The Prevalence of Late-Onset Hypogonadism in Middle and Old Aged Men and Its Impact on Erectile Function

Abstract

Background: Late-onset hypogonadism (LOH) has a significant impact on the quality of life of aging men. It is linked to lower testosterone levels and various associated symptoms. Erectile dysfunction is a common manifestation of LOH, impacting men's sexual health and overall well-being. Estimating the LOH prevalence and its effects on sexual function is critical to inform clinical practice and develop effective treatment. This study aimed to determine the prevalence of LOH and its impact on erectile function among Egyptian men aged 40 or older

Methodology: A total of 400 men aged 40 or older were recruited between July 2023 and March 2024. Participants completed the Male Andropause Symptoms Self-Assessment Questionnaire (MASSQ) to assess LOH symptoms and the International Index of Erectile Function (IIEF) to evaluate erectile function. Levels of serum total testosterone (TT) and free testosterone (FT) were determined and results were correlated with different scores and demographics.

Results: The average age of the participants was 56.5, with 48.2% being younger than 58 years old. 28.5% of the participants had TT levels below the normal threshold, indicating late-onset hypogonadism (LOH). The MASSQ scores for subjects with normal TT levels were analyzed and results show that the majority of subjects with normal TT levels might benefit from testosterone replacement therapy (TRT), with 77.97% possibly benefiting and 6.3% needing TRT based on their MASSQ scores. Correlation analyses revealed a relatively strong positive relationship between free and total testosterone with IIEF scores, while a moderate negative correlation was found between MASSQ and TT levels.

Conclusion: This study sheds light on the prevalence of LOH among middle and old-aged Egyptian men.  MASSQ and IIEF scores work better than testosterone levels (free or total) for diagnosis of LOH. The clinical LOH have substantial implications for sexual health and quality of life, reflecting the importance of early diagnosis and treatment.