title: Erectile dysfunction, loss of libido and low sexual frequency increase the risk of cardiovascular disease in men with low testosterone.
abstract: BACKGROUND
  Testosterone deficiency increases the cardiovascular disease (CVD) risk.
  
  
  OBJECTIVE
  To evaluate the effect of erectile dysfunction (ED), sexual frequency and hypogonadal symptoms on CVD risk.
  
  
  METHODS
  A total of 395 hypogonadal men aged 45-74 years were surveyed using the Androgen Deficiency in the Aging Male and the International Index of Erectile Function.
  
  
  METHODS
  The 10-year CVD risk was measured with the Framingham Risk Score. Logistic regression was performed to obtain the odds ratios of sexual function and hypogonadal symptoms for a 10-year CVD risk ≥20% (high risk).
  
  
  RESULTS
  The mean age was 56.1 ± 6.7 years. The mean 10-year CVD risk of the whole cohort was 18.1% ± 11.4%, while 131 subjects (33.2%) were classified as high risk. Logistic regression revealed that ED severity was associated with CVD risk [OR = 2.37 (CI 1.24-4.51) for mild-to-moderate ED, OR = 4.39 (1.78-8.43) for moderate ED and OR = 12.81 (4.65-26.11) for severe ED]. Compared to sexual frequency <1 per month, sexual frequency ≥4 decreased the risk of high CVD risk [OR = 0.35 (0.23-0.780)]. Loss of libido [OR = 2.95 (1.91-4.12)] and less strong erection [OR = 3.87 (CI 2.11-4.95)] increased the risk of high CVD risk. All remained significant after adjustment for age and testosterone.
  
  
  CONCLUSIONS
  ED, decreased sexual frequency and loss of libido predict a high 10-year CVD risk in hypogonadal men.
authors.affiliation: a Department of Urology , Taipei Medical University-Shuang Ho Hospital , New Taipei City , Taiwan .|b Department of Urology , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan .
authors.forename: Chen-Hsun
authors.initials: CH
authors.lastname: Ho
authors.affiliation: a Department of Urology , Taipei Medical University-Shuang Ho Hospital , New Taipei City , Taiwan .|b Department of Urology , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan .
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Wu
authors.affiliation: a Department of Urology , Taipei Medical University-Shuang Ho Hospital , New Taipei City , Taiwan .|b Department of Urology , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan .
authors.forename: Kuan-Chou
authors.initials: KC
authors.lastname: Chen
authors.affiliation: c Institute of Biomedical Engineering, National Taiwan University , Taipei , Taiwan , and.
authors.forename: Fu-Shan
authors.initials: FS
authors.lastname: Jaw
authors.affiliation: d Department of Urology , National Taiwan University Hospital and College of Medicine , Taipei , Taiwan.
authors.forename: Hong-Jeng
authors.initials: HJ
authors.lastname: Yu
authors.affiliation: d Department of Urology , National Taiwan University Hospital and College of Medicine , Taipei , Taiwan.
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Liu
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D007172:Erectile Dysfunction / Q000150:complications*; D005058:Eunuchism / Q000150:complications; D006801:Humans; D007989:Libido / Q000502:physiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000502:physiology*; D013739:Testosterone / Q000172:deficiency*
chemical_list: D013739:Testosterone
keywords: Framingham Risk Score; Testosterone; cardiovascular disease; erectile dysfunction; hypogonadism; libido