Endocrine evaluation and therapy of erectile dysfunction

Recent innovative laboratory and clinical investigations have implicated an organic cause for as many as 30 to 50 per cent of cases of impotence. Understanding the clinical subtleties of hypogonadism and the reproductive hormonal axis in the male is critical to the evaluation and treatment of impotence of endocrinologic origin. Gonadotropin assays are essential for detecting elevations of FSH and LH, which will help to distinguish primary from secondary testicular failure. The goal of androgen replacement is the maintenance of physiologic testosterone levels without the potential hepatotoxic effects.