Abstract
The objective of the study was to determine the effects of androgen depletion on erectile function in a population of male-to-female transsexuals. The erectile function of 25 consecutive male-to-female transsexuals on androgen depletion treatment and scheduled for surgical gender reassignment was prospectively evaluated using medical and sexual history, physical examination, total serum testosterone, International Index of Erectile Function (IIEF-15) questionnaire, penile colour-coded Doppler ultrasonography (CDU) after pharmacological stimulation and nocturnal penile tumescence (NPT) test. All but one had undetectable or low testosterone. Subjective erectile function, according to IIEF-15 scores, and penile CDU findings did not correlate with testosterone levels, whereas NPT test findings correlated well with testosterone levels. These findings would suggest that nocturnal erections are androgen-dependent whereas sexually induced erections are androgen-independent. It can also be assumed that testosterone is important but not essential for male erectile function and that other androgen-independent pathways can be responsible for sexually induced erections.
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References
Rousseau L, Dupont A, Labrie F, Couture M . Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration. Arch Sex Behav 1988; 17: 87–98.
Greenstein A, Plymate SR, Katz PG . Visually stimulated erection in castrated men. J Urol 1995; 308: 650–652.
Jain P, Rademaker AW, McVary KT . Testosterone supplementation for erectile dysfunction: results of a meta-analysis. J Urol 2000; 164: 371–375.
Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Rosen RC et al. The International Index of Erectile Function (IIEF): a multidimension scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.
Dykeman DA, Katz LS, Foote RH . Behavioral characteristics of beef steers administered estradiol, testosterone and dihydrotestosterone. J Anim Sci 1982; 55: 1303–1309.
Szczypka MS, Zhou QY, Palmiter RD . Dopamine-stimulated sexual behavior is testosterone dependent in mice. Behav Neurosci 1998; 112: 1229–1235.
Du J, Hull EM . Effects of testosterone on neuronal nitric oxide sythetase and tyrosine hydroxylase. Brain Res 1999; 836: 90–98.
Zvara P, Sioufi R, Schipper HM, Begin LR et al. Nitric oxide mediated erectile activity is a testosterone dependent event: a rat erection model. Int J Impot Res 1995; 7: 209–219.
Luisi M, Franchi F . Double-blind group comparative study of testosterone undecanoate and mesterolone in hypogonadal male patients. J Endocrinol Invest 1980; 3: 305–308.
Carani C, Scuteri A, Marrama P, Bancroft J . The effects of testosterone administration and visual erotic stimuli on nocturnal penile tumescence in normal men. Horm Behav 1990; 24: 435–441.
Carani C, Granata AR, Bancroft J, Marrama P . The effects of testosterone replacement on nocturnal penile tumescence and rigidity and erectile response to visual erotic stimuli in hypogonadal men. Psychoneuroendocrinology 1995; 20: 743–753.
Moreland RB . Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the Society for the Study of Impotence. Int J Impot Res 1998; 10: 113–120.
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Bettocchi, C., Palumbo, F., Cormio, L. et al. The effects of androgen depletion on human erectile function: a prospective study in male-to-female transsexuals. Int J Impot Res 16, 544–546 (2004). https://doi.org/10.1038/sj.ijir.3901216
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DOI: https://doi.org/10.1038/sj.ijir.3901216
Keywords
- erectile dysfunction
- transsexualism
- androgen insufficiency
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