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Biochemical screening in the assessment of erectile dysfunction: what tests decide future therapy?
Carolyn M Earle1, Bronwyn G A Stuckey
1Keogh Institute for Medical Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Objectives:
To evaluate which biochemical tests, performed as screening tests in the assessment of erectile dysfunction (ED), lead to a change in standard treatment.
Methods:
We examined the results of the biochemical and endocrine tests performed as part of the assessment of 1455 men presenting with ED. We also documented the subsequent therapy.
Results:
We found abnormal findings in testosterone (5.7%), prolactin (0.5%), thyroid function tests (0.13%), liver function tests (12.8%), glucose (9.3%), cholesterol (15% in a subset of 531 men), and ferritin (1.6%). Hyperprolactinemia was not invariably associated with a suppressed testosterone level. Specific therapy with a dopamine agonist for hyperprolactinemia and with testosterone for hypogonadism was effective in treating ED. For the others, standard ED therapy was used.
Conclusions:
The results of our study showed that screening tests fall into two categories. Testosterone and prolactin have a low yield but specific therapy is effective. Glucose and lipids have a higher yield but specific therapy is not immediately effective for ED. However, they, on their own merits, require management to prevent long-term morbidity and mortality.
