The Complex Relationship Between Erectile Dysfunction and Hypogonadism in Diabetes Mellitus

被引:1
作者
Holland, Levi C. [1 ,2 ]
Beilan, Jonathan A. [2 ]
Tatem, Alexander J. [2 ]
Lipshultz, Larry, I [2 ]
机构
[1] Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, 6431 Fannin St, Houston, TX 77030 USA
[2] Baylor Coll Med, Scott Dept Urol, 6624 Fannin St 1700, Houston, TX 77030 USA
关键词
Diabetes mellitus; Erectile dysfunction; Hypogonadism; Testosterone; Sexual dysfunction; Metabolic syndrome; Pathophysiology; Management;
D O I
10.1007/s11930-019-00216-9
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of ReviewAs the prevalence of diabetes mellitus grows worldwide, it is increasingly important to understand the commonly comorbid urologic conditions, hypogonadism and erectile dysfunction, in the setting of the diabetic man. The relationship between the diabetes, hypogonadism, and erectile dysfunction is complex with significant interplay among the disease processes and potential for unique management of the triad. The purpose of this review is to provide an update on the intertwined nature of these diseases in diabetics with special consideration for pathophysiology, diagnosis, and management.Recent FindingsThere is a wide range of pathophysiologic mechanisms central to hypogonadism and erectile dysfunction in diabetes mellitus which continue to be identified and better elucidated; nevertheless, metabolic syndrome, composed of insulin resistance, dyslipidemia, hypertension, and obesity, appears to be the common thread between both. An increasing body of evidence suggests that low testosterone is an independent risk factor for cardiovascular disease and worsened overall survival in diabetic men with potential that testosterone therapy may reduce these risks. The treatment of either erectile dysfunction or hypogonadism in diabetic men may also improve the other condition; some evidence suggests that testosterone therapy in hypogonadal diabetics may improve erectile function while daily vardenafil, in addition to improving erectile function, appears to restore hypogonadal diabetics' testosterone to the eugonadal range.SummaryMetabolic syndrome appears to be the central connection between the increasingly common clinical picture of diabetic men with erectile dysfunction and hypogonadism. The overlapping pathophysiology of these conditions results in unique management considerations.
引用
收藏
页码:358 / 369
页数:12
相关论文
共 125 条
[1]   The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism [J].
Aftab, S. A. Saboor ;
Kumar, S. ;
Barber, T. M. .
CLINICAL ENDOCRINOLOGY, 2013, 78 (03) :330-337
[2]   Testosterone therapy for sexual dysfunction in men with Type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials [J].
Algeffari, M. ;
Jayasena, C. N. ;
MacKeith, P. ;
Thapar, A. ;
Dhillo, W. S. ;
Oliver, N. .
DIABETIC MEDICINE, 2018, 35 (02) :195-202
[3]   Role of endothelin receptors and relationship with nitric oxide synthase in impaired erectile response in diabetic rats [J].
Alkan, E. ;
Ugan, R. A. ;
Basar, M. M. ;
Halici, Z. ;
Karakus, E. ;
Balbay, M. D. ;
Un, H. .
ANDROLOGIA, 2017, 49 (02)
[4]   Functional and structural changes in internal pudendal arteries underlie erectile dysfunction induced by androgen deprivation [J].
Alves-Lopes, Rheure ;
Neves, Karla B. ;
Silva, Marcondes A. B. ;
Olivon, Vania C. ;
Ruginsk, Silvia G. ;
Antunes-Rodrigues, Jose ;
Ramalhos, Leandra N. Z. ;
Tostes, Rita C. ;
Carneiro, Fernando Silva .
ASIAN JOURNAL OF ANDROLOGY, 2017, 19 (05) :526-532
[5]   Internal Pudental Artery Dysfunction in Diabetes Mellitus Is Mediated by NOX1-Derived ROS-, Nrf2-, and Rho Kinase-Dependent Mechanisms [J].
Alves-Lopes, Rheure ;
Neves, Karla B. ;
Montezano, Augusto C. ;
Harvey, Adam ;
Carneiro, Fernando S. ;
Touyz, Rhian M. ;
Tostes, Rita C. .
HYPERTENSION, 2016, 68 (04) :1056-1064
[6]  
[Anonymous], 1990, Lancet, V336, P955
[7]  
[Anonymous], 2016, World health organization
[8]   Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction [J].
Aversa, A ;
Isidori, AM ;
De Martino, MU ;
Caprio, M ;
Fabbrini, E ;
Rocchietti-March, M ;
Frajese, G ;
Fabbri, A .
CLINICAL ENDOCRINOLOGY, 2000, 53 (04) :517-522
[9]   Small-fibre neuropathy in men with type 1 diabetes and erectile dysfunction: a cross-sectional study [J].
Azmi, Shazli ;
Ferdousi, Maryam ;
Alam, Uazman ;
Petropoulos, Ioannis N. ;
Ponirakis, Georgios ;
Marshall, Andrew ;
Asghar, Omar ;
Fadavi, Hassan ;
Jones, Wendy ;
Tavakoli, Mitra ;
Boulton, Andrew J. M. ;
Jeziorska, Maria ;
Soran, Handrean ;
Efron, Nathan ;
Malik, Rayaz A. .
DIABETOLOGIA, 2017, 60 (06) :1094-1101
[10]   Testosterone Induces Erythrocytosis via Increased Erythropoietin and Suppressed Hepcidin: Evidence for a New Erythropoietin/Hemoglobin Set Point [J].
Bachman, Eric ;
Travison, Thomas G. ;
Basaria, Shehzad ;
Davda, Maithili N. ;
Guo, Wen ;
Li, Michelle ;
Westfall, John Connor ;
Bae, Harold ;
Gordeuk, Victor ;
Bhasin, Shalender .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2014, 69 (06) :725-735