Centre d'Etudes et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique, Lille, France.
J Sex Med. 2010 Apr;7(4 Pt 2):1627-56. doi: 10.1111/j.1743-6109.2010.01780.x.
Endocrine disorders may adversely affect men's sexual function.
To provide recommendations based on best evidence for diagnosis and treatment of endocrine-related male sexual dysfunctions.
The Endocrine Aspects of Male Sexual Dysfunctions Committee, including 11 members from eight countries and four continents, collaborated with the Endocrine subcommittee of the Standards Committee of the International Society for Sexual Medicine. Medical literature was reviewed in detail, followed by extensive internal committee discussion over 2 years, then public presentation and discussion with the other experts before finalizing the report.
Recommendations based on grading of evidence-base medical literature and interactive discussion.
From animal studies, it is derived that testosterone modulates mechanisms involved in erectile machinery, including expression of enzymes that both initiate and terminate erection. In addition, testosterone is essential for sexual motivation. Whether these findings could be extrapolated to human erections is unclear. Testosterone plays a broad role in men's overall health. Recent studies have established strong associations between low testosterone and metabolic and cardiovascular imbalances. In some studies, low testosterone decreased longevity; however, longitudinal studies do not support the predictive value of low testosterone for further cardiovascular events. The article proposes a standardized process for diagnosis and treatment of endocrine-related male sexual dysfunctions, updating the knowledge on testosterone and prostate safety. There is no compelling evidence that testosterone treatment causes prostate cancer or its progression in men without severe testosterone deficiency (TD). The possible roles of prolactin and thyroid hormones are also examined.
Men with erectile dysfunction, hypoactive sexual desire and retarded ejaculation, as well as those with visceral obesity and metabolic diseases, should be screened for TD and treated. Prospective interventional studies are required before screening for TD in more conditions, including cardiovascular diseases, and considering correction as preventive medicine as much data suggests.
内分泌紊乱可能会对男性的性功能产生不利影响。
根据最佳证据为与内分泌相关的男性性功能障碍的诊断和治疗提供建议。
包括来自八个国家和四大洲的 11 名成员的内分泌男性性功能障碍委员会与国际男科学会性医学标准委员会的内分泌分委会合作。详细审查了医学文献，然后在 2 年内进行了广泛的内部委员会讨论，之后在与其他专家一起公开陈述和讨论后，最终确定了报告。
基于医学文献证据等级和互动讨论的建议。
从动物研究中可以推断，睾丸激素调节参与勃起机制的机制，包括启动和终止勃起的酶的表达。此外，睾丸激素对性动机至关重要。这些发现是否可以推断到人类勃起尚不清楚。睾丸激素在男性的整体健康中起着广泛的作用。最近的研究已经确定了低睾丸激素与代谢和心血管失衡之间的强烈关联。在一些研究中，低睾丸激素降低了寿命；然而，纵向研究不支持低睾丸激素对进一步心血管事件的预测价值。本文提出了一种标准化的诊断和治疗与内分泌相关的男性性功能障碍的过程，更新了关于睾丸激素和前列腺安全性的知识。没有令人信服的证据表明睾丸激素治疗会导致没有严重睾丸激素缺乏（TD）的男性前列腺癌或其进展。还检查了催乳素和甲状腺激素的可能作用。
勃起功能障碍、性欲低下和射精延迟的男性，以及内脏肥胖和代谢疾病的男性，应筛查 TD 并进行治疗。在更多情况下（包括心血管疾病）进行 TD 筛查之前，需要进行前瞻性干预研究，并考虑将纠正作为预防性医学，因为有很多数据表明。
