SEATTLE — How do hormones affect sexual function recovery after autologous hematopoietic stem cell transplantation (AHSCT), which is the standard of care for younger patients with newly diagnosed multiple myeloma.
Researchers from the University of Washington and the VA Puget Sound Healthcare System, both in Seattle, point out that AHSCT is associated with sexual dysfunction and hypogonadism. “Androgens are associated with sexual function in healthy men, but the role of estrogens is less well-known, and the association of these sex steroids with sexual function during AHSCT has not been characterized,” they add.
Their study published in the journal Andrology sought to determine the predictive value of sex hormones in men “before and acutely after AHSCT on sexual function recovery.”1
The study team examined sex hormones and self-reported sexual function before (PRE) and one-month post-AHSCT in 19 participants, and sexual function again one-year post-AHSCT in 15 of them.
- Results indicated that sexual function decreased from PRE to MONTH1 (p ≤ 0.05) with no differences between PRE and YEAR1. Specifically, the study found that:
- Erectile dysfunction was prevalent at PRE (68.4%) and increased at MONTH1 (100%; p ≤ 0.05) but was not different between PRE and YEAR1 (60.0%).
- From PRE to MONTH1, total testosterone (TT), dihydrotestosterone (DHT), follicle-stimulating hormone, and sex-hormone-binding globulin (SHBG) increased (p ≤ 0.02) while estradiol (p ≤ 0.026) and estrone decreased (p ≤ 0.001).
- MONTH1 TT and DHT were associated with sexual function at MONTH1, while PRE SHBG, MONTH1 estradiol, and change in estrone predicted sexual function at YEAR1.
“Sexual dysfunction is very prevalent prior to AHSCT and is transiently and severely worsened acutely after,” the authors concluded. “AHSCT induces acute decreases in total and free estrogens, with SHBG increases leading to increases in total androgens, without changes in free androgens.”
The study noted that both androgens and estrogens are adversely affected by AHSCT and can be used to predict sexual dysfunction in AHSCT participants.
“This supports the premise that estrogen impacts sexual function independent from androgens and that steroid hormones are associated with acute changes in sexual function in this setting,” the researchers wrote. “Larger, controlled trials with long-term sex hormone assessment will need to confirm the association between early changes in estrogens and long-term sexual function recovery.”
- Anderson LJ, Migula D, Abay R, Crabtree S, et. al. Androgens and estrogens predict sexual function after autologous hematopoietic stem cell transplant in men. Andrology. 2022 Feb;10(2):291-302. doi: 10.1111/andr.13117. Epub 2021 Nov 25. PMID: 34624176; PMCID: PMC8760151.
