Kazunori Kimura

By Tomoya Kataoka and Kazunori Kimura

Androgens are essential for male physical activity and normal erectile function. Hence, age-related testosterone deficiency, known as late-onset hypogonadism (LOH), is considered a risk factor for erectile dysfunction (ED). This chapter summarizes relevant basic research reports examining the effects of testosterone on erectile function. Testosterone affects several organs and is especially active on the erectile tissue. The mechanism of testosterone deficiency effects on erectile function and the results of testosterone replacement therapy (TRT) have been well studied. Testosterone affects nitric oxide (NO) production and phosphodiesterase type 5 (PDE-5) expression in the corpus cavernosum through molecular pathways, preserves smooth muscle contractility by regulating both contraction and relaxation, and maintains the structure of the corpus cavernosum. Interestingly, testosterone deficiency has relationship to neurological diseases, which leads to ED. Testosterone replacement therapy is widely used to treat patients with testosterone deficiency; however, this treatment might also induce some problems. Basic research suggests that PDE-5 inhibitors, L-citrulline, and/or resveratrol therapy might be effective therapeutic options for testosterone deficiency-induced ED. Future research should confirm these findings through more specific experiments using molecular tools and may shed more light on endocrine-related ED and its possible treatments.

Part of the book: Sex Hormones in Neurodegenerative Processes and Diseases

By Tomoya Kataoka and Kazunori Kimura

Androgens are essential for male physical activity and normal erectile function. Moreover, estrogens also influence erectile function, and high estrogen levels are a risk factor for erectile dysfunction (ED). In this review, we summarize relevant research examining the effects of the sex hormone milieu on erectile function. Testosterone affects several organs, particularly erectile tissue. The mechanisms through which testosterone deficiency affects erectile function and the results of testosterone replacement therapy have been extensively studied. Estrogen, the female sexual hormone, also affects erectile function, as demonstrated in both clinical and basic studies. Interestingly, estradiol-testosterone imbalance is considered a risk factor for ED. Furthermore, endocrine-disrupting chemicals have estrogen-like effects and cause ED. Phosphodiesterase-5 (PDE-5) inhibitors, first-line drugs for the treatment of ED, increase the levels of testosterone and estradiol in patients with low testosterone levels. Therefore, estrogen levels should be carefully monitored in patients receiving PDE-5 inhibitors. Future studies are needed to confirm these findings using molecular tools in order to provide insights into the treatment and mechanisms of endocrine-related ED.

Part of the book: Estrogen