Abstract：
BACKGROUND: Androgens play important roles in regulating the growth and development of the male reproductive system and maintaining libido and erectile function. The specific mechanisms by which androgen deficiency leads to erectile dysfunction (ED) are not yet fully understood.
OBJECTIVE: To understand the mechanisms and treatment of androgen deficiency-related ED.
METHODS: A literature search in the past 10 years was conducted in PubMed and Google Scholar to determine the effects of androgen deficiency on erectile function and the treatment of androgen deficiency.
RESULTS: Androgen deficiency can be caused by hypothalamic-pituitary lesions and injuries, testicular-related diseases and injuries, endocrine and metabolic disorders, the side effects of medication, and age. Androgen deficiency can lead to ED by inhibiting the NOS/NO/cGMP pathway (nitric oxide synthase/nitric oxide/cyclic guanosine monophosphate) and altering the expression of ion channel proteins, as well as by inducing oxidative stress, death, and fibrosis in penile corpus cavernosum cells. Testosterone replacement therapy is effective at improving the serum testosterone levels and erectile function in patients with androgen deficiency. For patients who need to maintain a low androgenic state, erectile function can be improved by lifestyle changes, treatment with phosphodiesterase type 5 inhibitors, low-intensity extracorporeal shock wave therapy, and stem cell therapy.
CONCLUSIONS: Androgen deficiency can affect the structure and function of the penile corpus cavernosum, leading to ED. Areas of further study include how androgen replacement therapy can improve erectile function and how to improve the maintenance of erectile function in patients with hypoandrogenic status.
OBJECTIVE: To understand the mechanisms and treatment of androgen deficiency-related ED.
METHODS: A literature search in the past 10 years was conducted in PubMed and Google Scholar to determine the effects of androgen deficiency on erectile function and the treatment of androgen deficiency.
RESULTS: Androgen deficiency can be caused by hypothalamic-pituitary lesions and injuries, testicular-related diseases and injuries, endocrine and metabolic disorders, the side effects of medication, and age. Androgen deficiency can lead to ED by inhibiting the NOS/NO/cGMP pathway (nitric oxide synthase/nitric oxide/cyclic guanosine monophosphate) and altering the expression of ion channel proteins, as well as by inducing oxidative stress, death, and fibrosis in penile corpus cavernosum cells. Testosterone replacement therapy is effective at improving the serum testosterone levels and erectile function in patients with androgen deficiency. For patients who need to maintain a low androgenic state, erectile function can be improved by lifestyle changes, treatment with phosphodiesterase type 5 inhibitors, low-intensity extracorporeal shock wave therapy, and stem cell therapy.
CONCLUSIONS: Androgen deficiency can affect the structure and function of the penile corpus cavernosum, leading to ED. Areas of further study include how androgen replacement therapy can improve erectile function and how to improve the maintenance of erectile function in patients with hypoandrogenic status.
摘要：
背景：雄激素在调节男性生殖系统的生长发育以及维持性欲和勃起功能方面起着重要作用。雄激素缺乏导致勃起功能障碍（ED）的具体机制尚未完全了解。
目的：了解雄激素缺乏相关ED的发病机制和治疗方法。
方法：在PubMed和GoogleScholar进行了过去10年的文献检索，以确定雄激素缺乏对勃起功能的影响以及雄激素缺乏的治疗。
结果：雄激素缺乏可由下丘脑-垂体损伤引起，睾丸相关疾病和损伤，内分泌和代谢紊乱，药物的副作用，和年龄。雄激素缺乏可通过抑制NOS/NO/cGMP途径（一氧化氮合酶/一氧化氮/环磷酸鸟苷）并改变离子通道蛋白的表达而导致ED，以及通过诱导氧化应激，死亡,阴茎海绵体细胞纤维化。睾酮替代疗法可有效改善雄激素缺乏患者的血清睾酮水平和勃起功能。对于需要维持低雄激素状态的患者，改变生活方式可以改善勃起功能，用5型磷酸二酯酶抑制剂治疗，低强度体外冲击波疗法，和干细胞疗法。
结论：雄激素缺乏可影响阴茎海绵体的结构和功能，导致ED。进一步的研究领域包括雄激素替代疗法如何改善勃起功能以及如何改善低雄激素状态患者的勃起功能。
目的：了解雄激素缺乏相关ED的发病机制和治疗方法。
方法：在PubMed和GoogleScholar进行了过去10年的文献检索，以确定雄激素缺乏对勃起功能的影响以及雄激素缺乏的治疗。
结果：雄激素缺乏可由下丘脑-垂体损伤引起，睾丸相关疾病和损伤，内分泌和代谢紊乱，药物的副作用，和年龄。雄激素缺乏可通过抑制NOS/NO/cGMP途径（一氧化氮合酶/一氧化氮/环磷酸鸟苷）并改变离子通道蛋白的表达而导致ED，以及通过诱导氧化应激，死亡,阴茎海绵体细胞纤维化。睾酮替代疗法可有效改善雄激素缺乏患者的血清睾酮水平和勃起功能。对于需要维持低雄激素状态的患者，改变生活方式可以改善勃起功能，用5型磷酸二酯酶抑制剂治疗，低强度体外冲击波疗法，和干细胞疗法。
结论：雄激素缺乏可影响阴茎海绵体的结构和功能，导致ED。进一步的研究领域包括雄激素替代疗法如何改善勃起功能以及如何改善低雄激素状态患者的勃起功能。
