title: Sexual dysfunctions in men affected by autoimmune Addison's disease before and after short-term gluco- and mineralocorticoid replacement therapy.
abstract: BACKGROUND
  There is evidence suggesting that autoimmune Addison's disease (AD) could be associated with sexual dysfunctions probably caused by gluco- and mineralocorticoid deficiency; however, no study has yet treated this subject in males.
  
  
  OBJECTIVE
  To evaluate male sexuality and psychological correlates in autoimmune AD before and after gluco- and mineralocorticoid replacement therapy.
  
  
  METHODS
  Twelve subjects with a first diagnosis of autoimmune AD were studied before (baseline) and 2 months after (recovery phase) initiating hormone replacement therapy.
  
  
  METHODS
  Erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS), depression, and anxiety were studied using a number of questionnaires (International Index of Erectile Function, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory); clinical, biochemical, and hormone data were included in the analysis.
  
  
  RESULTS
  At baseline, low values were found for EF, OF, SD, IS, and OS and high values for depression and anxiety; all of these parameters improved significantly in the recovery phase compared with baseline. EF variation between the two phases correlated significantly and positively with the variation of serum cortisol, urinary free cortisol, systolic blood pressure, and diastolic blood pressure and inversely with that of upright plasma renin activity. Multiple linear regression analysis using EF variation as dependent variable confirmed the relationship of the latter with variation of serum cortisol, urinary free cortisol, and upright plasma renin activity but not with variation of systolic and diastolic blood pressure.
  
  
  CONCLUSIONS
  Our study showed that onset of autoimmune AD in males is associated with a number of sexual dysfunctions, all reversible after initiating replacement hormone therapy; cortisol and aldosterone deficiency seems to play an important role in the genesis of erectile dysfunction although the mechanism of their activity is not clear.
authors.affiliation: Endocrinology and Metabolic Diseases, University of Modena, Modena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tirabassi
authors.forename: Valeria
authors.initials: V
authors.lastname: Pugni
authors.forename: Giorgio
authors.initials: G
authors.lastname: Arnaldi
authors.forename: Marco
authors.initials: M
authors.lastname: Boscaro
authors.forename: Cesare
authors.initials: C
authors.lastname: Carani
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
mesh_terms: D000224:Addison Disease / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D000328:Adult; D005938:Glucocorticoids / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D008297:Male; D008875:Middle Aged; D008901:Mineralocorticoids / Q000627:therapeutic use*; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D008901:Mineralocorticoids; D006854:Hydrocortisone