Tan Robert S, Cook Kelly R, Reilly William G
Michael DeBakey VA Medical Center, Houston, TX, USA Baylor College of Medicine, Houston, TX, USA University of Texas, Houston, TX, USA Opal Medical Clinic, Houston, TX, USA Low T Institute, Southlake, TX, USA
Low T Institute, Southlake, TX, USA.
Am J Mens Health. 2015 May;9(3):229-34. doi: 10.1177/1557988314539000. Epub 2014 Jun 13.
Testosterone replacement improves quality of life and is aromatized in men in adipose tissues to estrogen. Hyperestrogenism is believed to be harmful to male sexuality. This is a description of our experience of screening 34,016 men in the Low T Centers, of which approximately 50% were converted to treatment. Men were treated with injectable testosterone, and we have available data from 2009 to 2014. The data were extracted from our electronic health record (AdvancedMD) of 35 Low T Centers across the United States. In all, 7,215 (20.2%) out of the 34,016 patients had high estradiol levels defined as ≥42.6 pg/ml. Estradiol was measured using electro-chemiluminescence immunoassay. Of the patients who had high estradiol levels, the age distribution was as follows: 132/989 (13.3%) were older than 65 years, 3,753/16,955 (22.1%) were between 45 and 65 years; 2,968/15,857 (18.7%) were between 25 and 44 years, 7/215 (3.3%) were younger than 25 years. The difference between extreme age groups (<25 and ≥65) was statistically significant using a chi-square test (p = .013). The correlation coefficient of serum estradiol to age was .53, SD = 8.21. It was observed that practitioners used aromatase inhibitor and selective estrogen receptor modulator to treat symptoms of hyperestrogenism, irrespective of blood estradiol levels. Gynecomastia was rarely documented as a reason for the prescription. Our finding was that high estradiol levels were not associated with higher rates of low libido but established higher rates of documented low libido with those with normal or lower estradiol levels. The difference was statistically significant (p < .05).
睾酮替代疗法可改善生活质量，且在男性体内，脂肪组织会将睾酮转化为雌激素。高雌激素血症被认为对男性性功能有害。本文描述了我们在低睾酮中心对34016名男性进行筛查的经验，其中约50%的人接受了治疗。男性接受注射用睾酮治疗，我们拥有2009年至2014年的可用数据。这些数据取自美国35个低睾酮中心的电子健康记录（AdvancedMD）。在34016名患者中，共有7215名（20.2%）的雌二醇水平较高，定义为≥42.6 pg/ml。雌二醇采用电化学发光免疫分析法测定。在雌二醇水平较高的患者中，年龄分布如下：132/989（13.3%）年龄大于65岁，3753/16955（22.1%）年龄在45至65岁之间；2968/15857（18.7%）年龄在25至44岁之间，7/215（3.3%）年龄小于25岁。使用卡方检验，极端年龄组（<25岁和≥65岁）之间的差异具有统计学意义（p = 0.013）。血清雌二醇与年龄的相关系数为0.53，标准差 = 8.21。据观察，无论血液雌二醇水平如何，医生都会使用芳香化酶抑制剂和选择性雌激素受体调节剂来治疗高雌激素血症的症状。男性乳房发育很少被记录为开处方的原因。我们的发现是，高雌二醇水平与低性欲发生率较高无关，但与雌二醇水平正常或较低的人相比，有记录的低性欲发生率更高。差异具有统计学意义（p < 0.05）。
