Estradiol is a risk factor for erectile dysfunction in young men with normal testosterone.

[madman]

Erectile dysfunction attributable to testosterone deficiency is less common in young males, and the effect of estradiol on erectile function in eugonadal young males is unclear. We analyzed data from 195 male participants, including 143 eugonadal patients with erectile dysfunction and 52 healthy men. To distinguish psychogenic and organic erectile dysfunction, penile rigidity was measured using the nocturnal penile tumescence rigidity test. Serum levels of sexual hormones were quantified by electrochemiluminescence, and penile vascular status was assessed by penile color Doppler ultrasound. Both serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy controls. Organic erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone, and estradiol was the only significant risk factor for organic erectile dysfunction (odds ratio: 1.094; 95% confidence interval: 1.042–1.149, P = 0.000). Moreover, serum estradiol levels were negatively correlated with penile rigidity. Serum estradiol levels were higher and penile rigidity was lower in patients with venous erectile dysfunction than in patients with non-vascular erectile dysfunction. We conclude that elevated serum estradiol levels may impair erectile function and may be involved in the pathogenesis of organic erectile dysfunction in eugonadal young men.


In conclusion, we showed that both estradiol levels and the ratio of estradiol to testosterone were higher in eugonadal young patients with organic ED than in those with psychogenic ED, and estradiol levels were higher in patients with venous ED than in those with nonvascular ED. Estradiol was an essential risk factor in organic ED in eugonadal young men. The mechanism underlying estradiol upregulation requires further study, and estradiol should be considered in both diagnosis and treatment of ED.

 

[madman]

Figure 1: Bland–Altman plots of serum sexual hormones and MAPR at the tip of the penis. (a) Relationship between TT and MAPR. There was no significant correlation between TT and MAPR. (b) Relationship between CFT and MAPR. There was no significant correlation between CFT and MAPR. (c) E2 was negatively correlated with MAPR. (d) E2/TT was negatively correlated with MAPR. MAPR: maximal average penile rigidity; TT: total testosterone; CFT: calculated free testosterone; E2: estradiol; E2/TT: estradiol to total testosterone ratio.

 

[madman]

Table 2: Univariate and multivariate logistic regression analysis of organic erectile dysfunction (maximal average penile rigidity at tip <60%)

 

[madman]

Table 3: Correlations between maximal average penile rigidity at the tip and base of the penis and serum sexual hormones

 

[madman]

Table 4: Correlations between estradiol and anthropological and gonadal axis parameters

 

[madman]

Table 5: Comparison of patient clinical parameters by penile vascular status

 

[Cataceous]

... Both serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy controls. Organic erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone, ...

I think they mean to say "positively associated" so the two sentences are consistent.

 

[Nelson Vergel]

Thanks, madman. Can you send me the PDF?

 

[apsjiml]

I wish they would do the free estradiol with lc ms/ms hardly ever see that.

 

[Nelson Vergel]

They should say lower Estradiol to Testosterone ratios (most men had TT under 500 ng/dL, by the way).

 

[Cataceous]

They should say lower Estradiol to Testosterone ratios (most men had TT under 500 ng/dL, by the way).

This passage may be saying that higher estradiol is an independent risk factor:

We found higher levels of serum estradiol and a higher estradiol-to-total testosterone ratio in eugonadal young men with organic ED, and estradiol levels were an independent risk factor for organic ED. Previous clinical studies reported that high estradiol and low testosterone were positively correlated with the severity of ED and that an elevated estradiol-to-total testosterone ratio was positively correlated with the incidence of ED.​