Abstract: PD45-04
Sources of Funding: none

Introduction

The role that estrogens play in male sexual function remains incompletely understood. We sought to explore whether or not serum estradiol is associated with patient-reported sexual function, independent of serum testosterone levels and BMI.

Methods

We retrospectively reviewed the records of men presenting to a single urologist with subspecialty practice in andrology over an 18 month period. Serum testosterone and estradiol levels were assessed prior to 10:30 AM by immunoassay. All patients filled out the Male Sexual Health Questionnaire (MSHQ) at the initial consultations, a validated, self-reported 25-question survey on 5 domains of male sexual function (erectile, ejaculatory, libido, satisfaction, and activity). Scores for each domain were obtained by calculating the average response to the questions in the domain. The following exclusion criteria were applied: Peyronie's disease, radical prostatectomy, inflatable penile prosthesis, and pelvic radiation therapy. The association of serum estradiol with sexual function was assessed using multivariate linear regression controlled for serum testosterone level and BMI.

Results

261 men met inclusion criteria and had complete data available. When controlling for total testosterone and BMI, serum estradiol was negatively associated with erectile function (p=0.036) [Figure 1]. We did not observe independent associations of serum estradiol with any other domains of sexual function. Men with estradiol levels above 40 pg/mL had significantly worse average erectile function scores on MSHQ than men with estradiol levels below 40 pg/mL (median 1.5 vs. 2.0, p=0.003, Wilcoxon rank-sum test) [Figure 2].

Conclusions

Elevated estradiol in men is independently associated with poor erectile function when controlling for total testosterone and BMI. Men with ED who have serum estradiol levels higher than 40 pg/mL may be candidates for treatment with aromatase inhibitors.

Funding

none