Poster 149: Testosterone/Estradiol Ratio and Low Libido in Men with Sexual Dysfunction
Title
TESTOSTERONE: ESTRADIOL RATIO A STEP FORWARD TOWARDS THE UNDERSTANDING OF LOW LIBIDO IN MEN WITH SEXUAL DYSFUNCTION
Authors
Rodrigo Freddi, Rubens Neto, Joao Gismondi, Romulo Nunes, Jose de Bessa Jr., Thiago Teixeira, William Nahas, Bruno Nascimento, Jorge Hallak
Affiliations
Division of Urology, Department of Surgery, Hospital das Clinicas, University of Sao Paulo Medical School, Brazil
Division of Urology, State University of Feira de Santana, Bahia, Brazil
Department of Surgery, Division of Urology, Amapa Federal University, Brazil
Androscience – Science and Innovation Center, Sao Paulo, Brazil
Department of Pathology, Reproductive Toxicology Unit, University of Sao Paulo Medical School, Brazil
Institute for Advanced Studies, University of Sao Paulo, Brazil
Introduction & Objective
Sexual desire (libido) is important for men's quality of life, cognitive function, and emotional balance.
Many factors influence libido, including cognitive, neurophysiological, and affective factors.
Hormonal balance, especially the equilibrium between testosterone (T) and estradiol (E), is also important.
The study aimed to evaluate the correlation between loss of libido and hormonal profiles, specifically the testosterone/estradiol (T/E) ratio, in men attending a tertiary center for andrology and sexual medicine in Brazil.
Methods
Retrospective analysis of medical records from a tertiary care center in Sao Paulo, Brazil.
Patients were asked if they perceived a decrease in libido or sexual desire in recent months.
All had morning hormone profiles checked (total testosterone, prolactin, estradiol, LH).
Hormonal profiles categorized into:
Low Testosterone (T < 300 ng/dl)
Normal Testosterone (T ≥ 300 ng/dl)
Standard T/E ratio (>100)
Low T/E ratio (≤100)
Patients with insufficient data or hyperprolactinemia were excluded.
Compared hormonal profiles between men with and without decreased libido, using univariate and multivariate analysis.
Results
Total patients evaluated: 228
Mean age: 61 ± 10 years
Prevalence: 30% complained of low libido
Hormonal findings:
25% had low T levels
22% had a low T/E ratio
Associations:
Among men with low T, 42% reported low libido (Odds Ratio [OR] 1.99; 95% CI: 1.08–3.73; p=0.01)
Among men with low T/E ratio, 52% reported decreased sexual desire (OR 3.47; 95% CI: 1.79–6.46; p=0.001)
In multivariate analysis, low T/E ratio was associated with decreased libido, regardless of T status.
Conclusion
Both low testosterone and low T/E ratios are strongly correlated with decreased libido in men with sexual dysfunction.
The T/E ratio is an independent predictor of decreased libido, irrespective of testosterone status.
Findings suggest that therapies aiming to increase T or decrease E, as well as lifestyle modifications (diet, exercise, metabolic control), may help improve libido in affected men.
Frequency of decreased libido based on hormonal profile
Conference Details:
Freddi R, Neto R, Gismondi J, Nunes R, de Bessa Jr J, Teixeira T, Nahas W, Nascimento B, Hallak J. Testosterone: Estradiol Ratio – A Step Forward Towards the Understanding of Low Libido in Men with Sexual Dysfunction. Poster 149. Presented at: ASA & ICA 2025 Annual Meeting; March 29–April 1, 2025; Washington, D.C., USA.
Title
TESTOSTERONE: ESTRADIOL RATIO A STEP FORWARD TOWARDS THE UNDERSTANDING OF LOW LIBIDO IN MEN WITH SEXUAL DYSFUNCTION
Authors
Rodrigo Freddi, Rubens Neto, Joao Gismondi, Romulo Nunes, Jose de Bessa Jr., Thiago Teixeira, William Nahas, Bruno Nascimento, Jorge Hallak
Affiliations
Division of Urology, Department of Surgery, Hospital das Clinicas, University of Sao Paulo Medical School, Brazil
Division of Urology, State University of Feira de Santana, Bahia, Brazil
Department of Surgery, Division of Urology, Amapa Federal University, Brazil
Androscience – Science and Innovation Center, Sao Paulo, Brazil
Department of Pathology, Reproductive Toxicology Unit, University of Sao Paulo Medical School, Brazil
Institute for Advanced Studies, University of Sao Paulo, Brazil
Introduction & Objective
Sexual desire (libido) is important for men's quality of life, cognitive function, and emotional balance.
Many factors influence libido, including cognitive, neurophysiological, and affective factors.
Hormonal balance, especially the equilibrium between testosterone (T) and estradiol (E), is also important.
The study aimed to evaluate the correlation between loss of libido and hormonal profiles, specifically the testosterone/estradiol (T/E) ratio, in men attending a tertiary center for andrology and sexual medicine in Brazil.
Methods
Retrospective analysis of medical records from a tertiary care center in Sao Paulo, Brazil.
Patients were asked if they perceived a decrease in libido or sexual desire in recent months.
All had morning hormone profiles checked (total testosterone, prolactin, estradiol, LH).
Hormonal profiles categorized into:
Low Testosterone (T < 300 ng/dl)
Normal Testosterone (T ≥ 300 ng/dl)
Standard T/E ratio (>100)
Low T/E ratio (≤100)
Patients with insufficient data or hyperprolactinemia were excluded.
Compared hormonal profiles between men with and without decreased libido, using univariate and multivariate analysis.
Results
Total patients evaluated: 228
Mean age: 61 ± 10 years
Prevalence: 30% complained of low libido
Hormonal findings:
25% had low T levels
22% had a low T/E ratio
Associations:
Among men with low T, 42% reported low libido (Odds Ratio [OR] 1.99; 95% CI: 1.08–3.73; p=0.01)
Among men with low T/E ratio, 52% reported decreased sexual desire (OR 3.47; 95% CI: 1.79–6.46; p=0.001)
In multivariate analysis, low T/E ratio was associated with decreased libido, regardless of T status.
Conclusion
Both low testosterone and low T/E ratios are strongly correlated with decreased libido in men with sexual dysfunction.
The T/E ratio is an independent predictor of decreased libido, irrespective of testosterone status.
Findings suggest that therapies aiming to increase T or decrease E, as well as lifestyle modifications (diet, exercise, metabolic control), may help improve libido in affected men.
Frequency of decreased libido based on hormonal profile
Conference Details:
- Event: ASA & ICA 2025 Annual Meeting
- Location: Washington, D.C., USA
- Dates: March 29 – April 1, 2025
- Poster Session: I
- Date/Time: Sunday, March 30, 2025, 1:30 PM – 3:00 PM
- Poster Number: 149
Freddi R, Neto R, Gismondi J, Nunes R, de Bessa Jr J, Teixeira T, Nahas W, Nascimento B, Hallak J. Testosterone: Estradiol Ratio – A Step Forward Towards the Understanding of Low Libido in Men with Sexual Dysfunction. Poster 149. Presented at: ASA & ICA 2025 Annual Meeting; March 29–April 1, 2025; Washington, D.C., USA.
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