Objectives: Erectile dysfunctions (EDs) are in part caused by hormonal causes; but in men over 65 years of age, testosterone deficiency seems to play an important role. However, in population of Polish men over 65 years of age with relative poor health status, the prevalence of testosterone deficiency in patients with ED is unknown.
Material and methods: 286 men over 65 years of age with EDs were invited to complete an erectile function questionnaire (IIEF-5), as a diagnostic tool for EDs. Serum total testosterone (TT) levels were measured. Linear regression model was used to analyze the factors that are associated with testosterone deficiency.
Results: The prevalence of testosterone deficiency was 17, 33, 42 and 57% for testosterone levels of less than 200, 250, 300 and 350 ng/dL, respectively. Only 47% patients had testosterone levels in the normal range (>350 ng/dL). The degree of ED was significantly higher in men with lowest testosterone levels (p < 0,002), and it was mild in 39.5% of cases, mild-to-moderate in 26.2%, moderate in 18.2% and severe in 16%. There was significant inverse relationship between age and TT (r = -0.3328, p < 0.05), IIEF-5 score and TT (r = -0.3149, p < 0.05) and IIEF-5 score and age (r = -0.3463, p < 0.05). The most common metabolic disorders were: obesity (68% in men with TT levels >350 ng/dL and 91% in men with TT levels <350 ng/dL) and dyslipidemia (54 and 95%, respectively). Obesity, age and hyperlipidemia all correlated with significantly decreased testosterone levels. Impaired fasting glucose did not affect the testosterone levels.
Conclusions: Testosterone deficiency was very common in population of Polish men presenting with EDs and correlated negatively with age, obesity and dyslipidemia. These results can be associated with relative poor health status of Polish population.