IGF1 and hypogonadotropic hypogonadism: The co-existence of hypogonadotropic hypogonadism due to tumour mass effect or treatments for acromegaly, such as neurosurgery and/or radiotherapy, and high levels of GH and IGF1 has been reported to alter the regular pulsatility of the gonadotropin secretion at the hypothalamic–pituitary level (57), thus contributing to the pathogenesis of erectile dysfunction as the expression of worse sexual health (21, 57, 58).