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Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic

International Journal of Impotence Research volume 18, pages 190–197 (2006)Cite this article

Abstract

Patients with diabetes mellitus (DM) were more often hypogonadal than normal fasting glucose subjects. The aim of this investigation is the assessment of characteristics and psychobiological correlates of DM associated with hypogonadism (DMAH). The Structured Interview SIEDY© was used along with several biochemical, psychological and instrumental investigations in a series of more than 1200 patients with erectile dysfunction (ED); 16% of whom with type II DM. Hypogonadism was defined as circulating total testosterone (T) below 10.4 nmol/l. The prevalence of hypogonadism was 24.5% in DM versus 12.6% in the rest of the sample (P<0.0001); differences in the prevalence of hypogonadism retained significance after adjustment for age and BMI. DMAH was associated with typical hypogonadism-related symptoms, such as reduction in sexual desire, leading to a decreased number of sexual attempts, and with higher depressive symptomatology. In DMAH, testis size and LH concentrations were significantly reduced, suggesting a central origin of the disease. At penile Duplex ultrasound examination, diabetic patients and in particular hypogonadal type II diabetic patients showed lower levels of basal and dynamic (after PGE1 injection) peak systolic velocity and acceleration, when compared to the rest of the sample, even after adjustment for age and BMI. Our results show that hypogonadism is frequently associated with type II DM, at least in the 6th decade. DMAH might exacerbate sexual dysfunction by reducing libido and mood and further compromising penile vascular reactivity.

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Acknowledgements

We thank Angela Magini, Csilla Krausz, Antonio Cilotti, Andrology Unit of the University of Florence, and Marco Bartolini, Radiology Unit of the University of Florence, for their helpful clinical collaboration during the course of the study. This study was partially supported by a grant from, Bayer SpA, Milano, Italy and by Centro di Ricerca Trasferimento ed Alta Formazione MCIDNENT of the University of Florence.

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Author notes

  1. G Corona and E Mannucci: These two authors contributed equally to this work

Authors and Affiliations

  1. Department of Clinical Physiopathology, Andrology Unit, University of Florence, Florence, Italy

    G Corona, L Petrone, R Mansani, G Forti & M Maggi

  2. Department of Critical Care, Diabetes Section Geriatric Unit, University of Florence, Florence, Italy

    E Mannucci

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

    V Ricca

  4. Department of Internal Medicine, Endocrinology Unit, Polytechnic University of Marche, Ancona, Italy

    G Balercia

  5. Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy

    G Corona & V Chiarini

  6. International Institute of Sexology, Florence, Italy

    R Giommi

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  1. G Corona
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Correspondence to M Maggi.

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Corona, G., Mannucci, E., Petrone, L. et al. Association of hypogonadism and type II diabetes in men attending an outpatient erectile dysfunction clinic. Int J Impot Res 18, 190–197 (2006). https://doi.org/10.1038/sj.ijir.3901391

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