Abstract
Erectile dysfunction (ED) is a frequent sexual disorder in adult men. Klinefelter syndrome (KS) is the most common sex chromosomal disorder and a frequent cause of male hypogonadism. Psychological and cognitive aspects are quite typical in KS and have been linked to ED, while the role of testosterone (T) levels in sexual function of KS subjects has not been fully elucidated. The purpose of the present study is to investigate the role of hormonal disturbances in erectile function of subjects with KS. We conducted a retrospective study involving 52 Klinefelter patients newly diagnosed who never received androgen replacing therapy. All the subjects underwent medical history, accurate physical examination, and blood tests. The International Index of Erectile Function questionnaire (IIEF-EF) score correlated negatively with estradiol/testosterone ratio (E2/T); this correlation remained statistically significant after correction for age (ρ −0.320 p = 0.018). A multiple linear regression analysis identified age and E2/T as the main predictors of IIEF-EF score (R2 0.169 F = 3.848 p = 0.008). Our findings corroborate previous KS data obtained in the general population showing an association between higher E2/T ratio and impaired erectile function. Larger studies are required to better elucidate the pathophysiology of ED in patients with KS.
Highlights
Erectile dysfunction (ED) is the most common sexual disorder in adult men along with premature ejaculation [1]
The purpose of the present study is to investigate the role of hormonal disturbances on the erectile function of subjects with Klinefelter syndrome (KS)
Sexual dysfunction is considered a possible presentation for patients with KS [28]
Summary
Erectile dysfunction (ED) is the most common sexual disorder in adult men along with premature ejaculation [1]. ED is defined as the persistent inability to obtain or maintain a penile erection firm enough for satisfactory sexual intercourse [2]. 25–30 new cases per 1000 people has been reported, and it is expected that by 2025 there will be a prevalence of 322 million people affected all over the world [3]. Male Aging Study, a global prevalence of 52% in patients between 40 and 70 years of age was reported. The prevalence of ED increases with age, reaching 67% in men over 70 years [4]. Other major risk factors are smoking, sedentarism, and common chronic diseases such as hypertension, hypercholesterolemia, obesity, and diabetes mellitus [5]
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