内分泌功能障碍往往性功能,同时,性功能障碍也往往预示着内分泌紊乱。糖尿病性自主神经功能障碍和血管内皮功能障碍会导致勃起障碍,而磷酸二酯酶抑制剂只能起到温和的治疗作用。
糖尿病对女性性功能的影响尤为复杂:迄今为止,最为一致的结论是女性性功能障碍和抑郁症之间的联系。而男性睾丸激素水平低下与性欲降低、夜间勃起少和射精量减少有关,所有这些症状在补充睾丸激素后都能得到改善。由于年龄增加所致的睾丸激素产量降低与性功能之间并无确切关系,补充睾丸激素后,并没有显示对性功能有益。
在女性,没有发现性功能障碍与血清睾酮浓度有关,但是这可能混淆了睾酮在细胞内所生产的比男性更为重要的效应与低浓度检测之间的联系。但是,对于更年期之后的女性补充睾酮能够提高女性性功能,但是在这方面的长期结果的数据还很缺乏。
本文译自Lancet 如转载请注明出处
Endocrine disease frequently interrupts sexual function, and sexual dysfunction may signal serious endocrine disease. Diabetic autonomic neuropathy and endothelial dysfunction impair erectile function, and phosphodiesterase inhibition produces only moderate benefit. The effect of diabetes on women's sexual function is complex: the most consistent finding is a correlation between sexual dysfunction and depression. Reductions in testosterone level in men are associated with low sexual desire and reduced nocturnal erections and ejaculate volume, all of which improve with testosterone supplementation. The age-dependent decline in testosterone production in men is not associated with precise sexual symptoms, and supplementation has not been shown to produce sexual benefit. In women, sexual dysfunction has not been associated with serum testosterone, but this may be confounded by limitations of assays at low concentrations and by the greater importance of intracellular production of testosterone in women than in men. Testosterone supplementation after menopause does improve some aspects of sexual function in women, but long-term outcome data are needed.
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