Impotence is not always psychogenic. Newer insights into hypothalamic-pituitary-gonadal dysfunction
R. F. Spark, R. A. White and P. B. Connolly
The concept that impotence is psychogenic in 95% of cases is reconsidered.
Screening serum testosterone levels of 105 consecutive patients with
impotence showed that 37 patients had previously unsuspected disorders of
the hypothalamic-pituitary-gonadal axis. Twenty patients had
hypogonadotropic-hypogonadism, seven had hypergonadotropic-hypogonadism,
eight had hyperprolactinemia, and two had occult hyperthyroidism. Once the
specific defect was defined, appropriate therapy was instituted, and
potency was restored in 33 patients. Screening serum testosterone levels is
useful in identifying hypothalamic-pituitary-gonadal dysfunction in
patients with impotence.
