Corona Giovanni, Isidori Andrea M, Aversa Antonio, Burnett Arthur L, Maggi Mario
Endocrinology Unit, Medical Department, Azienda USL Bologna, Maggiore-Bellaria Hospital, Bologna, Italy.
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
J Sex Med. 2016 Mar;13(3):317-37. doi: 10.1016/j.jsxm.2016.01.007.
Several hormones and neurotransmitters orchestrate men's sexual response, including the appetitive (sexual desire) and consummative (arousal and penile erection) phases.
To provide an overview and recommendations regarding endocrinologic control of sexual desire and arousal and erection and their disturbances.
Medical literature was reviewed by the subcommittee of the International Consultation of Sexual Medicine, followed by extensive internal discussion, and then public presentation and discussion with other experts. The role of pituitary (prolactin, oxytocin, growth hormone, and α-melanocyte-stimulating hormone), thyroid, and testicular hormones was scrutinized and discussed.
Recommendations were based on grading of evidence-based medical literature, followed by interactive discussion.
Testosterone has a primary role in controlling and synchronizing male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire that can be successfully corrected by appropriate treatments. Oxytocin and α-melanocyte-stimulating hormone are important in eliciting sexual arousal; however, use of these peptides, or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases.
Endocrine abnormalities are common in patients with sexual dysfunction. Their identification and treatment is strongly encouraged in disturbances of sexual desire and arousal.
多种激素和神经递质共同调节男性的性反应，包括性欲期（性欲望）和性高潮期（性唤起和阴茎勃起）。
提供有关性欲、性唤起和勃起的内分泌调控及其紊乱的概述和建议。
性医学国际咨询小组委员会对医学文献进行了综述，随后进行了广泛的内部讨论，然后进行了公开报告并与其他专家进行了讨论。仔细审查并讨论了垂体（催乳素、催产素、生长激素和α-黑素细胞刺激素）、甲状腺和睾丸激素的作用。
基于循证医学文献的分级提出建议，随后进行互动讨论。
睾酮在控制和同步男性性欲和性唤起方面起主要作用，作用于多个层面。因此，荟萃分析表明，对性腺功能减退个体进行睾酮治疗可改善性欲低下和勃起功能障碍。高催乳素血症与性欲低下有关，可通过适当治疗成功纠正。催产素和α-黑素细胞刺激素在引发性唤起方面很重要；然而，使用这些肽或其类似物来刺激性唤起仍在研究中。仅在特定情况下建议对其他内分泌疾病进行评估和治疗。
性功能障碍患者中内分泌异常很常见。强烈建议在性欲和性唤起障碍中识别并治疗这些异常情况。
