Login to Access Video or Poster Abstract: MP84-11
Sources of Funding: None

Introduction

Libido is thought to be influenced by hormonal milieu, particularly testosterone. The role of estradiol in male sexual function has grown in importance, with estradiol cut- point of 5 ng/dL in hypogonadal men thought to directly affect libido. We sought to assess the impact of sex hormones on libido in a cardiac patient population.

Methods

200 men in a cardiology practice completed IIEF-15, ADAM, and previous ED treatment questionnaires and had serum total testosterone (T), estradiol (E), and sex hormone binding globulin (SHBG) measured via morning lab draws. Free testosterone (CFT) was calculated using an online ISSM calculator. Patients previously treated for hypogonadism or who were on medications that could affect T were excluded. Answers to IIEF questions 11 and 12 (IIEF11, IIEF12), which concern libido, on a 5-point Likert scale were compared with hormone levels. Spearman correlations and multivariate logistic regression were performed to analyze end points.

Results

Mean total T was 310 ng/dL, CFT was 5.4 ng/dL, mean E was 4.4 ng/dL, mean T:E ratio was 8.2. 55% of subjects had T < 300 ng/dL. 74% of subjects had CFT < 6.5 ng/dL. Negative correlation was found between estradiol and IIEF11 and IIEF12, which did not reach statistical significance (p=0.08). Positive correlation was found between IIEF11 and IIEF12 and CFT and T:E ratio (p=0.007, p=0.009) At a cutoff of E=5ng/dL, no difference was found for either hypogonadal or eugonadal men on IIEF11 or IIEF12 (p=0.50, p=0.71).

Conclusions

Only CFT and T:E ratio were predictive of positive libido response on IIEF11 & 12 questionnaire in our cohort. Estradiol, even at a cutoff of 5 ng/dL, was not independently associated with improved libido. Surprisingly total testosterone did not associate with IIEF11 (desire frequency). The effect of testosterone and estradiol administration on libido requires further prospective study.

Funding

None