Impotence and Diabetes: Studies of Androgenic Function in Diabetic Impotent Males

Abstract

Androgenic function was studied in seven diabetics with sexual impotence and in five patients with paraplegia. Plasma concentration of testosterone was measured before and after administration of 5,000 U. of human chorionic gonadotropin (HCG). Steroid biosynthesis by testicular tissue was studied in vitro and testicular morphology was evaluated by light and electron microscopy. The diabetic patients were also evaluated neurologically. Motor conduction velocity, electromyography of the quadriceps and the function of urinary bladder were studied. Plasma concentration of testosterone was in the normal range in basal conditions in impotent diabetics (mean 578 ± 234 mμg./100 ml.) and paraplegics (mean 788 ± 184 mμg./ 100 ml.). After stimulation with HCG, impotent diabetics showed a mean value of 1,523 ± 314 mμg./100 ml. In vitro steroid biosynthesis by testicular homogenates of diabetics and paraplegics was normal. The morphology of the interstitial tissue was normal in patients with diabetes or paraplegia. Subcellular characteristics of Leydig cells were also normal. In the tubules, a marked hypospermatogenesis with desquamation of the germinal epithelium was observed in the two groups in all patients. Alterations of the motility of the bladder were seen in six diabetics and all paraplegics. Motor conduction velocity was abnormal in the diabetics. It is concluded that in our patients androgenic function was normal, and therefare impotence can not be attributed to hormonal deficieney.