The increase of ED in men with associated autoimmune disorders could hypothetically be due to common pathophysiology regarding an increase in systemic estrogens. Men diagnosed with ED often have increased serum estradiol when controlling for other factors such as serum testosterone, BMI, age, and smoking. Estrogen is known for its ability to regulate and class switch antibody expression, which is why women are typically predisposed to autoimmune disorders. Men receiving treatment for ED were also commonly associated with autoimmune disorders. A diagnosis of autoimmune disease and the required close follow-up with specialized healthcare providers could be a reason why men treated for ED were also found to have a related diagnosis of an autoimmune disorder. This subset of patients may be more likely to bring up ED symptoms to healthcare providers with a longitudinal relationship. Further prospective research is needed to identify causal relationships that may be contributing to the associations observed and treatment options that can be added or modified to improve treatments for men with ED.
- Lindsey N. Wright, BS, University of Utah School of Medicine, Salt Lake City, UT
- Jim Hotaling, MD, MS, FECSM, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
- Alexander W. Pastuszak, MD, PhD, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
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