The relationships between sex hormones and sexual function in middle-aged and older European men

Daryl B. O'Connor, David M. Lee, Giovanni Corona, Gianni Forti, Abdelouahid Tajar, Terence W. O'Neill, Neil Pendleton, G. Bártfai, Steven Boonen, Felipe F. Casanueva, Joseph D. Finn, Aleksander Giwercman, Thang S. Han, Ilpo T. Huhtaniemi, Krzysztof Kula, Fernand Labrie, Michael E J Lean, Margus Punab, Alan J. Silman, Dirk VanderschuerenFrederick C W Wu, Luisa Petrone, Herman Borghs, Jolanta Slowikowska-Hilczer, Renata Walczak-Jedrzejowska, Philip Steer, Stephen Pye, Mary Lage, I. Földesi, I. Fejes, Paul Korrovitz, Min Jiang

Research output: Contribution to journalArticle

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Abstract

Context: Limited data are available exploring the associations between sex hormones, multiple domains of sexual functioning, and sexual function-related distress in nonpatient samples in Europe. Objectives: The aim of the study was to investigate the relationships between serum testosterone (T), estradiol (E2), and dihydrotestosterone (DHT) and sexual function in a multicenter population-based study of aging in men. Design: Using stratified random sampling, 2838 men aged 40-79 yr completed the European Male Ageing Study-Sexual Function Questionnaire and provided a blood sample for hormone measurements. T, E2, and DHT were measured using gas chromatography-mass spectrometry. Setting: We conducted a community-based population survey in eight European centers. Main Outcome Measures: Self-reported sexual function (overall sexual function, sexual function-related distress, erectile dysfunction, masturbation) was measured. Results: Total and free T, but not E2 or DHT, was associated with overall sexual function in middle-aged and older men. E2 was the only hormone associated with sexual function-related distress such that higher levels were related to greater distress. Free T levels were associated with masturbation frequency and erectile dysfunction in the fully adjusted models, such that higher T was associated with less dysfunction and greater frequency. Moreover, therewas a T threshold for the relationship between total T, sexual function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less, T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter, the relationship came to a plateau. Conclusions: These findings suggest that different hormonal mechanisms may regulate sexual functioning (T) vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was a T threshold for overall sexual function such that at levels greater than 8 nmol/liter the relationship between T and sexual function did not become stronger.

Original languageEnglish
JournalJournal of Clinical Endocrinology and Metabolism
Volume96
Issue number10
DOIs
Publication statusPublished - Oct 2011

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Dihydrotestosterone
Gonadal Steroid Hormones
Erectile Dysfunction
Masturbation
Hormones
Sexual Behavior
Gas Chromatography-Mass Spectrometry
Population
Testosterone
Estradiol
Outcome Assessment (Health Care)
Psychology
Serum
Aging of materials
Surveys and Questionnaires
Gas chromatography
Mass spectrometry
Blood
Sampling

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

The relationships between sex hormones and sexual function in middle-aged and older European men. / O'Connor, Daryl B.; Lee, David M.; Corona, Giovanni; Forti, Gianni; Tajar, Abdelouahid; O'Neill, Terence W.; Pendleton, Neil; Bártfai, G.; Boonen, Steven; Casanueva, Felipe F.; Finn, Joseph D.; Giwercman, Aleksander; Han, Thang S.; Huhtaniemi, Ilpo T.; Kula, Krzysztof; Labrie, Fernand; Lean, Michael E J; Punab, Margus; Silman, Alan J.; Vanderschueren, Dirk; Wu, Frederick C W; Petrone, Luisa; Borghs, Herman; Slowikowska-Hilczer, Jolanta; Walczak-Jedrzejowska, Renata; Steer, Philip; Pye, Stephen; Lage, Mary; Földesi, I.; Fejes, I.; Korrovitz, Paul; Jiang, Min.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 96, No. 10, 10.2011.

