be met with poor libido-decreasing satisfaction and quality

of life. Carefully designed placebo-controlled trials to assess

the risks and benefits of both testosterone and oestrogen are

required.

Conﬂicts of interest:

Larry I. Lipshultz has been a clinical trials

participant, consultant, and speaker for Auxilium and Endo. The other

authors have nothing to disclose.

References

[1]

Finkelstein JS, Lee H, Burnett-Bowie SA, et al. Gonadal steroids and

body composition, strength, and sexual function in men. N Engl J

Med 2013;369:1011–22.

[2]

Carani C, Rochira V, Faustini-Fustini M, Balestrieri A, Granata AR.

Role of oestrogen in male sexual behaviour: insights from the

natural model of aromatase de±ciency. Clin Endocrinol (Oxf) 1999;

51:517–24.

[3]

Mohamed O, Freundlich RE, Dakik HK, et al. The quantitative ADAM

questionnaire: a new tool in quantifying the severity of hypogo-

nadism. Int J Impot Res 2010;22:20–4.

Ranjith Ramasamy

Jason M. Scovell

Jason R. Kovac

Larry I. Lipshultz*

Department of Urology, Baylor College of Medicine, Houston, TX, USA

*Corresponding author. 6624 Fannin Street, #1700,

Houston, TX 77030, USA.

E-mail address:

larryl@bcm.edu

(L.I. Lipshultz).

January 13, 2014

Published online ahead of print on January 23, 2014

EUROPEAN UROLOGY 65 (2014) 1224–1225

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