title: Endocrinologic Control of Men's Sexual Desire and Arousal/Erection.
abstract: BACKGROUND
  Several hormones and neurotransmitters orchestrate men's sexual response, including the appetitive (sexual desire) and consummative (arousal and penile erection) phases.
  
  
  OBJECTIVE
  To provide an overview and recommendations regarding endocrinologic control of sexual desire and arousal and erection and their disturbances.
  
  
  METHODS
  Medical literature was reviewed by the subcommittee of the International Consultation of Sexual Medicine, followed by extensive internal discussion, and then public presentation and discussion with other experts. The role of pituitary (prolactin, oxytocin, growth hormone, and α-melanocyte-stimulating hormone), thyroid, and testicular hormones was scrutinized and discussed.
  
  
  METHODS
  Recommendations were based on grading of evidence-based medical literature, followed by interactive discussion.
  
  
  RESULTS
  Testosterone has a primary role in controlling and synchronizing male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire that can be successfully corrected by appropriate treatments. Oxytocin and α-melanocyte-stimulating hormone are important in eliciting sexual arousal; however, use of these peptides, or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases.
  
  
  CONCLUSIONS
  Endocrine abnormalities are common in patients with sexual dysfunction. Their identification and treatment is strongly encouraged in disturbances of sexual desire and arousal.
authors.affiliation: Endocrinology Unit, Medical Department, Azienda USL Bologna, Maggiore-Bellaria Hospital, Bologna, Italy. Electronic address: m.maggi@dfc.unifi.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Isidori
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Deptartment of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Aversa
authors.affiliation: Department of Urology, the James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Burnett
authors.affiliation: Sexual Medicine and Andrology Unit, Department of Biomedical, Clinical and Experimental Sciences, University of Florence, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D001143:Arousal; D004700:Endocrine System Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone; D006801:Humans; D007989:Libido / Q000502:physiology; D008297:Male; D054526:Men's Health; D010410:Penile Erection; D017410:Practice Guidelines as Topic; D012725:Sexual Behavior; D013739:Testosterone / Q000172:deficiency / Q000627:therapeutic use*
chemical_list: D019382:Human Growth Hormone; D013739:Testosterone
keywords: Erectile Dysfunction; Sexual Desire; Testosterone