Research output: Contribution to journalArticle

O'Connor, DB, Lee, DM, Corona, G, Forti, G, Tajar, A, O'Neill, TW, Pendleton, N, Bártfai, G, Boonen, S, Casanueva, FF, Finn, JD, Giwercman, A, Han, TS, Huhtaniemi, IT, Kula, K, Labrie, F, Lean, MEJ, Punab, M, Silman, AJ, Vanderschueren, D, Wu, FCW, Petrone, L, Borghs, H, Slowikowska-Hilczer, J, Walczak-Jedrzejowska, R, Steer, P, Pye, S, Lage, M, Földesi, I, Fejes, I, Korrovitz, P & Jiang, M 2011, 'The relationships between sex hormones and sexual function in middle-aged and older European men', Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 10. https://doi.org/10.1210/jc.2010-2216
O'Connor, Daryl B. ; Lee, David M. ; Corona, Giovanni ; Forti, Gianni ; Tajar, Abdelouahid ; O'Neill, Terence W. ; Pendleton, Neil ; Bártfai, G. ; Boonen, Steven ; Casanueva, Felipe F. ; Finn, Joseph D. ; Giwercman, Aleksander ; Han, Thang S. ; Huhtaniemi, Ilpo T. ; Kula, Krzysztof ; Labrie, Fernand ; Lean, Michael E J ; Punab, Margus ; Silman, Alan J. ; Vanderschueren, Dirk ; Wu, Frederick C W ; Petrone, Luisa ; Borghs, Herman ; Slowikowska-Hilczer, Jolanta ; Walczak-Jedrzejowska, Renata ; Steer, Philip ; Pye, Stephen ; Lage, Mary ; Földesi, I. ; Fejes, I. ; Korrovitz, Paul ; Jiang, Min. / The relationships between sex hormones and sexual function in middle-aged and older European men. In: Journal of Clinical Endocrinology and Metabolism. 2011 ; Vol. 96, No. 10.
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abstract = "Context: Limited data are available exploring the associations between sex hormones, multiple domains of sexual functioning, and sexual function-related distress in nonpatient samples in Europe. Objectives: The aim of the study was to investigate the relationships between serum testosterone (T), estradiol (E2), and dihydrotestosterone (DHT) and sexual function in a multicenter population-based study of aging in men. Design: Using stratified random sampling, 2838 men aged 40-79 yr completed the European Male Ageing Study-Sexual Function Questionnaire and provided a blood sample for hormone measurements. T, E2, and DHT were measured using gas chromatography-mass spectrometry. Setting: We conducted a community-based population survey in eight European centers. Main Outcome Measures: Self-reported sexual function (overall sexual function, sexual function-related distress, erectile dysfunction, masturbation) was measured. Results: Total and free T, but not E2 or DHT, was associated with overall sexual function in middle-aged and older men. E2 was the only hormone associated with sexual function-related distress such that higher levels were related to greater distress. Free T levels were associated with masturbation frequency and erectile dysfunction in the fully adjusted models, such that higher T was associated with less dysfunction and greater frequency. Moreover, therewas a T threshold for the relationship between total T, sexual function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less, T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter, the relationship came to a plateau. Conclusions: These findings suggest that different hormonal mechanisms may regulate sexual functioning (T) vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was a T threshold for overall sexual function such that at levels greater than 8 nmol/liter the relationship between T and sexual function did not become stronger.",
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AU - Lee, David M.

AU - Corona, Giovanni

AU - Forti, Gianni

AU - Tajar, Abdelouahid

AU - O'Neill, Terence W.

AU - Pendleton, Neil

AU - Bártfai, G.

AU - Boonen, Steven

AU - Casanueva, Felipe F.

AU - Finn, Joseph D.

AU - Giwercman, Aleksander

AU - Han, Thang S.

AU - Huhtaniemi, Ilpo T.

AU - Kula, Krzysztof

AU - Labrie, Fernand

AU - Lean, Michael E J

AU - Punab, Margus

AU - Silman, Alan J.

AU - Vanderschueren, Dirk

AU - Wu, Frederick C W

AU - Petrone, Luisa

AU - Borghs, Herman

AU - Slowikowska-Hilczer, Jolanta

AU - Walczak-Jedrzejowska, Renata

AU - Steer, Philip

AU - Pye, Stephen

AU - Lage, Mary

AU - Földesi, I.

AU - Fejes, I.

AU - Korrovitz, Paul

AU - Jiang, Min

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N2 - Context: Limited data are available exploring the associations between sex hormones, multiple domains of sexual functioning, and sexual function-related distress in nonpatient samples in Europe. Objectives: The aim of the study was to investigate the relationships between serum testosterone (T), estradiol (E2), and dihydrotestosterone (DHT) and sexual function in a multicenter population-based study of aging in men. Design: Using stratified random sampling, 2838 men aged 40-79 yr completed the European Male Ageing Study-Sexual Function Questionnaire and provided a blood sample for hormone measurements. T, E2, and DHT were measured using gas chromatography-mass spectrometry. Setting: We conducted a community-based population survey in eight European centers. Main Outcome Measures: Self-reported sexual function (overall sexual function, sexual function-related distress, erectile dysfunction, masturbation) was measured. Results: Total and free T, but not E2 or DHT, was associated with overall sexual function in middle-aged and older men. E2 was the only hormone associated with sexual function-related distress such that higher levels were related to greater distress. Free T levels were associated with masturbation frequency and erectile dysfunction in the fully adjusted models, such that higher T was associated with less dysfunction and greater frequency. Moreover, therewas a T threshold for the relationship between total T, sexual function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less, T was associated with worse sexual functioning, whereas at T levels over 8 nmol/liter, the relationship came to a plateau. Conclusions: These findings suggest that different hormonal mechanisms may regulate sexual functioning (T) vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was a T threshold for overall sexual function such that at levels greater than 8 nmol/liter the relationship between T and sexual function did not become stronger.

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