Hormonal variations during sleep in men with erectile dysfunction and normal controls.

Five physically healthy young males suffering from erectile impotence and five normal controls of similar age are the subjects of this preliminary report. All were studied in the sleep laboratory during 3 to 5 nights with the last two devoted to sequential hormonal sampling by means of an indwelling venous catheter. Electroencephalogram, eye movements, and penile tumescence were monitored continually through the night. Plasma LH, FSH, and testosterone were measured every 20 minutes by radioimmunoassay. There were no differences between the patients with erectile impotence and normal controls in all sleep parameters investigated, including mean tumescent time, time in simultaneous REM and tumescence, and number of full and partial tumescent episodes. Marked fluctuations in plasma LH, FSH, and testosterone were observed during sleep without differences noted between the two groups. Mean plasma LH, but not FSH or testosterone, was significantly lower in the impotent men. There were no significant differences in mean plasma gonadotrophins and testosterone between tumescent episodes and nontumescent periods in either group. A significant relation was found in normals, but not in the men with erectile dysfunction, between the occurrence of REM sleep and abrupt elevations in testosterone. Testosterone levels during REM sleep with tumescence were also consistently higher than during the condition of non-REM without tumescence in the normal, but not in the impotent, group.