Pituitary-gonadal function during sleep in men with erectile impotence and normal controls.

Studies of pituitary-gonadal function in men with erectile disorders have provided conflicting findings. This study compares blood LH and testosterone during sleep in 17 physically healthy men with erectile impotence and 12 matched normal controls, and relates hormonal variations to stages of sleep and penile tumescence. Subjects, aged 23-36 were studied in a sleep laboratory for 3-6 nights with the last two nights devoted to sequential blood sampling every 20 minutes. Five men had never been able to achieve intercourse (primary impotent group) and 12 suffered from a life-long history of intermittent erectile failures (secondary-impotent group). There were no significant differences in sleep duration and REM time among the impotent groups and normal controls. Primary-impotent men showed half as many full tumescent episodes as secondary-impotent men and controls, and spent significantly less time above 80% of full tumescence. The secondary-impotent group did not differ in nocturnal penile tumescent measures from controls. There was a pattern of irregularly occurring fluctuations in plasma LH and testosterone with no differences among groups in frequency and amount of peak hormonal increases. Normal subjects had significantly higher mean testosterone concentrations during REM sleep than during other sleep stages, and during full tumescence than during partial and nontumescent periods. A direct causal relation between REM-related activity and circulating testosterone was not supported by the observation that the hormonal levels during REM sleep and during full tumescence did not differ statistically from the levels measured during adjacent time periods. As with normal subjects, the secondary-impotent group exhibited higher testosterone levels during REM sleep and full tumescence; by contrast, the primary-impotent group did not show significant hormonal differences across stages of sleep and tumescent/ nontumescent periods. These data are discussed with respect to the possible existence of subgroups of impotent men without known organic pathology than may be characterized by psychophysiologic and endocrine differences during sleep.

Hormonal variations during sleep in men with erectile dysfunction and normal controls.

Five physically healthy young males suffering from erectile impotence and five normal controls of similar age are the subjects of this preliminary report. All were studied in the sleep laboratory during 3 to 5 nights with the last two devoted to sequential hormonal sampling by means of an indwelling venous catheter. Electroencephalogram, eye movements, and penile tumescence were monitored continually through the night. Plasma LH, FSH, and testosterone were measured every 20 minutes by radioimmunoassay. There were no differences between the patients with erectile impotence and normal controls in all sleep parameters investigated, including mean tumescent time, time in simultaneous REM and tumescence, and number of full and partial tumescent episodes. Marked fluctuations in plasma LH, FSH, and testosterone were observed during sleep without differences noted between the two groups. Mean plasma LH, but not FSH or testosterone, was significantly lower in the impotent men. There were no significant differences in mean plasma gonadotrophins and testosterone between tumescent episodes and nontumescent periods in either group. A significant relation was found in normals, but not in the men with erectile dysfunction, between the occurrence of REM sleep and abrupt elevations in testosterone. Testosterone levels during REM sleep with tumescence were also consistently higher than during the condition of non-REM without tumescence in the normal, but not in the impotent, group.

Pituitary-gonadal function in XYY and XXY men identified in a population survey.

Evidence on pituitary-gonadal function in XYY subjects has been inconclusive and based, for the most part, on selected samples such as institutionalized individuals or subjects examined for particular behavioural or medical characteristics. We report the results of a double-blind hormonal study of a sample from an entire well-defined birth cohort of men. The starting population included all males born in Copenhagen during the period 1944-1947 comprising 31,436 individuals. Chromosome determinations conducted on 4139 men representing the top 15.9% of the height distribution of the sample identified 12 XYY and 16 XXY men. All the XYY subjects and 14 XXYs consented to participate in an individual case study and were individually matched to XY controls selected from the total sample. The XYY men had significantly higher plasma concentrations of LH, FSH and testosterone than matched XY controls. There were no differences in testicular size and in the reported number of children between the XYYs and control group. XXY men from the same population showed significantly higher LH and FSH, lower concentrations of testosterone, had smaller testes and reported fewer children than their matched controls.

Luteinizing hormone and testosterone during nocturnal sleep: relation to penile tumescent cycles.

Variations of plasma LH and testosterone in relation to sleep-related penile tumescence were assessed. Plasma LH and testosterone were measured at 10-20 min intervals in five normal adult men during 2 nights of sleep. Blood samples were obtained by means of an indwelling venous catheter while sleep was monitored polygraphically and penile tumescence recorded with a penile mercury strain gauge. Tumescent episodes were recorded in all subjects during 9 of the 10 nights of the study, and the percentage of time during sleep, which was associated with tumescence, ranged from 13% to 34%. Simultaneous REM and tumescence comprised 57.7% of total tumescent time. Abrupt elevations of plasma LH and testosterone were observed during the night without a significant relationship to stages of sleep. The mean of all hormonal determinations for the five subjects did not show significant differences in plasma LH and testosterone between fully and partially tumescent episodes and nontumescent periods. Mean testosterone during REM sleep with tumescence, a state of autonomic activation involving sexual function, was consistently higher for the five subjects than during periods free from REM and tumescence.