Erectile dysfunction is common among men with acromegaly and is associated with morbidities related to the disease.

Introduction: The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. This study was aimed at evaluating sexual function in men with acromegaly.Methods: Multicenter-based, retrospective analysis of a non-selected series of 57 acromegalic subjects (52.7±14.2 years). Acromegalic subjects reporting ED (n=24) were compared with matched ED-patients without acromegaly or pituitary disease (controls), selected from a cohort of more than 4000 subjects enrolled in the Florence Unit. Patients were interviewed using SIEDY structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile colour-Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. Results: ED was reported by 42.1% of acromegalic subjects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension, and more often reported an impairment of sleep-related erections and a longer smoking habit.Acromegaly-associated ED was characterized by a higher organic component (Scale 1) and worse PCDU. No relationship between ED and testosterone levels or other acromegaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer disease duration.In a case-control analysis, comparing acromegalic men with ED-matched-controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acromegalic patients with ED had a higher prevalence of major adverse cardiovascular events (MACE) history at enrolment and lower PCDU parameters. Conclusions:Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest including a sexual function evaluation in routine acromegaly follow-up.