Evaluation of male sexual function in active acromegalic patients and after disease remission: preliminary study
M. Galdiero1, P. Vitale1, L. Grasso1, F. Lo Calzo1, F. Cariati1, F. Lotti2, M. Maggi2, A. Colao1 & R. Pivonello1
Introduction: Acromegaly is frequently characterized by hypogonadotropic hypogonadism, endothelial dysfunction, hypertension and impaired glucose and lipid metabolism, classically associated with impaired sexual function (SF). There are no literature data on the SF in acromegaly. The purpose of this study was to evaluate the SF of patients with acromegaly.
Patients and methods: Twenty-two patients (47.8±8.6 years) were enrolled into the study. Among these patients, 48 were in remission (7 after surgery and 41 in medical therapy) and 26 in active disease (21 newly diagnosed and 5 in medical therapy). All patients were subjected to the questionnaire for the evaluation of the SF (IIEF-15), together with the evaluation of the clinical profile and of glycolipid and hormonal status. Patients were divided into two groups according to normal (group A) or high (group B) IGF1 levels.
Results: ED was found in 23 patients (32%). In particular, 15 of 49 (30.6%) patients of group A showed ED (14 with mild ED and one with moderate ED) whereas 8 of 23 (35%) patients of group B showed ED (four with mild ED and four with severe ED) (P=NS). There was no significant difference in the scores of all IIEF-15 scales subjects between group A and group B. Testosterone (P<0.05), 17β-oestradiol (P<0.005) and LH (P<0.05) levels were lower while PRL (P<0.05), HbA1c (P<0.05) and insulin (P<0.005) levels were higher in group B than in group A. In patients with ED, BMI (P<0.05) and waist circumference (P<0.05) were significantly higher while the score of desire (P<0.001) was significantly lower than those without ED. The score ED-IIEF correlated positively with orgasm (P<0.05), desire (P<0.01) and the presence of testosterone replacement therapy (P<0.05) and negatively with BMI (P<0.05), PRL (P<0.05), history of previous cardiovascular events (P<0.05) and GH levels (P<0.05). BMI was the major predictor of the score-DE of IIEF. Overall satisfaction correlated negatively with PRL (P<0.05) levels and use of drugs altering sexual function (P<0.05).
Conclusions: Acromegaly is associated with a high prevalence of ED that does not seem to be completely resolved by normalization of IGFI after disease remission.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.