Corona G, Jannini E A, Lotti F, Boddi V, De Vita G, Forti G, Lenzi A, Mannucci E, Maggi M
Department of Clinical Physiopathology, Andrology Unit and Endocrinology, University of Florence, Florence, Italy.
Int J Androl. 2011 Feb;34(1):41-8. doi: 10.1111/j.1365-2605.2010.01059.x.
Although it is well established that all the aspects of male reproduction are hormonally regulated, the endocrine control of the ejaculatory reflex is still not completely clarified. Sex steroids, thyroid and pituitary hormones (oxytocin and prolactin) have been proposed to control the ejaculatory process at various levels; however, only a few reports are currently available. The aim of this study was to evaluate the contribution of testosterone, thyrotropin (TSH) and prolactin (PRL) in the pathogenesis of ejaculatory dysfunction in a large series of subjects consulting for sexual dysfunction. Among the 2652 patients studied, 674 (25.2%) and 194 (7.3%) reported premature and delayed ejaculation (PE and DE), respectively. Categorizing ejaculatory difficulties on an eight-point scale starting from severe PE and ending with anejaculation (0 = severe PE, 1 = moderate PE, 2 = mild PE, 3 = no difficulties, 4 = mild DE, 5 = moderate DE, 6 = severe DE and 7 = anejaculation), PRL as well as TSH levels progressively increased from patients with severe PE towards those with anejaculation. Conversely, the opposite was observed for testosterone levels. All of these associations were confirmed after adjustment for age (adjusted r = 0.050, 0.053 and -0.038 for PRL, TSH and testosterone, respectively; all p < 0.05). When all hormonal parameters were introduced in the same regression model, adjusting for age, ΣMHQ (an index of general psychopathology) and use of selective serotonin reuptake inhibitor antidepressants, they were independently associated with ejaculatory problems (adjusted r = 0.056, 0.047 and -0.059 for PRL, TSH and testosterone, respectively; all p < 0.05). This study indicates endocrine system is involved in the control of ejaculatory function and that PRL, TSH and testosterone play an independent role.
尽管大家都清楚男性生殖的各个方面都受到激素调节，但射精反射的内分泌控制仍未完全阐明。有人提出性类固醇、甲状腺和垂体激素（催产素和催乳素）在不同水平上控制射精过程；然而，目前仅有少数报告。本研究的目的是评估睾酮、促甲状腺激素（TSH）和催乳素（PRL）在一大系列因性功能障碍前来咨询的受试者射精功能障碍发病机制中的作用。在所研究的2652例患者中，分别有674例（25.2%）和194例（7.3%）报告有早泄和射精延迟（PE和DE）。将射精困难按从严重早泄到无射精（0 = 严重早泄，1 = 中度早泄，2 = 轻度早泄，3 = 无困难，4 = 轻度DE，5 = 中度DE，6 = 严重DE，7 = 无射精）的八分制进行分类，PRL以及TSH水平从严重早泄患者到无射精患者逐渐升高。相反，睾酮水平则呈现相反的情况。在对年龄进行校正后，所有这些关联均得到证实（PRL、TSH和睾酮校正后的r分别为0.050、0.053和 -0.038；所有p < 0.05）。当将所有激素参数纳入同一回归模型，并对年龄、ΣMHQ（一种一般精神病理学指标）和选择性5-羟色胺再摄取抑制剂抗抑郁药的使用进行校正时，它们与射精问题独立相关（PRL、TSH和睾酮校正后的r分别为0.056、0.047和 -0.059；所有p < 0.05）。本研究表明内分泌系统参与射精功能的控制，并且PRL、TSH和睾酮发挥独立作用。
