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© The Canadian Journal of Urology™; 18(Supplement 1); April 2011
Address correspondence to Dr. Jack Barkin, Chief of Staff,
Humber River Regional Hospital, 960 Lawrence Avenue
West, Suite 404, Toronto, Ontario M6A 3B5 Canada
Erectile dysfunction and hypogonadism
(low testosterone)
Jack Barkin, MD
Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada
BARKIN J. Erectile dysfunction and hypogonadism
(low testosterone). The Canadian Journal of Urology.
2011;18(Supplement 1):2-7.
Erectile dysfunction (ED) is one of the earliest signs
and markers of present or potential future endothelial
dysfunction. One of the causes of ED can be low
testosterone levels or hypogonadism. This article describes
ways to identify and diagnose patients with ED or
hypogonadism, and it offers a plan for treatment of these
conditions. The mainstay first-line medical therapies
for ED are phosphodiesterase-5 (PDE-5) inhibitors. For
patients with symptomatic hypogonadism, testosterone
replacement therapy is both safe and effective.
Key Words:
erectile dysfunction, hypogonadism
with advancing age and characterized by a deficiency
in serum androgen levels with or without a decreased
genomic sensitivity to androgens,” which could
significantly alter a patient’s quality of life and
adversely affect multiple organs.
3
If a man manifests
symptoms ascribed to hypogonadism, the condition
can be called “symptomatic late-onset hypogonadism
(SLOH).” In the past, late-onset hypogonadism
was also called andropause, male menopause, or
testosterone deficiency syndrome.
Erectile dysfunction
The Massachusetts MaleAging Study -- a prospective,
10 year study that followed over 1100 men aged 40
to 70 years at study entry -- found that ED was more
prevalent in patients with diabetes, heart disease,
Background
Erectile dysfunction (ED) has been defined by a
consensus panel at the National Institutes of Health
(NIH)
1
as “the inability to obtain or maintain the
erection for satisfactory sexual performance.” The
prevalence of ED is fairly similar in different areas of
the world. An estimated 52% of men aged 40 to 70
years have some degree of ED, and the prevalence
increases with age.
2
One of the causes of ED can be
low testosterone levels or hypogonadism.
Late onset hypogonadismwas defined by Morales
and Lunenfeld as “a biochemical syndrome associated
2