275 Correlation Between Libido and Testosterone: Estradiol Ratio in Men with Sexual Dysfunction

ABSTRACT Introduction Sexual desire drives men to seek sexual activity, positively impacting cognitive function, emotional affective state and affecting the quality of life. This dynamic process is impacted by several factors including the cognitive, neurophysiological and affective spheres. Hormonal balance is also one of the known factors affecting libido. Our aim was to evaluate correlation between libido reduction and hormonal profile (HP), including the Testosterone(T):Estradiol(E) ratio. Methods Retrospective analysis of medical records of sexual medicine consultations in a tertiary care center. Patients were systematically questioned if they perceived their libido decreased using the following question (“Do you believe your libido or sexual desire has decreased in the last few months?”), and all had morning HP checked (Total and free testosterone, SHBG, E2, LH, FSH). HP was categorized into the following groups: Low T (T<300ng/dl) and Normal T (T≥300ng/dl); normal T:E ratio > 100 and Low T:E ratio <100. All patients with hyperprolactinemia (>35ng/dl) were excluded. Comparison of HP between men who referred decreased libido and those who did not was performed, and the relationship between the different parameters and sexual desire were studied by univariate and multivariate analysis. Results A total of 194 patients were evaluated, with a mean age of 61 ± 21 y. 188 (97%) reported being heterosexual and 154 (79%) had a steady partner. From this sample, 24% had low T levels. The percentage of patients referring decreased libido was 32.5%. In the Low T group, 67,5% reported decrease of Libido (OR 2,4; 95% IC: 1,2-4,8; p=0,01) and 67% of the Low T:E ratio group reported decrease of Libido (OR 3,7; 95% IC: 1,6-8,2; p=0,001). In multivariate analysis, after adjusting for age, we found the T:E ratio was associated with decreased of libido irrespective of T status. Conclusion In our sample of men seeking treatment for sexual dysfunction, low T and low T:E ratio was significantly correlated with perceived decreased libido. Recognizing the imbalance of T:E ratio can help clinicians to identify men with low sexual desire and their best management. Further studies are necessary to confirm this data and understand how treatment affects those parameters. Disclosure Work supported by industry: no.