Relevance of oestradiol-testosterone balance in erectile dysfunction patients' prognosis

The ageing process in man is accompanied by a number of endocrine changes including decline in testosterone (T), physiological imbalance between androgen and oestradiol (E2) and changes in the E2-T ratio. In this study, hormone profile data from a group of erectile dysfunction (ED) patients were reviewed to evaluate its impact on ED, with emphasis on oestradiol derangement.

30 ED patient case notes with a record of hormone profiles were retrospectively reviewed. Laboratory investigation included levels of total testosterone, total oestradiol, prolactin, luteinising and follicle stimulating hormones, in addition to lipid profile and glucose, based on specific history. These patients were divided into two groups based on the history of presence (Group A) or absence (Group B) of adequate sexual desire.

In Group B patients, the E2-T derangement with increasing age was statistically significant with lower serum T level (2.6 ng/ml; range, 1.6-3.7 ng/ml) and elevated E2 level (60 pg/ml; range, 40-120 pg/ml).

In this preliminary report, although low total testosterone level is seen together with impaired libido and erectile impairment, the accompanying significant increase in E2 indicates the possible role for oestrogen in causation and/or persistence of ED in this group of patients.