Endocrine Abstracts (2011) 26 P23

Multicenter study on the prevalence of sexual symptoms in men affected by Addison disease

A Granata1, V Pugni1, G Arnaldi2, A Guidi1, D Santi1, G Balercia2 & C Carani1

1Chair of Endocrinology, Department of Medicine, Endocrinology and Metabolism, Geriatrics, University of Modena and Reggio Emilia, Modena, Italy; 2Chair of Endocrinology, University of Ancona, Ancona, Italy.

Introduction: Male sexual behaviour is deeply influenced by the endocrine system. However, few data are available on low cortisol serum levels and sexuality.

Subjects and methods: In order to investigate the sexual function in 12 men before and during replacement treatment for Addison disease (AD), we performed sexual and psychological evaluations before replacement therapy (‘baseline’) and at least 8 weeks after complete recovery from cortisol deficiency (‘recovery phase’), by collecting blood and urine for hormonal assays and by filling the International Index of Erectile Function (IIEF) questionnaire, the Beck Depression Inventory (BDI), the Spielberger State Anxiety Inventory (SSAI) and the Spielberger Trait Anxiety Inventory (STAI).

Results: IIEF showed a significant improvement of libido and erectile function during the ‘recovery phase’. BDI, SSAI and STAI showed a significant improvement of depression and both trait and state anxiety in the ‘recovery phase’ compared to ‘baseline’. Testosterone and LH serum levels did not show a significant difference comparing the two phases of the study.

Discussion: Low cortisol serum levels could indirectly impair sexuality and mood through arterial hypotension and asthenia. For what concerns the high ACTH serum levels, it is well known that LH receptors on Leydig cells are down-regulated by ACTH, so it is possible that AD leads to a relative hypogonadism which can contribute to sexual dysfunction. Moreover, a relative hypogonadism could be due to GnRH serum levels lowered by CRH.

Conclusions: Several data and our results suggest the presence of mood disturbances in AD patients even if it is not clear which factor linked with cortisol has the prominent role in affecting sexual life, sexual behaviour and mood in hyposurrenalism.

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