Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience

Aydogan, Umit; Doganer, Yusuf Cetin; Haymana, Cem; Kaplan, Umit; Aydogdu, Aydogan; Demirci, Ibrahim; Meric, Coskun; Sonmez, Yusuf Alper

doi:10.20945/2359-3997000000539

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Original Article • Arch. Endocrinol. Metab. 67 (2) • Mar-Apr 2023 • https://doi.org/10.20945/2359-3997000000539 copy

Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters.

Materials and methods:

The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients’ blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded.

Results:

In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF-5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale.

Conclusion:

The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients.

Keywords
Hypogonadotropic hypogonadism; sexual functions; testosterone replacement therapy

	Pre-treatment Median (Min-Max)	Post-treatment (6-Month) Median (Min-Max)	p ^* * Wilcoxon signed-rank test.
BMI (kg/m²) (Mean ± SD)	24.98 ± 4.39 (12.98-34.78)	26.54 ± 4.71 (16.98-36.57)	0.001 ^ Paired samples t-test.
Total testosterone (ng/dL)	24.44 (1.00-178.30)	97.00 (2.00-181.00)	<0.001
Waist circumference (cm)	89 (68-112)	94 (79-104)	0.043
FSH (ng/dL)	1.56 (0.03-84.38)	0.84 (0.01-61.27)	0.131
LH (ng/dL)	1.08 (0.01-39.70)	0.17 (0.04-35.17)	0.657

	IIEF-5		p^* * Wilcoxon signed-rank test.
	Pre-treatment Median (Min-Max)	Post-treatment (6-Month)(Min-Max)
	8.00 (5-25)	15.00 (5-25)	<0.001
	ASEX
	Pre-treatment Median (Min-Max)	Post-treatment (6-Month) Median (Min-Max)
	18.00 (7-30)	14.00 (5-25)	<0.001
	IIEF
	Pre-treatment Median (Min-Max)	Post-treatment (6-Month) Median (Min-Max)
EF	6.00 (1-26)	13.00 (6-30)	<0.001
OF	0.00 (0-10)	4.00 (2-12)	<0.001
SD	5.00 (2-10)	6.00 (2-10)	0.362
IS	0.00 (0-9)	3.00 (3-13)	<0.001
OS	4.00 (2-9)	5.00 (2-10)	0.109

		IIEF-EF Pre-treatment	IIEF-OF Pre-treatment	IIEF-SD Pre-treatment	IIEF-IS Pre-treatment	IIEF-OS Pre-treatment	TOTAL TESTOSTERONE Pre-treatment
IIEF-5	p	0.758	0.456	0.837	0.998	0.998	0.241
Pre-treatment	r	0.046	0.111	0.031	0.000	0.000	0.174
		IIEF-EF Post-treatment (6-Month)	IIEF-OF Post-treatment (6-Month)	IIEF-SD Post-treatment (6-Month)	IIEF-IS Post-treatment (6-Month)	IIEF-OS Post-treatment (6-Month)	TOTAL TESTOSTERONE Post-treatment (6-Month)
IIEF-5- 6 – Month	p	0.001	0.011	0.000	0.001	0.000	0.027
	r	0.478	0.367	0.568	0.465	0.760	0.324

		IIEF-5 Pre-treatment	IIEF-EF Pre-treatment	IIEF-OF Pre-treatment	IIEF-SD Pre-treatment	IIEF-IS Pre-treatment	IIEF-OS Pre-treatment	TOTAL TESTOSTERONE Pre-treatment
ASEX	p	0.046	0.791	0.849	0.882	0.609	0.794	0.609
Pre-treatment	r	−0.293	−0.040	0.028	0.022	0.077	0.039	−0.076
		IIEF-5 Post-treatment (6-Month)	IIEF-EF Post-treatment (6-Month)	IIEF-OF Post-treatment (6-Month)	IIEF-SD Post-treatment (6-Month)	IIEF-IS Post-treatment (6-Month)	IIEF-OSPost-treatment (6-Month)	TOTAL TESTOSTERONE Post-treatment (6-Month)
ASEX	p	0.003	0.010	0.129	0.000	0.001	0.000	0.068
Post-treatment (6-Month)	r	−0.421	−0.371	−0.224	−0.575	−0.473	−0.542	−0.269

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[1] Correspondence to: Umit Aydogan University of Health Sciences, Gulhane School of Medicine Department of Family Medicine, Ankara, Turkey umit.aydogan@sbu.edu.tr