ANDROGENIC STATUS AND SEXUAL FUNCTION IN MALES WITH RHEUMATOID-ARTHRITIS AND ANKYLOSING-SPONDYLITIS

Abstract

The pituitary-testicular axis was investigated in 31 males with rheumatoid arthritis (age range 19-60 years, median 55 years) and 33 males with ankylosing spondylitis (age range 22-55 years, median 37 years) and compared with a control group of 95 normal male volunteers. Using analysis of covariance, patients with rheumatoid arthritis showed significantly lower serum testosterone (p < 0.05) and derived free testosterone (p < 0.01) concentrations and significantly higher serum LH and FSH concentrations (p < 0.05) compared with controls. All patients had normal serum prolactin and cortisol concentrations. Seurm testosterone correlated with ESR, haemoglobin concentrations and rheumatoid factor titers (r=-0.448, p < 0.02; r=0.440, p < 0.02; r=-0.360, p < 0.05 respectively) in the rheumatoid patients. Although there was a significant negative correlation between ESR and haemoglobin concentrations (p < 0.005) in the patients with ankylosing spondylitis, neither variable correlated with serum testosterone concentrations. There was no association between testicular dysfunction and the presence of extraarticular features of rheumatoid arthritis. Ten patients (33 per cent) with rheumatoid arthritis and four (13 per cent) with ankylosing spondylitis admitted to periods of impotence while 15 (50 per cent) of the former and 12 (39 per cent) of the latter had periods of decreased libido. There was no evidence for increased rates of infertilty in either group.