Endocrine Abstracts

Introduction: Perceived reduced sleep-related erections (PR-SREs), along with erectile dysfunction (ED) and hypoactive sexual desire, have been recently recognized as the most important symptoms characterizing late onset hypogonadism in community-dwelling European men. However, the clinical correlates of PR-SREs have not been thoroughly investigated. The aim of this study is to evaluate the psychobiological correlates of PR-SREs in a large series of subjects consulting for ED.

Methods: A consecutive series of 3888 (mean age 51.6±13.0 years) ED patients attending an Outpatient ED clinic was retrospectively analyzed. PR-SREs were investigated using validated question #13 of SIEDY structured interview, which showed an accuracy of about 70% in predicting RigiscanTM parameters in a consecutive subset of 199 subjects. Clinical, biochemical, hormonal, instrumental (penile color doppler ultrasound; PCDU) and intrapsychic (MHQ-questionnaire) correlates were also evaluated.

Results: 63.6% of patients reported PR-SREs. After adjustment for age, total, analog free, calculated free and calculated bioavailable testosterone (T) were significantly lower in subjects reporting more severe PR-SREs. After adjusting for T levels and other confounders, PR-SREs were still associated with higher BMI, glucose and triglyceride levels, as well as with an increased 10 year-cardiovascular risk score. Accordingly, PR-SREs were more prevalent in subjects showing a reduced dynamic peak systolic velocity at PDCU or reporting severe ED. Among intrapsychic parameters, depressive and histrionic traits were significantly higher and lower, respectively, in subjects with any degree of PR-SREs.

Conclusions: Our study indicates that investigating PR-SREs represents an important step during the andrological consultation. In fact, reduced SREs might indicate an endocrine, organic and/or psychiatric ED background that might help in directing further investigation.