Background: Some evidence has shown that the prevalence of hypoactive sexual desire and erectile dysfunction (ED) is associated with testosterone levels whilst higher levels of testosterone have been reported to increase the frequency of intercourse. Available evidence points towards an etiologic role for hypogonadism in the causation of diabetes, metabolic syndrome (Mets) and sexual dysfunction (SD) even though the exact pathophysiological linkage is yet to be fully elucidated. This study therefore sought to evaluate the impact of testosterone as well as its bioactive components on both the MetS and SD. Method: Diabetic men engaged in a stable heterosexual relationship for at least 2 years were recruited for this study. Participants were at least 18 years and provided an informed and signed consent to partake in this study. Fasting blood samples were taken from the participants for biochemical and hormonal assay. The participants were then evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). Metabolic syndrome was assessed using the NCEP-ATP III, IDF and WHO criteria. All data analyses were performed using the SPSS software, version 11.0 systat, Inc. Germany and GraphPad Prism, version 5.0, San Diego California, USA. Results: The mean total, free and bioavailable testosterone as well as SHBG recorded among the participants was 7.10 ± 1.23 ng/ml, 0.10 ± 0.01 ng/ml, 7.01 ± 1.41 ng/ml and 4.33 ± 1.12 nmol/l respectively. Subjects with the MetS showed significantly lower SHBG levels in comparison with subjects without the MetS. Participants with raised triglyceride levels showed significantly lower levels of total, free and bioavailable testosterone when compared to participant without raised triglycerides. Participants with problems of avoidance and infrequency of sexual activity showed significantly lower levels of total, free and bioavailable testosterone when compared to participants without avoidance or infrequency problems. The +SD/+MetS group recorded the lowest SHBG levels. Conclusion: Testosterone and its bioactive components are associated with male libido as well as the metabolic syndrome. Low levels of free and bioavailable testosterone are true determinants of the MetS in men.
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