestive of hyperestrogenism. Men with hyperestrogenism were older [median (IQR) 46 (35-59) vs. 44 (31-56) years; p<0.001], had higher rate of comorbidities [CCI=1: 26.0% vs. 7.4%; p<0.001] and higher serum total testosterone (tT) values [5.4 (5.2-8.0) vs. 4.3 (4.1-5.7) ng/mL; p = 0.01] than those with normal E2 values. A higher prevalence of severe ED [135 (29.9%) vs. 47 (48.9%) men; p = 0.01] and of hypogonadism [22 (4.8%) vs. 6 (6.3%) men; p = 0.004] were found in men with hyperestrogenism. Serum E2 levels were positively correlated with tT levels (ß 0.26, p<0.001), but negatively correlated with IIEF-OF (ß -0.24, p = 0.002) and IIEF-EF scores (ß -0.03, p<0.001). When IIEF scores were used to stratify ED patients, hyperestrogenism (OR 2.44, p = 0.02) was associated with severe ED.One out of five men seeking first medical help for ED showed elevated serum E2 values suggestive for hyperestrogenism. Hyperestrogenism was associated with health significant comorbidities, orgasmic function impairment, and ED severity. This article is protected by copyright. All rights reserved.

View details for DOI 10.1111/andr.13470

View details for PubMedID 37261881