Chicago-A recent study found low levels of free testosterone in older men with prostate cancer could increase these men’s odds of facing erectile dysfunction after undergoing radical prostatectomy.
The study, presented at the AUA annual meeting in Chicago, indicated low levels of free testosterone have a negative effect on erectile function in men older than 60 years of age who have prostate cancer—and the effect worsens with age, researchers from the department of urology at the University of California Irvine found.
As a result, the authors recommend obtaining free testosterone levels in all men over the age of 60 years who are preparing to undergo radical prostatectomy. These levels could be used to predict recovery of sexual function after surgery.
In fact, “Maybe we should be treating free testosterone even if there are no symptoms now, because there could be symptoms of erectile dysfunction later,” Maxwell Towe, BS, a clinical research fellow at University of California Irvine, told Urology Times.
Testosterone deficiency is associated with significant health problems in adult men, including obesity, diabetes, and hypertension. Low levels of total testosterone are one of the diagnostic criteria for hypogonadism. However, current clinical guidelines do not account for the impact of free testosterone levels on sexual dysfunction, even though levels of free testosterone are known to decrease as men age, while the prevalence of hypogonadism increases with age as well.
With this in mind, the authors sought to understand the relationships between free testosterone and sexual function in middle-aged-to-older men with prostate cancer.
The authors studied 820 men who underwent robot-assisted radical prostatectomy for primary treatment of localized prostate cancer. Preoperative evaluations included assessment of sexual function through International Index of Erectile Function (IIEF-5) scores and measurement of baseline sex hormone levels, including total testosterone, sex-hormone binding globulin, and free testosterone. The authors also studied the impact of age, body mass index, and pathologic grade on sexual function.
The men were then separated into two cohorts: those between the ages of 40 and 60 years (35.4% of patients) and those 60-80 years of age (64.6%).