Total testosterone level may have no influence on the occurrence and severity of erectile dysfunction in males aged between 30 and 60 years living with type 2 diabetes

Background: Erectile dysfunction is the most common sexual disorder in type 2 diabetes. Its pathogenesis may involve various disturbances including endothelial dysfunction and dysautonomia. The involvement of a low testosterone level is still debated. The aim of this study was to evaluate the contribution of total testosterone during erectile dysfunction in patients living with type 2 diabetes. Method: A cross-sectional study was conducted in a population of male with type 2 diabetes, aged 30-60 years, and enrolled at the National Obesity Centre of the Yaounde Central Hospital. Non-diabetic conditions that could affect testosterone level were excluded. Erectile dysfunction was assessed using the IIEF-5 questionnaire. Total testosterone was measured by ELISA. The relationship between erectile dysfunction and total testosterone has been explored through correlation using Pearson's coefficient. The significance threshold was set at 0.05. Results: A total of 83 participants were included, with an average age of 47.9 +/- 7.8 years. The median duration of diabetes was 24 (5; 72) months. The frequency of ED was 65.1%, severe for 50% of cases and significantly associated with the duration of diabetes (OR = 7.5 [2.4; 22.8]). The mean testosterone level was 14.3 +/- 5.1 nmol/l. A low level of testosterone was found in 8.4% (7/83) of participants, and sedentary lifestyle was significantly associated with low testosterone level (OR = 4.1 [1; 15.4]). There was no difference between the mean total testosterone level of patients with ED (14.1 +/- 4.7 nmol/l) and those without (14.3 +/- 5.9 nmol/l) (p=0.8). No association was found between total testosterone level and IIEF-5 score (r=-0.05; p = 0.5). Conclusion: Erectile dysfunction occurs in two out of three people living with type 2 diabetes and is severe for half of the cases. Total testosterone level does not seem to have an influence on the onset or severity of ED in male under 60 years with type 2 diabetes, but it is associated with a sedentary lifestyle.