Impact of GH Deficiency and Excess on Men Sexual Health and Fertility

A fair shred of evidence supports the mutual relationship between the hypothalamus-pituitary testis axis and the growth hormone (GH) pathway. Nevertheless, the role of GH on male sexual function and fertility is controversial, due to conflicting data from literature. The present review summarizes the available andrological consequences of two pathological extremes, i.e., either GH excess or deficiency. GH excess drives different disorders of male sexual health. On one hand, it indirectly favors the onset of erectile dysfunction (40.2% of cases) mostly by its detrimental vascular and metabolic effects, while testosterone levels don't appear as a key factor. On the other hand, GH excess directly impairs fertility, leading to secondary hypogonadism. Of note, compared to controls, this condition adversely affects the main sperm parameters, i.e., sperm concentration (p = 0.00), progressive motility (p = 0.03), and normal morphology (p = 0.02). Although with limited evidence, GH deficiency also fosters erectile dysfunction, while its effect on fertility is still unclear. On the whole, the available literature shows that any GH disorder plays a negative role in both male general and sexual health. Nevertheless, the potential benefit of testosterone replacement therapy in this population has not yet been explored.