Implications of Metabolic Syndrome and Androgen Levels on Erectile Dysfunction in a Sample of Egyptian Subjects: a Case-Controlled Prospective Study

Men with metabolic syndrome (MetS) are at a higher risk of developing erectile dysfunction (ED). To evaluate the relationship of ED with MetS and androgen levels, a case control study was designed. Group A was comprised of 60 patients suffering of erectile dysfunction. Group B was composed of 30 healthy age matched volunteers. Each group was classified into 2 subgroups according to the presence or absence of metabolic syndrome. We assessed the five-item International Index of Erectile Function questionnaire (IIEF-5) scores, blood sugars, lipid and hormonal profiles, and penile duplex ultrasonography. An increasing statistical significance severity of ED was observed among cases with MetS compared to ED cases without MetS. ED patients with MetS had a significantly lower mean IIEF-5 score of 9.30 ± 4.02 compared to ED patients with no MetS who had a mean score of 19.20 ± 0.55 ( p = 0.012). Decrease in testosterone level was associated with more decrease in IIEF-5 with a relative free testosterone decrease than total testosterone. MetS is a potential risk factor for ED in the sample of studied men. The presence of ED merits further evaluation for the presence of MetS. This study protocol was reviewed and approved by ethics committee on human research by Al Azhar faculty of medicine IRB (00012367).