雄激素缺乏与勃起功能障碍

Androgen Deficiency and Erectile Dysfunction

雄激素可通过增强性欲、性唤起等间接促进阴茎勃起,在维持阴茎正常的勃起组织结构方面起重要作用。睾酮缺乏可导致小梁平滑肌减少、细胞外基质增多、白膜下脂肪细胞沉积等。勃起时,阴茎组织的上述改变可引起静脉闭塞不全而发生静脉漏,从而出现勃起功能障碍;睾酮还可影响一氧化氮合酶(NOS)、RhoA/Rho激酶的表达及活性从而直接影响阴茎勃起。对单用磷酸二酯酶5(PDE5)抑制剂无反应的性腺功能减退的ED患者补充睾酮可收到良好的治疗效果。

Androgen not only indirectly affects penile erection by enhancing sexual desire and arousal, but also play an important role in maintaining the normal structure of the erectile tissue. Testosterone deficiency may result in a reduction of trabecular smooth muscle content concomitant with increased accumulation of extracellular matrix and deposition of adipocytes in the subtunical region. All this can lead to corporal veno-occlusive dysfunction. In addition, testosterone can affect the expression and activity of nitric oxide synthases （NOS） and RhoA/Rho kinase and influence penile erection directly. Androgen administration may restore erectile function for hypogonadal patients with erectile dysfunction who fail to respond to PDE5 inhibitors alone.