Sexual Dysfunction: A Hormonal Perspective

Sexual dysfunction isn’t just a psychological or relational concern—it can also signal underlying hormonal imbalances affecting both men and women. During the Women’s Health Conference, Dr. Seshadri Pramodh, Endocrinologist at Integra Healthcare, explored the critical role hormones play in sexual function, highlighting the need for proper diagnosis and targeted treatment.
From testosterone deficiency and diabetes-related complications to thyroid disorders and pituitary gland abnormalities, Dr. Pramodh discussed how hormonal health directly influences sexual well-being. He also shared practical strategies for diagnosis, treatment, and lifestyle modifications to help restore balance and improve overall health.

Read on for Dr. Pramodh’s key takeaways, and gain expert insights into the endocrinological factors behind sexual dysfunction.

Sexual Dysfunction: What you need to know from an endocrinological (hormonal) perspective

1. Be aware of the clinical features

Sexual Dysfunction due to a hormonal cause is generally characterized by the following clinical features

There are many causes of sexual dysfunction but one of the most important treatable cause is due to hormonal abnormalities

2. Rule out any endocrinological causes.

This is for two reasons:

a. There are effective treatment options which tend to improve quality of life. For example, many studies have shown that treating erectile dysfunction in men improves self-esteem, stabilizes low mood and improves symptoms of depression.

b. Hormonal causes for sexual dysfunction may be as a result of serious underlying medical issues including conditions like pituitary tumours and adrenocortical insufficiency. Erectile dysfunction serves as a cardiovascular risk factor for heart attacks and strokes in the future.

3. Evaluate for Diabetes

Erectile Dysfunction is perhaps the commonest clinically apparent complication in men with Diabetes. It occurs due to complications with the lining in the blood vessels, and nerves called autonomic nerves that both supply the genital organs. Studies have clearly shown a link between erectile dysfunction and significantly increased risk of heart attacks and strokes and hence presents with an opportunity to address those risk factors.
Diabetes is also associated with sexual dysfunction in women.

4. Rule out hypogonadism. If diagnosed, attempt to localize it and seek endocrinologist help

Testosterone deficiency (male hypogonadism). typically presents with loss of libido, erectile dysfunction and/or absence of spontaneous erections. There may be other symptoms like fatigue, loss of muscle mass, etc. and associated features like low bone mass, anemia etc. Measuring testosterone levels should be done early morning, in fasting state. Low testosterone levels may be temporary during acute illness, diabetes, being overweight, as a result of certain medications etc. warranting repeated measurements of testosterone and addressing the cause.

Severely low testosterone, that tends to be permanent, may be due to disorders of the Testes or the pituitary gland which secretes the stimulating hormones (LH and FSH) to stimulate the Testes to produce testosterone. Check FSH and LH to localize the site of the problem. Treatment involves replacing testosterone usually with injections or gel applied to the skin, aiming for levels at mid-range and also appropriate treatment of any underlying causes.

Monitor patients on testosterone replacement therapy regularly for erythrocytosis, and ensure prostate health monitoring, as per current guidelines.

Hypogonadism in woman (persistent low estrogen levels) usually presents with scanty or absent periods for 3 months or more, reduced libido, flushing, headaches, dryness of vagina etc. Menopause is the commonest physiological cause. Untreated hypogonadism in pre-menopausal women significantly increases the risk of osteoporosis and fractures. Hypogonadism can be due to reversible reasons like being underweight, and also due to conditions that affect the ovaries like premature ovarian failure or conditions that affect the pituitary gland. Treatment is directed towards treatment of the cause and with hormone replacement therapy after weighing the risks and benefits.

5. Check prolactin hormone if pituitary cause of hypogonadism suspected

High prolactin hormone levels are a common reason for hypogonadism in both men and women, where a pituitary cause is suspected.

6. Think of other endocrine conditions
Thyroid hormonal disturbance, Addison’s disease etc are also other less likely causes for sexual dysfunction in men and women.

Curious to explore sexual dysfunction from a gynaecological standpoint? Enhance your understanding with Dr. Lisa Hinzmann’s key takeaways on female sexual health. Gain further insights into diagnosis and treatment by checking out her detailed recap.

About Dr. Seshadri Pramodh
Dr. Seshadri Pramodh is a highly experienced Consultant Endocrinologist with over 24 years of expertise in Diabetes and Endocrinology. After completing his post-graduate training in the UK, including specialized training at King’s College Hospital and Portsmouth teaching hospitals, he obtained his Certificate of Completion of Training (CCT) in Endocrinology and Internal Medicine in 2007.

Dr. Pramodh spent 17 years as a Consultant at Yeovil District General Hospital, where he led key services in Diabetes management, Diabetes in pregnancy, and Endocrinology. He has a particular interest in intensive Type 1 Diabetes management, Diabetes in pregnancy, and hormonal causes of sexual dysfunction in both men and women. His holistic approach focuses on lifestyle modifications alongside cutting-edge medical treatments to improve patient outcomes.

If you are experiencing hormonal imbalances, Diabetes-related complications, or sexual dysfunction concerns, Dr. Pramodh provides expert, personalized care to help you achieve optimal health.

Book an appointment today by calling 345-745-7450 or visiting www.integra.ky

.