Hypogonadism and Erectile Dysfunction in Thai Men with Systemic Lupus Erythematosus

Abstract

Abstract Objectives: To determine the prevalence of hypogonadism and erectile dysfunction (ED), along with associated factors in male SLE patients Methods: A cross-sectional study of men with SLE conducted between January and December 2013. The demographic data, clinical parameters, sex chromosomes, testicular volume, and sex hormones (FSH, LH, and testosterone) were evaluated. We used Androgen Deficiency in the Aging Male (ADAM) screening questionnaires to determine androgen deficiency symptoms and the 5-item International Index for Erectile Function (IIEF-5) questionnaire to assess ED severity. Results: The study included 26 male SLE patients with a mean ± SD age of 37.5 ± 15.4 and disease duration of 4.2 ± 4.5 years. The modified-SLE disease activity index (mSLEDAI) and SLE collaborating clinic (SLICC) damage score were 3.4 ± 5.5 and 0.7 ± 1.0, respectively. All patients had an XY chromosome. Seven patients (27%) had biochemical hypogonadism (testosterone ≤300 ng/dl). Patients with biochemical hypogonadism had a significantly higher prevalence of neuropsychiatric-SLE (NPSLE) than those without (57% vs. 5%, p=0.010). The prevalence of symptomatic hypogonadism and ED based on the ADAM and ED questionnaires were 62% and 76%, respectively. Patients with ED had smaller testicular volume (9.4 ± 2.4 vs. 12.4 ± 2.4 ml, p=0.046). Testicular volume correlated positively with testosterone level (r=0.525, p=0.010) and IIEF-5 score (r=0.476, p=0.046), but negatively with SLICC damage score (r=-0.435, p=0.038). Conclusion: A substantial proportion of male SLE patients had symptomatic hypogonadism and ED. Patients with hypogonadotropic hypogonadism appeared to have higher proportion of NPSLE. ED by IIEF-5 score and testicular volume may be sensitive to predict hypogonadism in male SLE patients.