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Volume 22, Issue 6 (November 2020) 22, 636–641; 10.4103/aja.aja_135_19

Estradiol is an independent risk factor for organic erectile dysfunction in eugonadal young men

Hui-Rong Chen, Ru-Hui Tian, Peng Li, Hui-Xing Chen, Shu-Jie Xia, Zheng Li

Department of Andrology, The Center for Men's Health, Urologic Medical Center, Shanghai Key Laboratory of Reproductive Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China

Correspondence: Dr. Z Li (lizhengboshi@163.com)

Date of Submission 18-Feb-2019 Date of Acceptance 31-Oct-2019 Date of Web Publication 10-Jan-2020


Erectile dysfunction attributable to testosterone deficiency is less common in young males, and the effect of estradiol on erectile function in eugonadal young males is unclear. We analyzed data from 195 male participants, including 143 eugonadal patients with erectile dysfunction and 52 healthy men. To distinguish psychogenic and organic erectile dysfunction, penile rigidity was measured using the nocturnal penile tumescence rigidity test. Serum levels of sexual hormones were quantified by electrochemiluminescence, and penile vascular status was assessed by penile color Doppler ultrasound. Both serum estradiol levels and the ratio of estradiol to testosterone were higher in patients with organic erectile dysfunction than in patients with psychogenic erectile dysfunction or healthy controls. Organic erectile dysfunction was negatively associated with estradiol levels and the ratio of estradiol to testosterone, and estradiol was the only significant risk factor for organic erectile dysfunction (odds ratio: 1.094; 95% confidence interval: 1.042–1.149, P = 0.000). Moreover, serum estradiol levels were negatively correlated with penile rigidity. Serum estradiol levels were higher and penile rigidity was lower in patients with venous erectile dysfunction than in patients with nonvascular erectile dysfunction. We conclude that elevated serum estradiol levels may impair erectile function and may be involved in the pathogenesis of organic erectile dysfunction in eugonadal young men.

Keywords: erectile dysfunction; estradiol; organic etiology; testosterone; young

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