Erectile dysfunction and total testosterone level in men aged 35-45
DOI:
https://doi.org/10.2478/AMB-2025-0056Keywords:
testosterone, erectile dysfunction, menAbstract
Objective: To find the association between erectile dysfunction and testosterone level in men aged 35-45 years. Materials and Methods: We selected men aged 35 to 45 with/without erectile dysfunction, and comparеd the total testosterone level in both groups. Altogether 93 men were included for evaluation, 73 men with and 20 without erectile dysfunction. Each man filled out the International Erectile Function Index questionnaire and was measured for testosterone level and the sex hormone binding globulin three times every 45 days for 3 months. Results: We found significant differences between the studied patients and those of the control group in the questionnaire score and the total testosterone level. We did not register fluctuations in the blood flow of the arteria profunda penis bilaterally in all men. Conclusions: Our study shows that partial deficiency of total testosterone in some men aged 35 to 45 may also be a possible prerequisite for the occurrence of erectile dysfunction.
References
Huang IS, Mazur DJ, Kahn BE, et al. Risk factors for hypogonadism in young men with erectile dysfunction. J Ch Med Ass. 2019; 82: 477-481. doi: 10.1097/JCMA.0000000000000099.
Selvin E, Burnett A, Platz E. Prevalence and risk factors for erectile dysfunction in the US. Am J Med, 2007; 120(2): 151-157.
Capogrosso P, Colicchia, M, Ventimiglia E, et al. One patient out of four with newly diagnosed erectile dysfunction is a young man-worrisome picture from the everyday clinical practice. J Sex Med. 2013; 10: 1833-1841. doi: 10.1111/jsm.12179.
Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017; 6: 79-90. doi: 10.21037/tau.2016.09.06.
Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018; 200: 423-32. doi: 10.1016/j.juro.2018.03.115.
Santos HO, Howell S, Teixeira FJ. Beyond tribulus (Tribulus terrestris L.): The effects of phytotherapics on testosterone, sperm, and prostate parameters. J Ethnopharmacol. 2019; 235: 392-405. doi: 10.1016/j.jep.
Buvat J, Lemaire A. Endocrine screening in 1022 men with erectile dysfunction: clinical significance and cost-effective strategy. J Urol. 1997; 158: 1764–1767. doi: 10.1016/s0022-5347(01)64123-5.
Pivonello R, Menafra D, Riccio E, et al. Metabolic Disorders and Male Hypogonadotropic Hypogonadism. Front Endocrinol. 2019; 10: article 345. doi.org/10.3389/fendo.2019.00345.
Scovell JM, Ramasamy R, Wilken N, et al. Hypogonadal symptoms in young men are associated with a serum total testosterone threshold of 400 ng / dl. BJU Int. 2015; 116: 142-146. doi: 10.1111/bju.12970.
Zitzmann M, Faber S, Nieschlag E. Association of Specific Symptoms and Metabolic Risks with Serum Testosterone in Older Men. J Clin Endocrinol Metab 2006; 91(11): 4335–4343.
Rosen RC, Riley A, Wagner G, et al. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urol. 1997; 49: 822-830. doi: 10.1016/s0090-4295(97)00238-0
Weir CB, Jan A. BMI Classification Percentile and Cut Off Points. 2022 Last Update: June 27.
Jung DC, Park SY, Lee JY. Penile Doppler ultrasonography revisited. Ultrasonography. 2018; 37: 16–24. doi: 10.14366/usg.17022.
Lazarov G, Mladenov V. Changes in the hypothalamic-pituitary-gonadal axis in men aged 37 to 45 years with a testosterone level below the average values of the standard for a prolonged period. Case Reports and Reviews: Open Access. 2023; 4: 135.
Lazarov G. Estradiol/testosterone ratio and erectile dysfunction in men aged 35-45 E2/T ratio and ED in men aged 35-45. Folia Medica. 2025;67(4): 1-5. doi: 10.3897/folmed.67.e143525.
Bhasin S, Buckwalter G. Testosterone supplementation in older men: a rational idea whose time has not yet come. J Androl. 2001; 22: 718-731. doi.org/10.1002/j.1939-4640.2001.tb02570.x
Harman SM, Metter EJ, Tobin JD, et al. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab. 2001; 86: 724-731. doi: 10.1210/jcem.86.2.7219.
Swerdloff R, Wang C, Cunningham G, et al. Long-term pharmacokinetics of transdermal testosterone gel in hypogonadal men. J Endocrinol Metab, 2000; 85(12): 4500-4510.
Poobalan A, Aucott L. Obesity among young adults in developing countries: a systemic overview. Curr Obes Rep, 2016; 5(1): 2-13.
Aversa A, Crafa A, Greco EA, et al. The penile duplex ultrasound: How and when to perform it? Andrology. 2021; 9: 1457-1466. doi: 10.1111/andr.13029.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 G. Lazarov (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to share, copy and redistribute the material in any medium or format under these terms.