Hormones and sexual impotence

Abstract

A review of recent studies on the roles of testosterone and prolactin, the two hormones most specifically involved in human male sexuality, reveals that much research work remains to be done in this field. Whilst it is clear, for instance, that androgens variously affect the human male in all life phases, their effects are not completely understood particularly where sexual problems are concerned. In the adult it is now clear that androgen plasma levels are not a reliable guide to sexual orientation. A complicating factor appears to be a disturbed gluco-lipidic function, even one not implying severe diabetes; it now seems likely that impotence in such cases stems not from a lack of androgens but rather from a peripheral arteriolar or neurological problem. The effect of prolactin on the brain and its action via 5α-reductase and/or through an influence on the dopamine hypothalamic turnover needs to be further investigated. It is hypothesized that a confirmation of an action of prolactin on androgen metabolism in the brain would suggest that some psychosexual disturbances may be caused by an excess of cerebral oestrogens; this, in turn, leads to the speculation that treatment with an oestrogen antagonist could be of therapeutic value. Much research is needed, however, before this stage is reached.