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01.10.2015 | original article | Ausgabe 19-20/2015

Wiener klinische Wochenschrift 19-20/2015

Impact of elevated serum estradiol/free testosterone ratio on male varicose veins in a prospective study

Wiener klinische Wochenschrift > Ausgabe 19-20/2015
MD Ass. Prof. Sedat Özcan, Dolunay Odabasi, Tolga Kurt, Ali Kemal Gür, Aysegul Kunt, Yavuz Balaharoglu, Alper Sami Kunt



Although some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men.


We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P).


E2/fT ratio was significantly higher in group A (4.18 ± 0.54) compared with group B (2.98 ± 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2).


Serum E2/fT ratio is associated with varicose veins in male patients.

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