(PM-28) The role of sex hormone binding globulin in hormonal clusters and Hypogonadal symptoms among men with severe sexual dysfunction requiring surgical treatment

Abstract Introduction Sex Hormone Binding Globulin (SHBG), measured in nmol/L, regulates testosterone availability to tissues. Its influence on clinical symptoms and hormonal clustering in men remains underexplored. We investigated SHBG levels across hormonal profiles in men with severe sexual dysfunction requiring surgery. Methods Retrospective cohort of 96 adult men from a tertiary center with erectile dysfunction (ED), Peyronie’s disease (PD), or both. Inclusion required a complete hormonal panel (Total Testosterone [TT; ng/dL], calculated free testosterone [cFT; pmol/mL], SHBG, LH [IU/L], FSH, estradiol) and a standardized consultation performed by a trained Urologist. cFT was calculated from TT and SHBG, both measured by chemo immunoassay. Patients were classified into five hormonal clusters (A–E as shown in table 1) based on TT, cFT, and LH. Clinical variables included age, BMI, comorbidities, and hypogonadism symptoms (≥3 considered relevant). SHBG differences across clusters and variable correlations with symptoms were analyzed. Results Median age was 67.5 ± 10 years; BMI 28.3 ± 5.7 kg/m2 (34% obese). ED was present in 43.7%, PD in 17.7%, and both in 35.4%. SHBG ranged from 6–110.5 nmol/L (median 39.9 ± 23.7). Group A (n = 23): 39.1% had ≥3 symptoms; B (n = 27): 37%; C (n = 19): 21%; D (n = 2): 0%; E (n = 25): 12%. SHBG differed significantly between A vs B (median 26.9 ± 9.3 vs 50.3 ± 28.1; p = 0.00004), A vs E (median 26.9 ± 9.3 vs 40 ± 23.2; p = 0.012), and B vs D (median 50.3 ± 28.1 vs 19.2 ± 1.2; p = 0.039). No variable strongly predicted ≥3 symptoms. Conclusion SHBG levels vary across hormonal profiles and impact underlying endocrine dynamics even when TT or cFT appear normal. These findings reinforce the importance of SHBG in phenotyping androgenic status and optimizing evaluation of men with complex sexual dysfunction. Financing No conflict.