Acromegaly Presenting as Erectile Dysfunction: Case Reports and Review of the Literature

Erectile dysfunction (ED) is a common yet complex condition. The authors report two cases of acromegaly presenting with ED and hypogonadotropic hypogonadism. Surgical cure of the acromegaly was associated with either an improvement or resolution of hypogonadotropic hypogonadism-associated ED. Active acromegaly should be considered in the differential diagnosis of ED presenting with supporting clinical features, particularly hypogonadotropic hypogonadism.Key words: Erectile dysfunction, Endocrine dysfunction, Endocrinology, Acromegaly, Growth hormoneErectile dysfunction (ED), defined as an inability to obtain or maintain penile erection sufficient for sexual activity, is a common complaint with often complex etiology. Prevalence increases with age, ranging from 1% to 10% of men under age 40, 20% to 40% of men age 60 to 69 years, and 50% to 100% of men in their 70s and 80s.¹ ED can be a symptom of numerous underlying conditions, and guidelines on management of ED outline assessment for reversible hormonal causes such as hypogonadism, thyroid dysfunction, and hyperprolactinemia.^2,3 Although hypogonadism and hyperprolactinemia have been shown to be associated with acromegaly,⁴ the link between acromegaly and ED has not been widely reported.^5,6 We describe two cases of acromegaly with ED as the presenting feature and review the outpatient diagnosis of acromegaly.