BERKELEY, CA (UroToday.com) - Studies over the past few decades have demonstrated that sex hormones are closely related to health risks, but that they also promote health. Our study investigated possible correlations of sex hormone levels and sexual intercourse in patients with penile prosthesis (PP). We tested whether PP usage after a long period of time having no penile-vaginal intercourse and sexual activity in erectile dysfunction (ED) patients impacts on sex hormone levels. We showed that PP usage caused a significant increase in dehydroepiandrosterone sulfate (DHEAS) levels after PP usage. We also demonstrated that mean total and free testosterone, estradiol, and luteinizing hormone (LH) levels were clinically increased after PP usage. The results, however, were statistically insignificant. Our results carry important clinical implications. In particular, the findings suggest that PP implantation presents not only a change in sex life of a man but also a change in hormone levels in a positive direction. These increases become especially more important when we take longitudinal studies into account because longitudinal studies in male aging research have demonstrated that serum testosterone levels decline with age.[1]
The significance of hormone alterations related to sexual activity is not known and has not been studied directly. However, it is obvious that an acute increase of testosterone should present some benefits to the body during sexual intercourse, or after it. In this study, we demonstrated a significant increase in DHEAS levels after PP usage. Actually, dehydroepiandrosterone (DHEA) has very low androgenic potency, but serves as the major direct or indirect precursor for most sex steroids. DHEA is secreted by the adrenal gland and production is at least partly controlled by adrenocorticotropic hormone. The bulk of DHEA is secreted as a 3-sulfoconjugate i.e., DHEAS. In gonads and several other tissues, most notably skin, steroid sulfatases can convert DHEAS back to DHEA, which can then be metabolized to stronger androgens and to estrogens. The significant increase in DHEAS levels after PP usage may be due to its utilization as a precursor of T, in addition to testicular production.
In our study, the testosterone increase was being driven from higher levels. As has been demonstrated in the previous studies,[2, 3, 4] the current study showed that sexual activity influences serum testosterone levels by increasing LH secretion in males. In a recent review article, researchers looked for potential health benefits of various sexual activities and focused on the effects of different sexual activities.[5] Among different sexual activities, penile-vaginal intercourse was shown to be associated with better psychological and physiological health indices.[5] From a practical standpoint, our findings imply that penile-vaginal intercourse, augmented by PP, improved our patients’ testosterone levels, which is crucial for general health.
Despite its practical value, our study has limitations. Firstly, there is a lack of prospective study design. Secondly, the difference in the time interval between surgery and blood taken for controlling testosterone levels was not the same. Thirdly, sample size was relatively small. This was mainly due to reluctance of our PP patients to participate in this study, one that was done years after the surgery. Since they did not have any problem and were satisfied with their PP, they did not want to participate and give blood samples. According to literature, androgen levels have circadian rhythms and exhibit daily and seasonal fluctuations, in addition to age-related decline.[6] Unfortunately, we did not classify our study patients’ testosterone levels according to the season when blood samples given. However, all blood samples after PP usage were taken in the same month from all participants.
In conclusion, the present study suggests that penile-vaginal intercourse by PP usage appears to result in an increase in sex hormone levels relative to baseline levels that existed prior to PP implantation.
References:
- Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. J Clin Endocrinol Metab 2001; 86: 724-31.
- Jannini EA, Screponi E, Carosa E, Pepe M, Lo Giudice F, Trimarchi F, et al. Lack of sexual activity from erectile dysfunction is associated with a reversible reduction in serum testosterone. Int J Androl 1999; 22: 385-92.
- Carosa E, Benvenga S, Trimarchi F, Lenzi A, Pepe M, Simonelli C, et al. Sexual inactivity results in reversible reduction of LH bioavailability. Int J Impot Res 2002; 14: 93-9; discussion 100.
- Stoleru SG, Ennaji A, Cournot A, Spira A. LH pulsatile secretion and testosterone blood levels are influenced by sexual arousal in human males. Psychoneuroendocrinology 1993; 18: 205-18.
- Brody S. The Relative Health Benefits of Different Sexual Activities. J Sex Med 2010; 7: 1336-61.
- Anders S, Watson N. Social neuroendocrinology: Effects of social contexts and behaviors on sex steroids in humans. Human Nature 2006; 17: 212-37.
Written by:
Onder Canguven, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Hamad General Hospital, Urology Department, Doha, Qatar
The impact of sexual activity on serum hormone levels after penile prosthesis implantation - Abstract