Erectile dysfunction: Diagnostic and therapeutic approach

A. Aversa, M. Rocchietti-March, V. Bonifacio, M. Caprio, D. Giannini, A. Fabbri, A. Isidori

Research output: Contribution to journalArticlepeer-review


Male sexual behavior is regulated by the combined action of several hormones, the most important of which is testosterone (T). GnRH and LH play a key role in regulating sexual desire and potency, but their importance in contributing to the pathophysiology of male impotence is still unclear. Psychoneuroendocrine causes of erectile dysfunction are related to stress altered secretion and/or function of the major central neurotransmitters (i.e. epinephrine, norephinephrine, opioid peptides, serotonin, dopamine, oxytocin) involved in the psychogenic regulation of erection. Studies of these alterations, which account for most of non organic causes of erectile dysfunction (about 50% out of the total causes of impotence), may be evaluated by the psychological profile (i.e. State Trait Anxiety Inventory) as well as by the measurement of biological (Bio) LH levels and of Bio/Immuno LH ratio. Organic factors account for the remaining causes of impotence and can be ruled out through an accurate evaluation of vascular, neurologic and endocrine function. Endocrine alterations (which represents about one third out of the organic causes) are evaluated by the assay of plasma total (T) and free testosterone (FT), estradiol (E), dehydrotestosterone (DHT), prolactin (PRL), thyrotropin-stimulating-hormone (TSH) and sex-hormone-binding-globulin (SHBG). The application of different procedures and current therapeutic approaches is reviewed.

Original languageEnglish
Pages (from-to)261-273
Number of pages13
JournalMolecular Andrology
Issue number3-4
Publication statusPublished - 1995

ASJC Scopus subject areas

  • Endocrinology
  • Nephrology

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