Sexual Endocrinopathies.
There is compelling experimental and clinical evidence that for adequate sexual function, there must be complex and efficient cross-communication between the endocrine and nervous systems, both centrally and peripherally. The central nervous system (CNS) controls the release of sex steroids, while at the same time, these hormones are primary modulators of neurologic activity. The investigation and treatment of men suspected of hypogonadism is simple, but careful monitoring is essential. Unfortunately, sexual dysfunction is frequently multifactorial, and in many patients, the dysfunction does not improve with hormonal replacement. However, hypotestosteronemia is associated with a variety of alterations in different organ systems beyond sexual activity. It is important to the practice of urology to be familiar with neuroendocrine interactions and to maintain an adequate knowledge of the evaluation and treatment of hormonal deficiencies, particularly in men beyond middle age, in whom hypogonadism is prevalent.
Morales
A
Department of Urology, Queen's University, Kingston, Ontario, Canada.