Hormonal Therapy for Male Sexual Dysfunction

Hormonal therapy offers a potentially powerful approach to the treatment of sexual disorders in men. However the interplay of different hormones within different bodily systems is carefully balanced; judicious judgement is required in the therapeutic use of hormones to minimize unwelcome side effects.

A better understanding of how hormones work will help the physician to better tailor therapies for improved sexual responses in men.   Hormonal Therapy for Male Sexual Dysfunction will provide the rationale for hormonal therapy in male sexual disorders, explaining the language of sexual endocrinology and its application in clinical practice.

The aim of this book is to provide a clinical ‘in the office’ or ‘at the bedside’ guide to effective patient care for sexual medicine physicians, urologists, gynecologists and other health-care providers in practice and in training. The tone will be practical, not academic. The working assumption is that readers want to know what (and what not) might or should be done, without over emphasis on the why. That said, it is important to review the crucial basic science necessary for effective diagnosis and management, and to provide reminders in  the context of the practical chapters.

It will not be heavily referenced, in line with a more practical approach. This allows for smoother reading (and also relieves the burden of comprehensive citing from authors). Key evidence (clinical trials, Cochrane or other meta analyses) should be summarized in ‘Evidence at a Glance’ boxes and key references such as reviews, major papers can be provided in the ‘selected bibliography’ at the end of each chapter.

  Practical guidance will be provided through:

- the use of algorithms and guidelines where they are appropriate

- ‘Tips and Tricks’ boxes – hints on improving outcomes perhaps via practical technique, patient questioning etc

- ‘Caution’ warning boxes – hints on avoiding problems, perhaps via contraindications

- ‘Science Revisited’ – quick reminder of the basic science principles necessary for understanding

Preface vii

List of Contributors ix

CHAPTER 1 Male Gender Identity and Masculine Behavior: the Role of Sex Hormones in Brain Development 1
Baudewijntje P.C. Kreukels and Peggy T. Cohen-Kettenis

CHAPTER 2 Pheromonal Regulation of Male Sexuality 11
Andrea Mazzatenta, Diego Mazzatenta, and Alessandro Cellerino

CHAPTER 3 Hormonal Regulation of Erectile Function, from Basic to Bedside (Androgen, Estrogen, Prolactin, GH, Thyroid Hormones) 28
Annamaria Morelli, Linda Vignozzi, and Mario Maggi

CHAPTER 4 Testosterone and Other Hormonal Therapies (Antiestrogen, DHEA, Thyroid Hormones) for Erectile Dysfunction 42
Gianni Forti, Giovanni Corona, Linda Vignozzi, and Mario Maggi

CHAPTER 5 Risk and Benefi t of Androgen Deprivation Therapy in Prostate Cancer 55
Giovanni Corona, Mauro Gacci, Elisabetta Baldi, Gianni Forti, and Mario Maggi

CHAPTER 6 Hormonal Regulation of Male Sexual Desire: the Role of Testosterone, Estrogen, Prolactin, Oxytocin, Vasopressin, and Others 72
Antonio R. Granata, Valeria Pugni, Vincenzo Rochira, Lucia Zirilli, and Cesare Carani

CHAPTER 7 Endocrinology of the Ejaculatory Process (Thyroid Hormones, Prolactin, Oxytocin, Testosterone) 83
Emmanuele A. Jannini and Andrea Lenzi

CHAPTER 8 Paraphilic Disorders: Diagnosis and Treatment 94
Alessandra D. Fisher, Elisa Bandini, Helen Casale, and Mario Maggi

CHAPTER 9 Sexual Aspects of Klinefelter’s Syndrome and other Sex-Chromosome Disorders 111
Linda Vignozzi, Annamaria Morelli, and Mario Maggi

CHAPTER 10 Sexual Counterpart of Hormonal Male Contraception 118
Maria Cristina Meriggiola, Antonietta Constantino, and Silvia Cerpolini

Index 128