Necessity of endocrine screening in men with erectile dysfunction

OBJECTIVES: It is an issue of debate whether or not to perform hormonal testing as a first-line investigation in patients with erectile dysfunction. This study aimed to assess the contribution of hormonal testing to the diagnostic investigations of patients who present with erectile dysfunction. METHODS: Investigations were performed in patients who applied to our andrology clinic and in whom hormonal causes were suspected, by looking at least two of the FSH, LH, prolactin and testosterone levels. The rates of hormonal disturbances and their correlation with age were determined. Additionally, whether any modification was performed or not according to the results of these tests was noted. RESULTS: Hormonal investigation was performed in 227(63.8%) of 356 patients. The increased levels of FSH,LH,prolactin and decreased level of testosterone were seen in 9.5%(20/221),7.1% (16/224),4.7%(10/211) and 3.7%(7/191) of the patients.There was a positive correlation between FSH and LH and age,a negative correlation between prolactin and age,and no correlation between testosterone and age. One of the 10 patients with prolactin increase had been diagnosed and been receiving treatment for hypophysis adenoma. Since the level of prolactin was not twice the normal level no further examination was requested in the remaining 9 patients by the endocrinologists. Testosterone replacement was given in two of 7 patients with decreased libido. In the remaining 5 patients no replacement was needed. CONCLUSIONS: Our findings indicate that performing the hormonal investigation as a first line investigation in an erectile dysfunction patient does not contribute to the treatment additionally. Hormonal investigations should be performed after detailed history and physical examination and only in necessary cases