Department of Urology, Suez Canal University, 41111 Ismailia, Egypt.
Asian J Androl. 2013 Jul;15(4):492-6. doi: 10.1038/aja.2013.20. Epub 2013 May 6.
Our aim was to assess the impact of the association between elevated oestradiol (E2) and low testosterone (T) levels on erectile dysfunction (ED) severity. A total of 614 male patients with ED and a normal or low T level in association with normal or elevated E2 levels were enrolled. Patients underwent routine laboratory investigations in addition to measurements of total T, total E2, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. We compared the responses to the erectile function domain, Q3 (achieving erection) and Q4 (maintaining erection) of the International Index for Erectile Function (IIEF) score in patients with the following: normal T and E2 levels; low T level; low T level and elevated E2 level; and elevated E2 level. Of the patients included, 449 (73.1%) had normal T and E2 levels, 110 (17.9%) had a low T level, 36 (5.9%) had a low T level and an elevated E2 level, and 19 (3.1%) had an elevated E2 level. Increased ED severity was significantly associated with low T levels, elevated E2 levels, and both a low T level and an elevated E2 level. Additionally, the mean values of the EF-domain, Q3 and Q4 were significantly lower in patients with both a low T level and an elevated E2 level compared to patients with any condition alone. In conclusion, a low T level had the primary effect on erectile function; however, a concomitantly elevated E2 level had an additive impairment effect.
我们的目的是评估雌二醇（E2）升高和睾酮（T）水平降低与勃起功能障碍（ED）严重程度之间的关联的影响。共纳入 614 名 ED 男性患者，其 T 水平正常或降低，同时 E2 水平正常或升高。患者接受了常规实验室检查，以及总 T、总 E2、卵泡刺激素（FSH）、黄体生成素（LH）和催乳素的测量。我们比较了以下患者的勃起功能域（国际勃起功能指数（IIEF）评分的 Q3 和 Q4）的反应：正常 T 和 E2 水平；低 T 水平；低 T 水平和升高的 E2 水平；以及升高的 E2 水平。在纳入的患者中，449 名（73.1%）患者的 T 和 E2 水平正常，110 名（17.9%）患者 T 水平降低，36 名（5.9%）患者 T 水平降低且 E2 水平升高，19 名（3.1%）患者 E2 水平升高。ED 严重程度的增加与低 T 水平、高 E2 水平以及低 T 水平和高 E2 水平均显著相关。此外，与任何单一情况相比，同时存在低 T 水平和高 E2 水平的患者的 EF 域、Q3 和 Q4 的平均值明显更低。总之，低 T 水平对勃起功能有主要影响；然而，同时升高的 E2 水平具有附加的损害作用。
