Endocrine factors play an important role in the regulation of penis erection, so many endocrine diseases are associated with a high incidence of impotence in clinical practice. In addition to diseases that directly affect androgen levels such as hypogonadism, the following diseases are often accompanied by impotence.
thyroid disease
Both hyperthyroidism and hypothyroidism can adversely affect erectile function. "For hyperthyroidism, the levels of estrogen and androgen binding globulin in the blood increase, resulting in a widespread impact on sexual function under the dual effects of reduced free testosterone and elevated estrogen.". It has been reported that the incidence of low libido in patients with hyperthyroidism is 71%, and the incidence of impotence is 56%. Some patients can even experience feminization of breasts.
In patients with hypothyroidism, androgen binding globulin in the blood decreases or is normal, but the concentration of total testosterone decreases, and testosterone metabolism is also abnormal, no longer converting to androstenone, which affects the patient's erectile function.
Hyperprolactinemia
Because this disease is not as common as diabetes, hyperthyroidism and other diseases, when such patients seek medical advice with impotence, doctors or patients may think that impotence is caused by age or psychological factors, so it is difficult to make a correct etiological judgment.
It is generally believed that the occurrence of impotence caused by hyperprolactinemia is caused by a decrease in testosterone levels due to the impact on the hypothalamus-pituitary-testis axis. However, after testosterone replacement therapy, it seems that its erectile function cannot be satisfactorily improved. After bromocriptine is administered to reduce the level of prolactin, its erectile function can be quickly corrected. Therefore, in addition to affecting the hypothalamus-pituitary-testis axis, there may also be some central mechanism for this disease.