A.G. and G.T. contributed equally and are both to be considered as first authors.
ORIGINAL RESEARCH-MEN’S SEXUAL HEALTH
Sexual Dysfunctions in Men Affected by Autoimmune Addison's Disease Before and After Short-Term Gluco- and Mineralocorticoid Replacement Therapy
Article first published online: 16 MAR 2012
© 2012 International Society for Sexual Medicine
The Journal of Sexual Medicine
Volume 10, Issue 8, pages 2036–2043, August 2013
How to Cite
Granata, A., Tirabassi, G., Pugni, V., Arnaldi, G., Boscaro, M., Carani, C. and Balercia, G. (2013), Sexual Dysfunctions in Men Affected by Autoimmune Addison's Disease Before and After Short-Term Gluco- and Mineralocorticoid Replacement Therapy. Journal of Sexual Medicine, 10: 2036–2043. doi: 10.1111/j.1743-6109.2012.02673.x
Acknowledgements of financial support: No external funding, apart from the support of the authors' institution, was available for this study.
- Issue published online: 1 AUG 2013
- Article first published online: 16 MAR 2012
- Sexual Dysfunction;
- Addison's Disease;
Introduction. There is evidence suggesting that autoimmune Addison's disease (AD) could be associated with sexual dysfunctions probably caused by gluco- and mineralocorticoid deficiency; however, no study has yet treated this subject in males.
Aim. To evaluate male sexuality and psychological correlates in autoimmune AD before and after gluco- and mineralocorticoid replacement therapy.
Methods. Twelve subjects with a first diagnosis of autoimmune AD were studied before (baseline) and 2 months after (recovery phase) initiating hormone replacement therapy.
Main Outcome Measures. Erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS), depression, and anxiety were studied using a number of questionnaires (International Index of Erectile Function, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory); clinical, biochemical, and hormone data were included in the analysis.
Results. At baseline, low values were found for EF, OF, SD, IS, and OS and high values for depression and anxiety; all of these parameters improved significantly in the recovery phase compared with baseline. EF variation between the two phases correlated significantly and positively with the variation of serum cortisol, urinary free cortisol, systolic blood pressure, and diastolic blood pressure and inversely with that of upright plasma renin activity. Multiple linear regression analysis using EF variation as dependent variable confirmed the relationship of the latter with variation of serum cortisol, urinary free cortisol, and upright plasma renin activity but not with variation of systolic and diastolic blood pressure.
Conclusions. Our study showed that onset of autoimmune AD in males is associated with a number of sexual dysfunctions, all reversible after initiating replacement hormone therapy; cortisol and aldosterone deficiency seems to play an important role in the genesis of erectile dysfunction although the mechanism of their activity is not clear. Granata A, Tirabassi G, Pugni V, Arnaldi G, Boscaro M, Carani C, and Balercia G. Sexual dysfunctions in men affected by autoimmune Addison's disease before and after short-term gluco- and mineralocorticoid replacement therapy. J Sex Med 2013;10:2036–2043.