Sexual dysfunctions in subjects with Klinefelter's syndrome
Giovanni Corona1,2, Luisa Petrone1, Francesca Paggi3, Francesco Lotti1, Valentina Boddi1, Alessandra Fisher1, Linda Vignozzi1, Giancarlo Balercia3, Alessandra Sforza2, Gianni Forti1, Edoardo Mannucci4 & Mario Maggi1
Introduction: While the association of Klinefelters syndrome (KS) with infertility is well known, very few investigations have evaluated the prevalence of sexual dysfunction in KS. The aim of the present study is to systematically analyse the prevalence of KS in a consecutive series of adult male patients consulting for sexual problems and to investigate its specific correlates.
Methods: Among a consecutive series of 1386 patients (mean age 48.9±12.7 years old), 23 (1.7%) subjects with KS were found.
Results: Patients with KS were younger and more often hypogonadal when compared to the rest of the sample. Among patients with KS, 5 (22.7%) subjects reported severe erectile dysfunction, 14 (60.9%) hypoactive sexual desire (HSD), 2 (9.5%) premature and 2 (9.5%) delayed ejaculation. Only the association between KS and HSD was confirmed after adjustment for age (HR=3.2 (1.377.5)), however, when patients with KS were compared with age, smoking habit, and testosterone matched controls, even the association between KS with HSD disappeared. In comparison to matched hypogonadal controls, subjects with KS had lower levels of education, a higher frequency of cryptorchidism and poorer pubertal progression.
Conclusions: Our results indicate that sexual symptoms eventually present in KS are not specifically associated with the syndrome but are due to the underlying hypogonadal state. Further studies are needed to evaluate the efficacy of testosterone substitution in ameliorating the hypoactive sexual desire often reported in subjects with KS.