Hormone abnormalities are not related to the erectile dysfunction and decreased libido found in many men with infertility

Reduced libido and erectile dysfunction are common in young, infertile men. Using multivariable logistic analysis of a large cohort, our data suggest that this is unrelated to hormone changes.

Raj Satkunasivam, M.D., Michael Ordon, M.D., Brian Hu, M.D., Brendan Mullen, M.D., Kirk Lo, M.D., Ethan Grober, M.D., Keith Jarvi, M.D.

Volume 101, Issue 6, Pages 1594–1598


To evaluate whether hormonal markers predict erectile dysfunction (ED) and symptoms of T deficiency syndrome (TDS), which are commonly found in the population of infertile men.

Retrospective study utilizing a prospectively maintained infertility database.

A tertiary referral center.

A total of 1,750 of 2,783 men presenting for evaluation of infertility between 1995 and 2010 completed validated questionnaires.

Androgen Deficiency in the Aging Male (ADAM) and Sexual Health Inventory for Men questionnaires were administered. Baseline risk factors for ED and TDS were also measured. Subjects underwent serum hormone evaluation for total T, calculated bioavailable T, sex hormone–binding globulin, E2, LH, FSH, and PRL.

Main Outcome Measure(s):
Multivariable logistic regression modeling was used to determine the significance of hormonal markers in predicting ED (Sexual Health Inventory for Men score <22) and/or a positive ADAM score. Result(s):
The prevalence of ED and a positive response to the ADAM questionnaire were 30.5% and 45.2%, respectively, in this population (mean age, 36 years). Low serum T (total T < 10 nmol/L) was found in 29.4%. Neither T nor bioavailable T was significantly associated with the symptoms of ED or TDS on multivariable regression analysis. Conclusion(s):
Erectile dysfunction and TDS in young, infertile men seem to be unrelated to hormone changes.

  • Jason Kovac

    This is a really good point by Dr. Balmori. Looking at the couple together is the best, and only way, to truly analyze sexual dysfunction in an “infertile” couple. I do not believe that any study has truly addressed this point. Perhaps looking at this combined approach could yield more insight into the difficulties that couples have conceiving. the development of a “couples” questionnaire for sexual dysfunction would be key to assessing these points.

  • Carlos Balmori

    This article confirms what we have observed in our clinical practice. Assisted reproduction treatments cause sexual dysfunctions, in a numerous group of couples.

    It is useful that in this cases the women also perform the questionnaires such as SHIM for example. In my experience there are differences according to the perception of each person of the couple. The different points of view about their sexual problems can
    even surprise you.

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