High estradiol level is associated with erectile dysfunction: A systematic review and meta-analysis

Area of Science:

• Endocrinology
• Urology
• Reproductive Health

Background:

• While testosterone's role in erectile dysfunction (ED) is well-studied, the association with estradiol levels is less understood.
• Estradiol, a key estrogen, plays a role in male reproductive health and may influence erectile function.

Purpose of the Study:

• To quantitatively synthesize existing studies evaluating the relationship between estradiol levels and ED.
• To assess the strength of the association between estradiol and ED through a meta-analysis.

Main Methods:

• A systematic literature search was performed in PubMed, Web of Science, and Cochrane Library up to January 10, 2021.
• Six studies meeting PICOS criteria were included, with quality assessed using the Newcastle-Ottawa Scale.
• Standardized Mean Difference (SMD) and pooled Odds Ratio (OR) were calculated to compare estradiol levels and assess the association with ED.

Main Results:

• ED patients exhibited statistically higher estradiol levels than healthy subjects (SMD 0.45, 95% CI 0.28-0.63).
• A significant positive correlation was found between estradiol levels and ED (pooled OR 1.08, 95% CI 1.05-1.12).
• Sensitivity analyses and subgroup analyses confirmed the robustness of these findings, with no detected publication bias.

Conclusions:

• This meta-analysis demonstrates a significant correlation between elevated estradiol levels and erectile dysfunction.
• Estradiol may play a more significant role in ED pathophysiology than previously recognized, warranting further investigation.