R Pedrenho Neto, B Chiesa Gouveia Nascimento, R dos Santos Sobreira Nunes, João Gismondi, J De Bessa Junior, W Carlos Nahas, Jorge Hallak
Abstract
Abstract Introduction Sexual desire drives men to seek sexual activity and have a positive effect on cognitive function, emotional, affective state and affecting the quality of life. This dynamic process is impacted by several factors including the cognitive, neurophysiological and affective spheres. Hormonal balance, including Testosterone (T) and Estradiol (E), is a is also one of the knownwell- known associated factors affecting to sexual desire.libido. Objective Our aim was to evaluate the correlation between libido reduction and hormonal profile (HP), including the Testosterone(T):Estradiol(E) ratio. Methods Retrospective analysis of medical records of sexual medicine consultations in a tertiary care center was performed. Patients were systematically questioned if they perceived their libido decreased using the following question (“Do you believe your libido or sexual desire has decreased in the last few months?”), and all had morning HP checked (Total and free testosterone, SHBG, E2, LH, FSH). HP was categorized into the following groups: Low T (T 100 and Low T:E ratio 35ng/dl) were excluded. Comparison of HP between men who referred decreased libido and those who did not was performed, and the relationship between the different parameters and sexual desire were studied by univariate and multivariate analysis. Results Data from 273 patients were available for analysis evaluated, with amean age of 61 y (± 10) y. From them, 264 (97%) reported being heterosexual and 210 (77%) had a steady partner. From this sample, 25% had low T levels. The percentage of patients referring decreased libido was 30%. In the Low T group, 42% reported decrease of Libido (OR 1,9; 95% IC: 1,08- 3,73; p=0,01) and 52% of the Low T:E ratio group reported decrease of Libido (OR 3,47; 95% IC: 1,79-6,46; p=0,001). In multivariate analysis, after adjusting for age, we found the T:E ratio was associated with decreased of libido, irrespective of T status. Conclusions In this study, our sample of men seeking treatment for sexual dysfunction, low T and low T:E ratio was significantly correlated with perceived decreased libido. Recognizing the imbalance of T:E ratio can help clinicians to identify men with low sexual desire and their best management. Further studies are necessary to confirm this data, and understand how treatment affects those parameters and if this should be addressed in clinical practice. Disclosure No