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01-12-2019 | Erectile Dysfunction | Female Sexual Dysfunction and Disorders (A Pastuszak and N Thirumavalavan, Section Editors)

The Complex Relationship Between Erectile Dysfunction and Hypogonadism in Diabetes Mellitus

Authors: Levi C. Holland, B.S., Jonathan A. Beilan, M.D., Alexander J. Tatem, M.D., Larry I. Lipshultz, M.D.

Published in: Current Sexual Health Reports | Issue 4/2019

Abstract

Purpose of Review

As 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 Findings

There 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.

Summary

Metabolic 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.

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Title: The Complex Relationship Between Erectile Dysfunction and Hypogonadism in Diabetes Mellitus
Authors: Levi C. Holland, B.S.
Jonathan A. Beilan, M.D.
Alexander J. Tatem, M.D.
Larry I. Lipshultz, M.D.
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Erectile Dysfunction
Insulins
Vardenafil
Diabetes
Insulins
Testosterone
Hypogonadism
Published in: Current Sexual Health Reports / Issue 4/2019
Print ISSN: 1548-3584
Electronic ISSN: 1548-3592
DOI: https://doi.org/10.1007/s11930-019-00216-9

At a glance: The STEP trials

Springer Medicine

The Complex Relationship Between Erectile Dysfunction and Hypogonadism in Diabetes Mellitus

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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