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The clinical association between free androgen index and erectile dysfunction in men.

AUTHORS: Hameed A, Thwaini A, Aslam Z, Shergill I, Ahmed R, Yahia G, Morgan D. Barts and the London Hospitals, UK.

SOURCE: Can J Urol. 2009 Feb;16(1):4478-83.

Background: Recently more and more practitioners noticed the benefit of replacing testosterone to men with ED who do not sufficiently respond to PDE5I and low or normal low range limits of testosterone. Does this observation is evidence established? This is a very preliminary study.

OBJECTIVES: The relation of sex hormone levels in men, as measured by Free Androgen Index (FAI), with severity of erectile dysfunction (ED) and with their response to treatment was assessed.

METHODS: This study retrospectively reviewed the medical records of 150 men who consecutively attended the urology clinic with the complaint of ED between March 2004 and October 2007. The Sexual Health Inventory for Men (SHIM) score was used as the main outcome measure in this study, and its variation was tested by certain variables using the Epi Info software.

RESULTS: The majority of patients (93%) had FAI in the normal range levels, and had shown no relation to the SHIM score even after adjustment for other factors. However, FAI was highly related to patients' response to treatment, with the higher the level the higher was the proportion of patients responded well to treatment. Age of the patient was the only factor influencing the SHIM score they could attain, as shown by the linear regression analyses.

CONCLUSION: The FAI level is not related to the severity of ED. Its role however, is confined to the way patients are going to respond to medical treatment of ED. Further studies are therefore needed to assess the effectiveness of using this parameter as a reliable test of bioactive testosterone for men with ED.