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INTRODUCTIONSexual hormonal milieu plays a fundamental role in promoting a harmonious balance for male general health, thus including sexual health in its complexity.1,2 In this context, testosterone levels are associated with cognitive function, physical performance, and sexual activity,1,2 but men's health is also fundamentally linked with circulating estrogen levels. For instance, estradiol (E2) might impact on hypothalamic–pituitary–gonadal axis control, sexual functioning, the development and upkeep of bone structures, body composition, and vasomotor stability.3 In clinical practice, heart attacks, strokes, and prostate cancer,4–6 mostly of higher grades,7 have all been linked to greater blood estrogen levels. However, most investigations have been unable to demonstrate a meaningful connection involving E2 concentrations and men mortality.8Overall, it has been established that through its role in the development of the penis and in controlling the physiological mechanisms causing an erection in adults, androgen signaling is essential for erectile function.9,10 In addition, to control components of adult physiology that contribute to erections, such as penile hemodynamics, endogenous estrogen signaling has recently been linked to genital development.11 Previous studies have shown that men suffering from erectile dysfunction (ED) have considerably greater levels of circulating estrogens and a higher estrogen‐to‐testosterone ratio than those with normal erectile functioning, thus
Andrology – Wiley
Published: Jun 1, 2023
Keywords: erectile dysfunction; estradiol; estrogens; sex hormones
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