Beste apotheek van Nederland

Prevalence of Hypogonadism (Total Serum Testosterone Levels)
The studies reporting prevalence rates of hypogonadism in ED patients are described in
Table 2. All studies included men with a previous diagnosis of erectile dysfunction. The
diagnosis of erectile dysfunction was given by a combination of clinical examination and
validated questionnaires: the modified 5-item International Index of Erectile Function (IIEF–5)
and Aging Males Symptoms (AMS).
The prevalence of hypogonadism ranged from 1.72 to 47.7 percent. In one study conducted
in Japan, hypogonadism was found in 47.7 percent of the patients. Note that all participants in
this study had been diagnosed with partial androgen deficiency of the aging male (PADAM)
before entry in the study. 68 In one study, 38 which reported a prevalence of 6.6 percent, patients
had been receiving androgen therapy. In Zohdy et al. 2007 75 all participants presented with
obesity and other signs of metabolic syndrome.
In several studies, patients with ED and hypogonadism, who had been referred to urology
clinics, were found more likely to have decreased libido, 20,38,67,72 testicular
damage/abnormality, 20,38,70 psychological problems with their partner, 70 arterial disease, 70,72
obesity, 67,75 hyperlipidemia, 62 diabetes, 62,72 or hyperprolactinemia. 72
In other studies, patients with hypogonadism did not differ (p-value > 0.05) from eugonadal
patients either with respect to age, 60,64,67 ED severity, 60,62,67 ED duration, 60,67 the presence of
chronic disease, 60 smoking, 60 loss of libido, 64 or premature ejaculation. 67 In contrast, one study 72
demonstrated that age, ED severity, and longer duration of ED were statistically significant
predictors of having hypogonadism in patients with ED.
In two primary care clinic based studies, 57,65 hypogonadal patients were more likely to have
higher levels of prolactin 65 or hypothalamic abnormalities than those with normal levels of
testosterone (21.2 versus 2.9 percent). 57
Prevalence of Hypogonadism (Free Serum Testosterone Levels)
Two studies reported the prevalence of hypogonadism measured by FT (radioimmunoassay,
analog method) 66,74 and two studies reported calculated FT levels based on the TT serum levels
(Table 3). 59,73
The prevalence of hypogonadism using FT serum levels (radioimmunoassay, analog method)
across these studies varied from 12.5 to 25.32 percent. The corresponding range for the
prevalence of hypogonadism using calculated-free testosterone serum levels was 15.7 to 17.58
percent.
One study, 74 found a statistically significant association between hypogonadism and insulin
resistance by showing a higher proportion of patients with insulin resistance amongst
hypogonadal versus eugonadal patients (92.3 versus 25.2 percent, p value= 0.02).
Prevalence of Hypogonadism (Bioavailable Serum Testosterone
Levels)
Serum Bio-T levels were reported in one study. 73 , where the prevalence of hypogonadism
was 0.41 percent and the average level of Bio-T was 0.84 ± 0.28 nmol/L. (Table 4).
Populations (Studies Reporting on Hyperprolactinemia)
Ten studies measured prolactin serum levels in men with ED to detect hyperprolactinemia. 20,
38,56,58,60,61,65,67,72,73 Patients were recruited from primary care clinics 56,65,73 or from specialized
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