Elevated estradiol levels may lead to impotence, finds study

Erectile dysfunction is a persistent inability to attain an erection sufficient to permit satisfactory sexual intercourse and is on the rise globally. It has an adverse effect on the quality of life of affected persons. Past studies have shown that elevated estradiol levels could inhibit penile erection, but the relationship between estradiol and erection of the penile tip or base has not been extensively researched.

Dr Zhi-He Xu at Qilu Medical College, Shandong University, Jinan, China and colleagues conducted a cross-sectional study and have found that estradiol inhibits penile erection, particularly at the penile base. The study has been published in the Journal of Translational Andrology and  Urology.

The researchers investigated estradiol's effects on the erection of the penile tip and base, with a cross-sectional study of 135 patients with erectile dysfunction (ED), based on scores of ≤21 according to the International Index of Erectile Function-5. All patients were tested for nocturnal penile tumescence, blood pressure (BP), serum glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), progesterone (P), estradiol (E), and testosterone (T). Univariate and multivariate analyses were used to assess associations between estradiol levels and erection at the penile tip and base.

We found no obvious relationship between erection time at penile tip and estradiol levels but did observe a negative correlation between base erection time and estradiol level [hazard ratio (HR): −0.11; 95% CI: −0.80–1.72]. With increasing estradiol concentration, multivariate analysis showed an obvious reduction in base erection time among patients with normal Rigiscan results (HR: −0.31; 95% CI: −1.63–1.29) (P<0.05) as estradiol concentration increased.

The researchers concluded that estradiol inhibits penile erection, particularly at the penile base which is more sensitive to estradiol than the penile tip. Moreover, when the effective erection time of the penile base lasts longer than 10 min, estradiol has a more obvious inhibitory effect on penile base erection.

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Transl Androl Urol. 2019 Dec; 8(6): 574–582.

DOI: 10.21037/tau.2019.10.15