title: Different testosterone levels are associated with ejaculatory dysfunction.
abstract: BACKGROUND
  The role of testosterone (T) in pathogenesis of ejaculatory symptoms has not been completely clarified.
  
  
  OBJECTIVE
  To evaluate the possible contribution of T and hypogonadism in the control of the ejaculatory reflex, comparing subjects with premature ejaculation (PE) or delayed ejaculation (DE) to those without ejaculatory dysfunction.
  
  
  METHODS
  A consecutive series of 2,437 (mean age 51.9 +/- 13.0 years) male patients with sexual dysfunction was studied.
  
  
  METHODS
  Several hormonal and biochemical parameters were studied, along with the structured interview on erectile dysfunction (SIEDY) structured interview. Hypogonadism were defined when total testosterone (TT) was lower than 10.4 nmol/L.
  
  
  RESULTS
  Among the patients studied, 714 (25.9%) and 121 (4.4%) reported PE and DE, respectively. In the youngest age band (25-40 years), subjects with PE reported higher TT and free testosterone (FT) levels when compared to the other groups (subjects with DE or those without PE and DE; P < 0.05 for both). Conversely, in the oldest age band (55-70 years), lower TT and FT levels were observed in DE subjects. Accordingly, patients with PE showed the lowest (12%) and subjects with DE the highest (26%) prevalence of hypogonadism. These differences were confirmed even after adjustment for confounders such as age and libido (HR = 0.75 [0.57-0.99] and 1.83 [1.14-3.94] for PE and DE, respectively; both P < 0.05).
  
  
  CONCLUSIONS
  Our data seem to suggest that T plays a facilitatory role in the control of ejaculatory reflex. Both central and peripheral mechanisms have been advocated to explain this association. Clinical studies are currently in progress to further establish the role of T in the ejaculatory dysfunction, attempting to revert DE by androgen administration.
authors.affiliation: Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Emmanuele A
authors.initials: EA
authors.lastname: Jannini
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.forename: Alessandra D
authors.initials: AD
authors.lastname: Fisher
authors.forename: Francesco
authors.initials: F
authors.lastname: Lotti
authors.forename: Luisa
authors.initials: L
authors.lastname: Petrone
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.forename: Elisa
authors.initials: E
authors.lastname: Bandini
authors.forename: Valerio
authors.initials: V
authors.lastname: Chiarini
authors.forename: Gianni
authors.initials: G
authors.lastname: Forti
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000328:Adult; D000368:Aged; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D007006:Hypogonadism / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012018:Reflex / Q000502:physiology; D012735:Sexual Dysfunction, Physiological / Q000097:blood*; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone