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Sadeghi M, Askari A, Bostan F, Heidari A, Rafiee H, Alavi Tabatabaei G, Ghasemi G, Roohafza H. Impact of cardiac rehabilitation on erectile dysfunction in cardiovascular patients: a systematic review and meta-analysis. Sex Med 2024; 12:qfae043. [PMID: 38953013 PMCID: PMC11215551 DOI: 10.1093/sexmed/qfae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 07/03/2024] Open
Abstract
Background Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals. Aim To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis. Methods This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis. Outcomes The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function. Results A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity (I 2 = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue. Clinical Translation CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group. Strengths and Limitations The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment. Conclusion The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).
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Affiliation(s)
- Masoumeh Sadeghi
- Chamran Cardiovascular Research and Education Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Askari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Bostan
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afshin Heidari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamed Rafiee
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Golsa Ghasemi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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2
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Alzharani AAY, Alshami AM, Khan MA, Siddique N, Abualait T. Prevalence and trends in physical therapy interventions for erectile dysfunction: A Scopus-based bibliometric analysis (1989-2022). Andrology 2024. [PMID: 38735868 DOI: 10.1111/andr.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/23/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Erectile dysfunction (ED) is a condition that affects many males. Physical therapy (PT) is the one potential treatment for ED that may improve blood flow, muscle strength, and other factors that may contribute to the issue. Data on the prevalence and trends of research on PT for ED are lacking. OBJECTIVE This study aimed to evaluate the literature trends in PT for ED via bibliometric and visualized analysis. METHODS Data on publications were collected from Scopus covering the period between 1989 and 2022. To refine the data, bibliometric analyses were conducted using Microsoft Access, Microsoft Excel, an online visualization platform, and BiblioAnalytics. Power BI and Bibliomaster were used to generate figures and tables, while Biblioshiny and VOSviewer were used for visualization. RESULTS A total of 494 documents were identified. The year 2019 generated the largest number of publications, with a total of 54. These studies have received 12,917 citations related to PT for ED. The most common document type was the original article with 283 publications. The University of California, USA, was the most productive institution on this topic, with 21 publications and 2,035 citations. The USA led all countries with 114 publications on the topic. The Journal of Sexual Medicine secured the top ranking with an h-index of 18. The main topics studied were erectile dysfunction, shockwave therapy, and physiotherapy. CONCLUSION The number of publications on PT for ED has demonstrated an upward trend over the last three decades.
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Affiliation(s)
- Abdulaziz Ali Y Alzharani
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Physical Therapy, Armed Forces Center for Health Rehabilitation, Taif, Saudi Arabia
| | - Ali M Alshami
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ajmal Khan
- Deanship of Library Affairs, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nadeem Siddique
- Library Department, Lahore University of Management Sciences, Lahore, Pakistan
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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3
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Chang CJ, Fan YH, Chiu YC, Cheng WM. Cold hypersensitivity in the hands and feet is associated with erectile dysfunction in young Taiwanese men. Sci Rep 2024; 14:10577. [PMID: 38719920 PMCID: PMC11078973 DOI: 10.1038/s41598-024-60260-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
Cold hypersensitivity in the hands and feet (CHHF) is a protective or predisposing factor for many diseases; however, the relationship between CHHF and erectile dysfunction (ED) remains unclear. We aimed to investigate associations between CHHF and ED among young men of Southeast Asian origin. In this cross-sectional study, sexually active Taiwanese men aged 20-40 years were enrolled via an online questionnaire comprising general demographic information, comorbidities, subjective thermal sensations of their hands and feet in the past 6 months, and their erectile function using the International Index of Erectile Function-5 (IIEF-5). Participants who reported cold sensation of hands and feet were classified to have CHHF; those with IIEF-5 score ≤ 21 were considered to have ED. Total 54.2% and 27.9% of participants had ED and CHHF, respectively. Men with CHHF were significantly younger, had lower body mass index and IIEF-5 scores (p < 0.001), and a lower prevalence of diabetes mellitus (p = 0.033) along with higher prevalence of ED, psychiatric disorders, and insomnia (p < 0.001). After adjusting for predisposing factors of ED, CHHF (odds ratio 1.410, 95% confidence interval 1.159-1.714; p = 0.001) remained an independent predictor of ED. Thus, CHHF is independently associated with ED, affecting more than a quarter of young Taiwanese men. Autonomic dysregulation and subclinical endothelial dysfunction may be common pathophysiologies of CHHF and ED.
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Affiliation(s)
- Che-Jui Chang
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Yu-Hua Fan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chun Chiu
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan
| | - Wei-Ming Cheng
- Division of Urology, Department of Surgery, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan.
- Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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4
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Cripps SM, Marshall SA, Mattiske DM, Ingham RY, Pask AJ. Estrogenic endocrine disruptor exposure directly impacts erectile function. Commun Biol 2024; 7:403. [PMID: 38565966 PMCID: PMC10987563 DOI: 10.1038/s42003-024-06048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Erectile dysfunction (ED) is an extremely prevalent condition which significantly impacts quality of life. The rapid increase of ED in recent decades suggests the existence of unidentified environmental risk factors contributing to this condition. Endocrine Disrupting Chemicals (EDCs) are one likely candidate, given that development and function of the erectile tissues are hormonally dependent. We use the estrogenic-EDC diethylstilbestrol (DES) to model how widespread estrogenic-EDC exposure may impact erectile function in humans. Here we show that male mice chronically exposed to DES exhibit abnormal contractility of the erectile tissue, indicative of ED. The treatment did not affect systemic testosterone production yet significantly increased estrogen receptor α (Esr1) expression in the primary erectile tissue, suggesting EDCs directly impact erectile function. In response, we isolated the erectile tissue from mice and briefly incubated them with the estrogenic-EDCs DES or genistein (a phytoestrogen). These acute-direct exposures similarly caused a significant reduction in erectile tissue contractility, again indicative of ED. Overall, these findings demonstrate a direct link between estrogenic EDCs and erectile dysfunction and show that both chronic and acute estrogenic exposures are likely risk factors for this condition.
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Affiliation(s)
- Samuel M Cripps
- School of BioSciences, The University of Melbourne, Melbourne, Australia
| | - Sarah A Marshall
- The Ritchie Centre, Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia
| | - Deidre M Mattiske
- School of BioSciences, The University of Melbourne, Melbourne, Australia
| | - Rachel Y Ingham
- School of BioSciences, The University of Melbourne, Melbourne, Australia
| | - Andrew J Pask
- School of BioSciences, The University of Melbourne, Melbourne, Australia.
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5
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Viken AF, Siiak SP, Schlünssen V, Thorarinsdottir EH, Skulstad SM, Gyawali S, Bertelsen RJ, Real FG. Muscle Strength and Male Sexual Function. J Clin Med 2024; 13:426. [PMID: 38256560 PMCID: PMC10816204 DOI: 10.3390/jcm13020426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Sexual dysfunction, in particular erectile dysfunction, is a common complaint among aging men. Obesity, diabetes, hypertension, and smoking are shown to be independent risk factors for erectile dysfunction, while cardiorespiratory fitness is shown to be protective. Less is known about the role of muscle strength in male sexual function. Our objective was to study the association between male sexual function and typical cardiovascular risk factors, together with exercise and muscle strength. We included data from the fourth wave of the RHINE study. Data on anthropometrics, exercise habits, diseases, muscle strength, and sexual function were collected using questionnaires, including the Aging Males' Symptoms (AMS) scale. We used multivariable logistic regression analysis to measure the association between sexual function and body mass index (BMI), age, smoking, diabetes, hypertension, exercise and muscle strength status. We included 2116 men aged 48-75 from four Nordic-Baltic countries. BMI, age, smoking, diabetes, and hypertension were found to be associated with higher odds of reporting decreased sexual function, while reporting intact muscle strength was associated with lower odds. In a large Nordic-Baltic male study population, we show that known cardiovascular risk factors are associated with decreased sexual function, while reporting intact muscle strength is associated with lower odds of reporting decreased sexual function.
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Affiliation(s)
- Anders Flataker Viken
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (R.J.B.); (F.G.R.)
| | | | - Vivi Schlünssen
- Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark;
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
| | | | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway (S.G.)
| | - Sanjay Gyawali
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway (S.G.)
| | | | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (R.J.B.); (F.G.R.)
- Department of Gynecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway
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6
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Merrill RM, Song D, Ashton MK. Comparing the Strength of Associations Between Male Genital Problems and Mental Illnesses and Sleep Disorders. Am J Mens Health 2024; 18:15579883241228243. [PMID: 38279822 PMCID: PMC10822091 DOI: 10.1177/15579883241228243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
This study compares the rate of selected types of mental illnesses (stress, anxiety, depression) and sleep disorders (insomnia, sleep apnea) according to the status of eight male genital problems. Analyses utilize medical claims data for male employees aged 18 to 64 years of a large corporation, 2017 to 2021. Approximately 1,076 (7.3%) men per year have one or more genital problems. The most common being benign prostatic hyperplasia (BPH; 3.8%) and then erectile dysfunction (ED; 1.7%). For BPH patients, the rate experiencing stress, anxiety, depression, or a combination of these is 0.96%, 6.2%, 5.3%, and 5.1%, respectively. Corresponding rates for ED are 1.5%, 7.2%, 5.9%, and 7.5%. For BPH patients, the rate experiencing insomnia, sleep apnea, or both is 3.1%, 22.7%, and 2.0%, respectively. Corresponding rates for ED are 1.2%, 20.6%, and 2.2%. Male genital problems positively associate with having one or more mental illnesses (stress, anxiety, depression), except for hydrocele, with ED and penis disorder having the strongest associations. Male genital problems also positively associate with having insomnia and/or sleep apnea, except for infertility and orchitis, with BPH and ED having the strongest associations. The positive associations involving BPH and ED with mental illnesses are each more pronounced in the younger age group (18-49 vs. 50-64). Similar results are seen in the models involving sleep disorders. Thus, comorbid male genital problems, mental illnesses, and sleep disorders exist, with the strength of associations unique to the male genital problem and sometimes modified by age.
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Affiliation(s)
- Ray M. Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Dajeong Song
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - McKay K. Ashton
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
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7
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Carella MC, Forleo C, Stanca A, Carulli E, Basile P, Carbonara U, Amati F, Mushtaq S, Baggiano A, Pontone G, Ciccone MM, Guaricci AI. Heart Failure and Erectile Dysfunction: a Review of the Current Evidence and Clinical Implications. Curr Heart Fail Rep 2023; 20:530-541. [PMID: 37962749 PMCID: PMC10746762 DOI: 10.1007/s11897-023-00632-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE OF REVIEW Heart failure (HF) and erectile dysfunction (ED) are two common conditions that affect millions of men worldwide and impair their quality of life. ED is a frequent complication of HF, as well as a possible predictor of cardiovascular events and mortality. ED deserves more attention from clinicians and researchers. RECENT FINDINGS The pathophysiology of ED in HF involves multiple factors, such as endothelial dysfunction, reduced cardiac output, neurohormonal activation, autonomic imbalance, oxidative stress, inflammation, and drug side effects. The diagnosis of ED in HF patients should be based on validated questionnaires or objective tests, as part of the routine cardiovascular risk assessment. The therapeutic management of ED in HF patients should be individualized and multidisciplinary, considering the patient's preferences, expectations, comorbidities, and potential drug interactions. The first-line pharmacological treatment for ED in HF patients with mild to moderate symptoms (NYHA class I-II) is phosphodiesterase type 5 inhibitors (PDE5Is), which improve both sexual function and cardiopulmonary parameters. PDE5Is are contraindicated in patients who use nitrates or nitric oxide donors for angina relief, and these patients should be advised to avoid sexual activity or to use alternative treatments for ED. Non-pharmacological treatments for ED, such as psychotherapy or couples therapy, should also be considered if there are significant psychosocial factors affecting the patient's sexual function or relationship. This review aims to summarize the most recent evidence regarding the prevalence of ED, the pathophysiology of this condition with an exhaustive analysis of factors involved in ED development in HF patients, a thorough discussion on diagnosis and management of ED in HF patients, providing practical recommendations for clinicians.
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Affiliation(s)
- Maria Cristina Carella
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Cinzia Forleo
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Alessandro Stanca
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Eugenio Carulli
- Cardiology Unit, Madonna Delle Grazie Hospital, Matera, Italy
| | - Paolo Basile
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Umberto Carbonara
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari Aldo Moro, Bari, Italy
| | - Fabio Amati
- Department of Basic Medicine Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Saima Mushtaq
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Andrea Baggiano
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Gianluca Pontone
- Perioperative Cardiology and Cardiovascular Imaging Department, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Marco Matteo Ciccone
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Andrea Igoren Guaricci
- Cardiovascular Disease Section, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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8
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Khera M, Bhattacharyya S, Miller LE. Effect of aerobic exercise on erectile function: systematic review and meta-analysis of randomized controlled trials. J Sex Med 2023; 20:1369-1375. [PMID: 37814532 DOI: 10.1093/jsxmed/qdad130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND The health benefits of regular aerobic exercise are well established, although there is limited high-quality evidence regarding its impact on erectile function. AIM To determine the effect of aerobic exercise on erectile function in men and to identify factors that may influence this effect. METHODS This systematic review and meta-analysis included randomized controlled trials that evaluated the effects of aerobic exercise on erectile function via the Erectile Function domain of the International Index of Erectile Function (IIEF-EF). The mean difference in IIEF-EF scores between the aerobic exercise and nonexercising control groups was estimated by a random-effects meta-analysis. Meta-regression was used to evaluate the association of moderator variables on meta-analysis results. OUTCOMES The IIEF-EF score is reported on a 6-30 scale, with higher values indicating better erectile function. RESULTS Among 11 randomized controlled trials included in the analysis, aerobic exercise resulted in statistically significant improvements in IIEF-EF scores as compared with controls, with a mean difference of 2.8 points (95% CI, 1.7-3.9; P < .001) and moderate heterogeneity among studies (I2 = 53%). The effect of aerobic exercise on erectile function was greater in men with lower baseline IIEF-EF scores, with improvements of 2.3, 3.3, and 4.9 points for mild, moderate, and severe erectile dysfunction, respectively (P = .02). The meta-analysis results were not influenced by publication bias or individual study effects. CLINICAL IMPLICATIONS Health care providers should consider recommending regular aerobic exercise as a low-risk nonpharmacologic therapy for men experiencing erectile difficulties. STRENGTHS AND LIMITATIONS The primary strength of this review was the generation of level 1 evidence on a topic of general interest regarding sexual health in men. However, the included studies evaluated diverse groups, which may complicate data interpretation for specific segments of the population. CONCLUSION Regular aerobic exercise can improve the erectile function of men, particularly those with lower baseline IIEF-EF scores.
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Affiliation(s)
- Mohit Khera
- Baylor College of Medicine, Houston, TX, 77030, United States
| | - Samir Bhattacharyya
- Health Economics and Market Access, Boston Scientific, Marlborough, MA, 01752, United States
| | - Larry E Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN, 37604, United States
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9
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Cayetano-Alcaraz AA, Tharakan T, Chen R, Sofikitis N, Minhas S. The management of erectile dysfunction in men with diabetes mellitus unresponsive to phosphodiesterase type 5 inhibitors. Andrology 2023; 11:257-269. [PMID: 35929992 DOI: 10.1111/andr.13257] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Erectile dysfunction is associated with diabetes mellitus with an estimated prevalence of 52.5% in the diabetic population. The first-line therapy for erectile dysfunction is phosphodiesterase type 5 inhibitors, but data suggest that diabetic men may be less responsive than non-diabetic men. Thus, other treatments, including intracavernosal injections, intraurethral prostaglandin, vacuum erection devices and penile prosthetic surgery, should be considered in management of diabetic men with erectile dysfunction refractory to phosphodiesterase type 5 inhibitors. Furthermore, combination therapy of phosphodiesterase type 5 inhibitors and other oral treatments such as arginine or l-carnitine may have synergistic effects resulting in better outcomes. In addition, there are novel therapies such as low-intensity shockwave therapy and stem-cell therapy, which may also be effective in targeted treatment modalities. Furthermore, studies suggest that erectile dysfunction can be improved by targeting concurrent comorbidities or metabolic diseases such as depression, hypertension, hypogonadism, and dyslipidaemia. We present an evidence-based narrative review focusing on the management of erectile dysfunction in diabetic men who have not responded to phosphodiesterase type 5 inhibitors. CONCLUSIONS Both clinicians and patients should be aware of the different management options in diabetic patients who have not responded to phosphodiesterase type 5 inhibitors.
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Affiliation(s)
| | - Tharu Tharakan
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Runzhi Chen
- Faculty of Medicine, Imperial College London, London, UK
| | - Nikolaos Sofikitis
- Department of Urology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Suks Minhas
- Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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10
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Kling JM, Saadedine M, Faubion SS, Kapoor E. Sexual Health Update in Women. J Womens Health (Larchmt) 2023; 32:10-14. [PMID: 36413021 DOI: 10.1089/jwh.2022.0392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Clinical Update series is intended to help busy clinicians stay up to date with recently published important and potentially practice-changing articles on topics pertinent to the care of women. In this update on sexual health, we review studies on use of vaginal dilators for vaginal stenosis in gynecologic cancer survivors, sexual dysfunction in transgender people, as well as studies evaluating the effect of physical activity and infertility on female sexual health.
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Affiliation(s)
- Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA.,Center for Women's Health, Mayo Clinic, Rochester, Minnesota, USA
| | - Mariam Saadedine
- Center for Women's Health, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Stephanie S Faubion
- Center for Women's Health, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, Minnesota, USA.,Menopause and Women's Sexual Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.,Women's Health Research Center, Mayo Clinic, Rochester, Minnesota, USA
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11
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Abstract
Compared to women, increasing male age is not accompanied by such marked changes in reproductive function but changes certainly do happen. These include alterations to the hypothalamo-pituitary-testicular axis, with resultant implications for testosterone production and bioavailability as well as spermatogenesis. There is a decline in sexual function as men age, with a dramatic increase in the prevalence of erectile dysfunction after the age of 40, which is a marker for both clinically evident as well as covert coronary artery disease. Despite a quantitative decline in spermatogenesis and reduced fecundability, the male potential for fertility persists throughout adult life, however there are also increasingly recognised alterations in sperm quality and function with significant implications for offspring health. These changes are relevant to both natural and medically assisted conception.
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Affiliation(s)
- Sarah Martins da Silva
- Reproductive Medicine Research Group, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, DD1 9SY, Dundee, UK
| | - Richard A Anderson
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, EH16 4TJ, Edinburgh, UK.
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12
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Wang T, Heath MA, Tanaka SK, Tanaka H. Sexual Function, Behavior, and Satisfaction in Masters Athletes. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 35:82-90. [PMID: 38596768 PMCID: PMC10903591 DOI: 10.1080/19317611.2022.2148802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/16/2022] [Accepted: 10/28/2022] [Indexed: 04/11/2024]
Abstract
Objectives Masters athletes are endowed with high functional capacity, long-term health, and psychological outlook. However, their sexual activity and function are largely unknown. We investigated the influence of sustained moderate to vigorous exercise on sexual life using a model of masters athletes. Methods A 55-item survey adapted from previous American Association of Retired People (AARP) sexuality study were distributed to masters athletes associations. The responses from 166 masters athletes were compared with AARP dataset that represented a general population. Results Both male and female masters athletes demonstrated more frequent sexual desire and greater involvements in different types of sexual activities (i.e., kissing or hugging, touching or caressing, sexual intercourse, oral sex, and self-stimulation; all p < 0.05). Sexual satisfaction was greater in female masters athletes than in female general population (p = 0.025), but no such group difference was observed in men. Male athletes had a lower degree of erectile dysfunction. No difference was observed in orgasm frequency between the two population groups. Age-associated decline in sexual activity was apparent in general population (p < 0.05) but absent in masters athletes. Females recorded lower engagements in partner-involved sexual behaviors than men in the general population, but no such gender difference was observed in women. The primary factor predicting improvement in sexual satisfaction was "better health for myself" (29.7%) in the general population, whereas master athletes identified "better health for partner" (23.5%). Conclusion Masters athletes in general and female athletes in particular demonstrate superior sexual function, satisfaction, and behavior presumably due to their better overall health status.
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Affiliation(s)
- Tianyu Wang
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Melanie A. Heath
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Sebastian K. Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
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Toldam NE, Graugaard C, Meyer R, Thomsen L, Dreier S, Jannini EA, Giraldi A. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022; 10:714-753. [PMID: 37051956 PMCID: PMC9242892 DOI: 10.1016/j.sxmr.2022.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The COVID-19 pandemic impacted profoundly on the wellbeing and social interactions of the world population, and all dimensions of sexual health were potentially affected by globally implemented preventive measures. OBJECTIVES The scoping review aimed to compile existing research investigating possible effects of COVID-19 lockdowns on adult sexual health, that is, sexual behavior, functioning, and satisfaction. Further, studies on the interplay between mental health and sexual well-being during the pandemic were reviewed. METHODS The review was conducted in accordance with guidelines established by the Joanna Briggs Institute and the Extension for Scoping Reviews (PRISMA-ScR) Checklist. On October 11-12, 2021, PubMed, Embase, PsycInfo, Cinahl, Cochrane, Sociological Abstracts and Scopus were systematically searched for relevant peer-reviewed papers employing quantitative methodology. Additionally, unpublished ("grey") research studies on the subject were retrieved. The screening, data extraction, and analysis of evidence were conducted by 4 independent reviewers using an iterative approach. RESULTS Based on 107 studies included, the scoping review showed that the pandemic had had a wide impact on all dimensions of sexual health. Except for solo sex activities, mainly negative COVID-19 implications were identified, although findings were, in sum, characterized by complexity and unpredictability. Thus, sexual behavior, functioning, and satisfaction during the pandemic appeared to be mitigated by a broad range of sociodemographic and contextual factors. Finally, sexual health seemed deeply entwined with overall mental health. CONCLUSION The scoping review revealed a broad range of COVID-19-related effects on sexual health, including an overall decline in partnered sex and a concurrent increase in solo sex activities. It also emphasized a need for future research to shed light on possible long-term consequences of the pandemic in various population groups and on all aspects of sexual health. Toldam NE, Graugaard C, Meyer R, et al. Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 2022;10:714-753.
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Affiliation(s)
- Nana Ernst Toldam
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark,Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark
| | - Christian Graugaard
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Denmark
| | - Rikke Meyer
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark
| | | | | | | | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Copenhagen, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Corresponding Author: Annamaria Giraldi, MD, PhD, FECSM, IF, Sexological Clinic, Mental Health Center, Copenhagen, Copenhagen University Hospital – Mental Health Services CPH, Ole Maaloesvej 14, 2200 Copenhagen, Denmark. Tel: + 45 38 64 71 69
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Patoulias D, Katsimardou A, Imprialos K, Doumas M. Exercise, Erectile Dysfunction and Co-Morbidities: "The Good, the Bad and the Ugly". Rev Cardiovasc Med 2022; 23:304. [PMID: 39077699 PMCID: PMC11262406 DOI: 10.31083/j.rcm2309304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/24/2022] [Accepted: 08/17/2022] [Indexed: 07/31/2024] Open
Abstract
Erectile dysfunction (ED), defined as the inability to attain or maintain sufficient penile erection for sexual intercourse, is a growing health problem, which unfortunately remains underreported, underdiagnosed and undertreated. Growing evidence suggests that ED is a promising cardiovascular risk marker, as it is associated with major co-morbidities increasing cardiovascular disease burden, while it is an independent predictor of cardiovascular morbidity and mortality. The role of exercise as a non-pharmacological therapeutic intervention in ED has been widely investigated during the last two decades, both in observational studies and in randomized controlled trials, enrolling different patients' populations. In the present narrative review, we summarize relevant evidence concerning the effect of exercise on vascular ED and the pathophysiologic background, underscoring the importance of enhanced physical activity as a recommendation in all subjects with vascular ED.
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Affiliation(s)
- Dimitris Patoulias
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Alexandra Katsimardou
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Konstantinos Imprialos
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Michael Doumas
- Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
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Type D Personality Independently Predicts Erectile Dysfunction in Taiwanese Young Men. J Sex Med 2022; 19:1397-1403. [DOI: 10.1016/j.jsxm.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/31/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022]
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Elnegaard CM, Christensen J, Thuesen J, Areskoug-Josefsson K, Gerbild HN. Psychometric Properties of the Danish Version of the Questionnaire Professionals’ Attitudes towards Addressing Sexual Health (PA-SH-D). Sex Med 2022; 10:100527. [PMID: 35588600 PMCID: PMC9386636 DOI: 10.1016/j.esxm.2022.100527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background Health professionals’ attitudes towards addressing sexual health are important to promote patients’ sexual health. Therefore, measurement of health professionals’ attitudes towards addressing sexual health is essential. Aim This study aimed to adapt the questionnaire Students’ Attitudes towards Addressing Sexual Health (SA-SH-D) to health professionals working with rehabilitation in Danish municipalities and evaluated psychometric properties of the adapted questionnaire: The Danish Version of the Professionals’ Attitudes towards Addressing Sexual Health (PA-SH-D). Methods The SA-SH-D was adapted to PA-SH-D and a face validity evaluation focusing on phrasing, functionality, perception and relevance was done. In a pilot study, the PA-SH-D was answered by health professionals and internal consistency reliability and floor and ceiling effects were evaluated. Outcomes Face validity included phrasing, functionality, perception and relevance of the items in PA-SH-D, internal consistency with Cronbach's alpha in the total scale and floor and ceiling effects. Results Face validity of the PA-SH-D was acceptable. The sample size was 52 health professionals working with rehabilitation, the internal consistency reliability (Cronbach's alpha: 0.89 [lower confidence interval {CI}: 0.85]) and floor and ceiling effects (0.0%–13.7%) of the PA-SH-D were acceptable. Clinical translation As sexual health is important in human quality of life, the validation of the PA-SH-D is highly valuable as it evaluates health professionals’ attitudes towards addressing sexual health, and thereby is able to measure the need for education and training in sexual health and detect changes in attitudes following an educational intervention. Strengths and limitations Strengths were that the PA-SH-D measures both attitudes and competences and covered a need in clinical practice. The recruitment was broad and we used the work of others to orient this work. Limitations were that this study covered a preliminary psychometric evaluation and a thorough evaluation covering other aspects of psychometry should be done. We used both paper-based and online-based survey which possibly could cause bias. The study had a relatively small sample size. Comparing health professionals to students can be seen as both a limitation and a strength. Conclusion The results in face validity and internal consistency reliability indicate usefulness of the PA-SH-D to measure health professionals’ attitudes towards addressing sexual health. Further evaluation of psychometric properties of the PA-SH-D is recommended. Elnegaard CM, Christensen J, Thuesen J, et al. Psychometric Properties of the Danish Version of the Questionnaire Professionals’ Attitudes towards Addressing Sexual Health (PA-SH-D). Sex Med 2022;10:100527.
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Chung E, Rhee H. Impact of Physical Exercise Program Interventions on Erectile Function and Cardiovascular Health in Males with Prostate Cancer. World J Mens Health 2022; 40:361-367. [PMID: 34169682 PMCID: PMC9253808 DOI: 10.5534/wjmh.210032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer (PC) and its associated treatments can cause significant cardiovascular and sexual dysfunctions. While structured exercise interventions can induce positive outcomes in males with PC, there are limited data on its effects on cardiovascular health, erectile function, or the combination of these outcomes. It has been proposed that positive changes in biomarkers of cardiovascular health through physical exercise programs, can result in cardiovascular remodelling and improve penile haemodynamic and erectile function recovery in those with metabolic syndrome and/or cardiovascular diseases, although the data is accruing in males who are diagnosed and/or treated for PC. While the results of this review article support structured physical exercise interventions to effectively prevent and mitigate the development of both sexual and cardiovascular dysfunctions in males with PC, appropriate caution should be maintained and future clinical research should focus on the development of standardised and evidence-based exercise guidelines in the setting of PC survivorship.
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Affiliation(s)
- Eric Chung
- AndroUrology Centre, Brisbane, QLD and Sydney, NSW, Australia
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Macquarie University Hospital, Sydney, NSW, Australia.
| | - Handoo Rhee
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
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Moyad MA. Nutraceuticals and Phytotherapy in Men's Health: Antioxidants, Pro-oxidants, and a Novel Opportunity for Lifestyle Changes. Urol Clin North Am 2022; 49:239-248. [DOI: 10.1016/j.ucl.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Impact of Environmental and Dietary Issues on Male Sexual Health. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-021-00317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Yardimci A, Ulker N, Bulmus O, Sahin E, Alver A, Gungor IH, Turk G, Artas G, Kaya Tektemur N, Ozcan M, Kelestimur H, Canpolat S. Irisin Improves High-Fat Diet-Induced Sexual Dysfunction in Obese Male Rats. Neuroendocrinology 2022; 112:1087-1103. [PMID: 35189621 DOI: 10.1159/000523689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/15/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Obesity is known to cause sexual dysfunction including erectile dysfunction and poor semen quality. Lifestyle modifications such as exercise have increasingly been more recognized to lower the likelihood of having sexual dysfunction or infertility in obese men. In this context, as an exercise-mimetic hormone, irisin has a potential to improve obesity-related reproductive dysfunctions. We aimed to elucidate possible effects of irisin on high-fat diet (HFD)-induced reproductive dysfunction in obese male rats. METHODS Rats were divided into four groups: vehicle, irisin, obese, and obese + irisin. The rats in obese and obese+irisin groups were fed with HFD (60% kcal fat) pellets for 12 weeks to induce obesity, and then obesity-induced sexual dysfunction was confirmed by the sexual behavior test (SBT). Irisin and obese+irisin groups received irisin (100 ng/kg/day) infusion by an s.c. osmotic minipump for 4 weeks after HFD-induced obesity was formed. RESULTS Irisin did improve a number of measures of copulation, including penile erection, ejaculation, and sexual performance, and also improved sperm morphology and motility and decreased fat-induced testicular damage. It decreased serum leptin levels. On the other hand, irisin did not affect serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. It also increased gene expression of tyrosine hydroxylase (TH) and adrenoceptor alpha 1A (ADRA1A) in the medial preoptic area (mPOA) and nucleus accumbens (NAc). CONCLUSION Irisin provided a marked enhancement of HFD-induced decrease in libido, potency, sexual performance, and erection in SBT. Taken together, our results emphasize that irisin has a restorative and improver role in HFD-induced reproductive dysfunctions in obese male rats.
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Affiliation(s)
- Ahmet Yardimci
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nazife Ulker
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Ozgur Bulmus
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Balikesir University, Balikesir, Turkey
| | - Elif Sahin
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Alver
- Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ibrahim Halil Gungor
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Gaffari Turk
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Gokhan Artas
- Department of Medical Pathology, Firat University, Faculty of Medicine, Elazig, Turkey
| | - Nalan Kaya Tektemur
- Department of Histology and Embryology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Mete Ozcan
- Department of Biophysics, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Haluk Kelestimur
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Sinan Canpolat
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
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Nakamura S, Watanabe Y, Goto T, Ikegami K, Inoue N, Uenoyama Y, Tsukamura H. Kisspeptin neurons as a key player bridging the endocrine system and sexual behavior in mammals. Front Neuroendocrinol 2022; 64:100952. [PMID: 34755641 DOI: 10.1016/j.yfrne.2021.100952] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/20/2021] [Accepted: 10/19/2021] [Indexed: 02/08/2023]
Abstract
Reproductive behaviors are sexually differentiated: for example, male rodents show mounting behavior, while females in estrus show lordosis behavior as sex-specific sexual behaviors. Kisspeptin neurons govern reproductive function via direct stimulation of gonadotropin-releasing hormone (GnRH) and subsequent gonadotropin release for gonadal steroidogenesis in mammals. First, we discuss the role of hypothalamic kisspeptin neurons as an indispensable regulator of sexual behavior by stimulating the synthesis of gonadal steroids, which exert "activational effects" on the behavior in adulthood. Second, we discuss the central role of kisspeptin neurons that are directly involved in neural circuits controlling sexual behavior in adulthood. We then focused on the role of perinatal hypothalamic kisspeptin neurons in the induction of perinatal testosterone secretion for its "organizational effects" on masculinization/defeminization of the male brain in rodents during a critical period. We subsequently concluded that kisspeptin neurons are key players in bridging the endocrine system and sexual behavior in mammals.
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Affiliation(s)
- Sho Nakamura
- Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Ehime 794-8555, Japan
| | - Youki Watanabe
- Graduate School of Applied Life Science, Nippon Veterinary and Life Science University, Tokyo 180-8602, Japan
| | - Teppei Goto
- RIKEN Center for Biosystems Dynamics Research, Hyogo 650-0047, Japan
| | - Kana Ikegami
- Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Naoko Inoue
- Graduate School of Bioagricultural Science, Nagoya University, Nagoya 464-8601, Japan
| | - Yoshihisa Uenoyama
- Graduate School of Bioagricultural Science, Nagoya University, Nagoya 464-8601, Japan
| | - Hiroko Tsukamura
- Graduate School of Bioagricultural Science, Nagoya University, Nagoya 464-8601, Japan.
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Unnikrishnan R. Aquatic exercise as an adjunct therapy for erectile dysfunction: A narrative review. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2022. [DOI: 10.4103/ajprhc.ajprhc_37_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prebble KS, Gerbild H, Abrahamsen C. Content validity and reliability of the danish version of health care students' attitudes towards addressing sexual health: a psychometric study. Scand J Caring Sci 2021; 36:515-523. [PMID: 34859482 DOI: 10.1111/scs.13048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/22/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Danish version of Health Care Students' Attitudes towards Addressing Sexual Health (SA-SH-D) is a questionnaire for measuring the attitudes of health care professional students' towards addressing sexual health in their future professional practice and care. AIM To assess content validity and reliability of the SA-SH-D. METHOD Following COSMIN guidelines, the study consisted of a cognitive interview study and a questionnaire study. Health care students from nursing, physiotherapy and occupational therapy programmes participated; seven were interviewed following the 'Think Aloud' method and 111 responded to two paper-based SA-SH-D administered with a two-week interval. RESULTS The SA-SH-D was found to be relevant, comprehensive and comprehensible. Three suboptimal wordings were identified. Floor and ceiling effects were found for six items. Cronbach's α for the total scale was 0.84 indicating good internal consistency. After a two-week interval, the percentage of agreement per item ranged from 88.2% to 100% when allowing for a one-point difference. The mean agreement percentage for the overall scale was 95.2% when allowing for a one-point difference. CONCLUSION The Danish version of Health Care Students Attitudes towards Addressing Sexual Health is a valid and reliable questionnaire for measuring health care professional students' attitudes towards addressing sexual health in their future professional practice and care.
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Affiliation(s)
- Kristina S Prebble
- Department of Public Health, J.B.Winsløwsvej 9B, University of Southern Denmark, Odense C, 5000, Denmark
| | - Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway
| | - Charlotte Abrahamsen
- Department of Public Health, J.B.Winsløwsvej 9B, University of Southern Denmark, Odense C, 5000, Denmark
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Effect of Foot Reflexology on Sexual Function of Patients under Hemodialysis: A Randomized Parallel Controlled Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8553549. [PMID: 34721645 PMCID: PMC8553438 DOI: 10.1155/2021/8553549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 11/24/2022]
Abstract
Introduction Hemodialysis patients experience sexual dysfunction due to the nature of their disease and its complications. Dialysis patients have reported sexual dysfunction as one of the most important stressors, which leads to many psychological and physiological problems. Sexual function in hemodialysis patients has been improved with pharmaceutical and nonpharmacological therapies. Foot reflexology is a complementary and alternative treatment that can be used in conjunction with contemporary care. By activating the chemical nerve system, reflexology may balance enzymes and regulate endocrine function. Objectives To determine the effect of foot reflexology on the sexual function of hemodialysis patients. Methods This randomized controlled trial was conducted on 47 patients on chronic hemodialysis referred to Imam Reza Hospital in Sirjan, Iran, who were divided into two groups of reflexology (n = 24; male = 19 and female = 5) and sham (n = 23; male = 18, and female = 5). The intervention group received foot reflexology during dialysis for four weeks, three times a week, 30 minutes each time (15 minutes per foot). The sham group received nonspecific foot massage without applying pressure on standard reflex points with the same condition and duration as the intervention group. The international index of erectile function and female sexual function index was assessed before, immediately, and one month after the intervention. Results The results showed that immediately after the intervention, male orgasm function, sexual desire, and intercourse satisfaction in the reflexology group was significantly higher than those of the sham group. There was no significant difference between the two groups regarding erectile function and overall satisfaction. Furthermore, there was no significant difference between the two groups in terms of different aspects of female sexual function. Conclusions Foot reflexology, as an effective intervention treatment, can reduce some aspects of sexual dysfunction of male patients under hemodialysis.
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Reimer N, Zopf EM, Böwe R, Baumann FT. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med 2021; 18:1899-1914. [PMID: 37057481 DOI: 10.1016/j.jsxm.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 08/27/2021] [Accepted: 09/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Emerging evidence suggests that exercise interventions may improve sexual dysfunction, one of the most common and distressing long-term adverse effects of cancer treatment. AIM The aim of this systematic review is to provide an overview of the effects of exercise on sexual dysfunction in prostate cancer patients. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The systematic literature search was performed on 13th July 2021 using CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline and Web of Science. Studies were included if they were randomized controlled trials (RCTs) assessing sexual function in prostate cancer patients conducting an exercise intervention alone or in combination with other supportive interventions. The methodological quality was assessed using the Physiotherapy Education Database Score and Jadad scale. Outcomes were reported as between-group differences. Intragroup differences were also reported if significant. OUTCOMES Positive intervention effects on sexual function were primarily observed in patients following prostatectomy and undergoing anti-hormone treatment and for pelvic floor muscle exercises as well as aerobic and resistance exercise. RESULTS 22 RCTs (n = 1.752 patients) met the eligibility criteria, conducting either an exercise-only intervention (n = 10), a multimodal (exercise plus other supportive therapy) intervention (n = 4), or pelvic floor muscle exercises (n = 8). 6 RCTs assessed sexual dysfunction as a primary endpoint and 8 RCTs used dedicated assessment methods. 9 of the 22 RCTs found significant between-group differences in favor of the intervention group. CLINICAL IMPLICATIONS The multifaceted etiology of sexual dysfunction provides a strong rationale to further investigate the effects of exercise on sexual dysfunction in prostate cancer patients and also to consider a multidisciplinary approach. STRENGTHS AND LIMITATIONS A strength is the comprehensive literature search to identify RCTs involving different exercise interventions and a wide range of sexual function assessments. Further, this is the first systematic review on this topic. The main limitations include the difficulty to compare studies due to the heterogeneity of exercise interventions and low questionnaire completion rates in some studies. CONCLUSION Preliminary data from a small number of studies suggest that certain exercise interventions may improve sexual dysfunction in prostate cancer patients, however further trials involving sexual dyfunction as a primary outcome and more comprehensive assessment tools are needed to confirm the rehabilitative and preventive effects of exercise on sexual dysfunction in prostate cancer patients. Nadine Reimer, Eva Maria Zopf, Rebecca Böwe, et al. Effects of Exercise on Sexual Dysfunction in Patients With Prostate Cancer - A Systematic Review. J Sex Med 2021;18:1899-1914.
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Affiliation(s)
- Nadine Reimer
- University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany.
| | - Eva Maria Zopf
- Australian Catholic University, Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Rebecca Böwe
- Hochschule Fresenius, University of Applied Sciences, Faculty of Health & Social Work, Cologne, Duesseldorf, Germany
| | - Freerk Theeagnus Baumann
- University of Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University Hospital of Cologne, Cologne, Germany
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol 2021; 29:5-115. [PMID: 34558602 DOI: 10.1093/eurjpc/zwab154] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA).,International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, Benetos A, Biffi A, Boavida JM, Capodanno D, Cosyns B, Crawford C, Davos CH, Desormais I, Di Angelantonio E, Franco OH, Halvorsen S, Hobbs FDR, Hollander M, Jankowska EA, Michal M, Sacco S, Sattar N, Tokgozoglu L, Tonstad S, Tsioufis KP, van Dis I, van Gelder IC, Wanner C, Williams B. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2021; 42:3227-3337. [PMID: 34458905 DOI: 10.1093/eurheartj/ehab484] [Citation(s) in RCA: 2240] [Impact Index Per Article: 746.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Alessandro Biffi
- European Federation of Sports Medicine Association (EFSMA)
- International Federation of Sport Medicine (FIMS)
| | | | | | | | | | | | | | | | | | | | - F D Richard Hobbs
- World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) - Europe
| | | | | | | | | | | | | | | | | | | | | | - Christoph Wanner
- European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
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Gopal A, Sydow R, Block V, Allen DD. Effectiveness of Physical Therapy in Addressing Sexual Dysfunction in Individuals with Multiple Sclerosis: A Systematic Review and Meta-analysis. Int J MS Care 2021; 23:213-222. [PMID: 34720761 PMCID: PMC8550487 DOI: 10.7224/1537-2073.2020-039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Individuals with multiple sclerosis (MS) frequently report sexual dysfunction, a condition that may result in low sexual satisfaction and decreased quality of life. Although sexual dysfunction is usually treated pharmacologically, physical therapists, especially those trained in pelvic floor physical therapy (PT), are well-equipped to address a variety of impairments that contribute to poor sexual function. The current evidence for effectiveness of PT interventions in improving sexual dysfunction, sexual satisfaction, and the emotional well-being aspect of quality of life was analyzed. METHODS The PubMed, CINAHL, and PEDro databases were searched through December 2019. Articles were included if participants had a clinical diagnosis of MS, reported sexual dysfunction or pain with intercourse, and had an intervention within the PT scope that addressed sexual dysfunction. Means and SDs were extracted from each study independently by two authors. Effect sizes (d) and 95% CIs were calculated within and across studies. RESULTS Eight studies met the inclusion criteria. Combined effects were significant and large across six studies for sexual function (d = 0.82, 95% CI, 0.57-1.06), moderate across seven studies for sexual satisfaction (d = 0.65, 95% CI, 0.43-0.87), and moderately large across two studies for emotional well-being (d = 0.78, 95% CI, 0.17-1.40). Between-group differences reached significance for sexual satisfaction (d = 0.29, 95% CI, 0.03-0.55). CONCLUSIONS Sexual function, sexual satisfaction, and emotional well-being can all be effectively addressed with various PT interventions. Highly effective interventions included pelvic floor muscle training and mindfulness. Future research should compare PT interventions with non-PT controls to determine best practice in this population.
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Affiliation(s)
- Arpita Gopal
- From the Department of Physical Therapy and Rehabilitation Science (AG, RS, DDA), University of California, San Francisco, CA, USA
| | - Rebecca Sydow
- From the Department of Physical Therapy and Rehabilitation Science (AG, RS, DDA), University of California, San Francisco, CA, USA
| | - Valerie Block
- Weill Institute for Neurosciences, Department of Neurology (VB), University of California, San Francisco, CA, USA
| | - Diane D. Allen
- From the Department of Physical Therapy and Rehabilitation Science (AG, RS, DDA), University of California, San Francisco, CA, USA
- Department of Physical Therapy, San Francisco State University, San Francisco, CA, USA (DDA)
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30
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Pettersson H, Alexanderson H, Poole JL, Varga J, Regardt M, Russell AM, Salam Y, Jensen K, Mansour J, Frech T, Feghali-Bostwick C, Varjú C, Baldwin N, Heenan M, Fligelstone K, Holmner M, Lammi MR, Scholand MB, Shapiro L, Volkmann ER, Saketkoo LA. Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS). Best Pract Res Clin Rheumatol 2021; 35:101695. [PMID: 34217607 PMCID: PMC8478716 DOI: 10.1016/j.berh.2021.101695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Systemic sclerosis (SSc) is a heterogeneous multisystem autoimmune disease whereby its main pathological drivers of disability and damage are vascular injury, inflammatory cell infiltration, and fibrosis. These mechanisms result in diffuse and diverse impairments arising from ischemic circulatory dysfunction leading to painful skin ulceration and calcinosis, neurovascular aberrations hindering gastrointestinal (GI) motility, progressive painful, incapacitating or immobilizing effects of inflammatory and fibrotic effects on the lungs, skin, articular and periarticular structures, and muscle. SSc-related impairments impede routine activities of daily living (ADLs) and disrupt three critical life areas: work, family, social/leisure, and also impact on psychological well-being. Physical activity and exercise are globally recommended; however, for connective tissue diseases, this guidance carries greater impact on inflammatory disease manifestations, recovery, and cardiovascular health. Exercise, through myogenic and vascular phenomena, naturally targets key pathogenic drivers by downregulating multiple inflammatory and fibrotic pathways in serum and tissue, while increasing circulation and vascular repair. G-FoRSS, The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis recognizes the scientific basis of and advocates for education and research of exercise as a systemic and targeted SSc disease-modifying treatment. An overview of biophysiological mechanisms of physical activity and exercise are herein imparted for patients, clinicians, and researchers, and applied to SSc disease mechanisms, manifestations, and impairment. A preliminary guidance on exercise in SSc, a research agenda, and the current state of research and outcome measures are set forth.
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Affiliation(s)
- Henrik Pettersson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Helene Alexanderson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, USA
| | - Janos Varga
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Malin Regardt
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Department of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Russell
- University of Exeter, College of Medicine and Health, Exeter, UK; National Institute of Health Research, Senior Nurse Research Leader, London, UK
| | - Yasser Salam
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kelly Jensen
- Oregon Health and Science University, Portland, OR, USA; New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Jennifer Mansour
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Tracy Frech
- Vanderbilt University, Division of Rheumatology, Nashville, TN, USA
| | | | - Cecília Varjú
- Department of Rheumatology and Immunology, University of Pécs Clinical Center, Pecs, Hungary
| | | | - Matty Heenan
- Scleroderma Foundation/Pulmonary Hypertension Association, Tucson, AZ, USA
| | - Kim Fligelstone
- Scleroderma & Raynaud Society UK (SRUK), London, UK; Royal Free Hospital, London, UK
| | - Monica Holmner
- The Swedish Rheumatism Association National Association for Systemic Sclerosis, Sweden
| | - Matthew R Lammi
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA
| | - Mary Beth Scholand
- University of Utah, Division of Pulmonary Medicine, Pulmonary Fibrosis Center, Salt Lake City, UT, USA
| | - Lee Shapiro
- Division of Rheumatology, Albany Medical Center, Albany, NY, USA; Steffens Scleroderma Foundation, Albany, NY, USA
| | - Elizabeth R Volkmann
- University of California, David Geffen School of Medicine, UCLA Scleroderma Program and UCLA CTD-ILD Program, Division of Rheumatology, Department of Medicine, Los Angeles, CA, USA
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA.
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31
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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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Wang J, Zhao J, Zhang C, Zhang Y, Jiang N, Wei X, Wang J, Yu J. Comorbidity, lifestyle factors, and sexual satisfaction among Chinese cancer survivors. Cancer Med 2021; 10:6058-6069. [PMID: 34254466 PMCID: PMC8419754 DOI: 10.1002/cam4.4118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/05/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aims to explore the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Methods A cross‐sectional study was performed among 3996 Chinese cancer survivors recruited at Shanghai Cancer Rehabilitation Club from March to April 2017. Data were collected through self‐reported questionnaires. The questionnaire includes information about demographic, cancer characteristics, comorbidities, lifestyle factors, and sexual satisfaction. Sexual satisfaction was measured by a single‐item scale. The distribution of sexual satisfaction among different demographic and cancer characteristics was compared using the chi‐squared test. Logistic regression models were conducted to assess the effects of lifestyle factors, comorbidities on sexual satisfaction after adjustment for demographic and cancer characteristics. Results More than 40% of male and female cancer survivors reported no sexual satisfaction. Sexual satisfaction of cancer survivors is significantly associated with both the number and the type of comorbidities. Heart disease, musculoskeletal system disease, diabetes, and hyperlipidemia are the comorbidities significantly associated with sexual satisfaction of cancer survivors. Lifestyle factors other than smoking, including exercise or fitness, drinking alcohol, and eating fruits and vegetables are significantly correlated with sexual satisfaction. Besides, all of the above associations show gender differences. In addition, demographic characteristics include sex, age, marital status, living status, and average monthly income are also significantly associated with sexual satisfaction of cancer survivors. Conclusion Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction. This study aims to investigate the prevalence of sexual satisfaction among Chinese cancer survivors, and explore the association of sexual satisfaction with comorbidity and lifestyle factors. Comorbidity and lifestyle factors are associated with sexual satisfaction of cancer survivors, and the associations show gender differences. Improving the lifestyles of cancer survivors, and controlling and reducing their comorbidities are important for improving their sexual satisfaction.
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Affiliation(s)
- Jingya Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jie Zhao
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Chenggang Zhang
- Shanghai Xuhui Centre for Disease Control and Prevention, Shanghai, China
| | - Yuxin Zhang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Nan Jiang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Xiaomin Wei
- Shanghai Health Promotion Center, Shanghai, China
| | - Jiwei Wang
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Key Lab of Health Technology Assessment of National Health Commission and Key Lab of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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33
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Smith L, Carrie A, Tully M, Barnett Y, Butler L, Gillvray C, Lindsay R, Abbs A, Trott M, Olanrewaju O, Yang L, Ilie CP. The CADENCE pilot trial - Promoting physical activity in bladder cancer survivors: A protocol paper. Contemp Clin Trials Commun 2021; 22:100809. [PMID: 34195472 PMCID: PMC8239430 DOI: 10.1016/j.conctc.2021.100809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/01/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Participation in physical activity has been found to be beneficial for mental and physical health outcomes among cancer survivors. However, to date no intervention exists specifically to promote physical activity among bladder cancer survivors. In light of this knowledge a home-based exercise intervention was co-created for those recently diagnosed with bladder cancer. Aim The aim of the present study, financially supported by Action Bladder Cancer UK [1], is to pilot the home-based exercise intervention tailored specifically for bladder cancer survivors (i.e. from the point of diagnosis) to improve physical and mental health outcomes (during treatment and beyond) in this population. Methods This study will use a randomised controlled trial design. Arm one will consists of the 14 week home-based exercise intervention and arm two usual care (15 participants will be randomised to each arm). Baseline data collection will take place shortly after clinical diagnosis of bladder cancer, and follow-up approximately 7 weeks and then again approximately 14 weeks after commencement of the intervention. At each data collection point data will be collected from participants relating to demographics, physical and mental health. Participants will aslo be asked to wear an Actigraph Accelerometer at each data collection point for seven consecutive days. Immediately after baseline data collection participants in the intervention arm will be given the home-based exercise booklet. Ethics and dissemination Ethical approval was obtained for the present study via The London- City and East Research Ethics Committee (ID:291676). Results of this study will be disseminated through peer-reviewed publications and scientific presentations.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Anne Carrie
- The Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
| | - Mark Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, BT37 0QB, UK
| | - Yvonne Barnett
- Faculty of Science and Technology, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Laurie Butler
- Faculty of Science and Technology, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Claire Gillvray
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rosie Lindsay
- Vision and Hearing Sciences Research Center, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Adam Abbs
- Pennine Acute Hospitals, NHS Trust, UK
| | - Mike Trott
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Olawale Olanrewaju
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, UK.,The Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention, Cancer Care Alberta, Alberta Health Services,Calgary, AB T2S 3C3, Canada
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Maseroli E, Rastrelli G, Di Stasi V, Cipriani S, Scavello I, Todisco T, Gironi V, Castellini G, Ricca V, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi L. Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much. J Sex Med 2021; 18:1217-1229. [PMID: 37057426 DOI: 10.1016/j.jsxm.2021.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Research on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking. AIM To investigate the clinical, psychological, and sexual correlates of PA in women with FSD. METHODS A non-selected series of n = 322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (<1 hour/week: sedentary, 1-3 hours/week: active, 4-6 hours/week: very active, >6 hours/week: extremely active) were investigated with a specific question. OUTCOMES FSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index, Female Sexual Distress Scale-Revised, Body Uneasiness Test, and Middlesex Hospital Questionnaire. RESULTS At multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several Female Sexual Function Index domains - including desire, arousal and lubrication - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (Body Uneasiness Test Global severity index), psychopathological symptoms (Middlesex Hospital Questionnaire total score) and sexual distress (Female Sexual Distress Scale-Revised score). These latter 2 factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction and histrionic/hysterical symptoms), even compared to a sedentary lifestyle. CLINICAL IMPLICATIONS Women consulting for FSD may gain benefits on desire, arousal, lubrication and sex-related distress from regular PA; however, physicians should remain alert to the downsides of excessive exercise. STRENGTHS & LIMITATIONS The main strength lies in the novelty of the findings. The main limitations are the cross-sectional nature, the clinical setting, the small sample size of the different PA groups, and the use of self-reported instruments for the evaluation of PA. CONCLUSION In women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction. Maseroli E, Rastrelli G, Di Stasi V, et al. Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much. J Sex Med 2021;18:1217-1229.
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Affiliation(s)
- Elisa Maseroli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Giulia Rastrelli
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, , Florence, Italy
| | - Vincenza Di Stasi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Sarah Cipriani
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Irene Scavello
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Tommaso Todisco
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, , Florence, Italy
| | - Veronica Gironi
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, , Florence, Italy
| | - Giovanni Castellini
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, , Florence, Italy
| | - Valdo Ricca
- Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, , Florence, Italy
| | - Flavia Sorbi
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Massimiliano Fambrini
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Felice Petraglia
- Gynecology Unit, Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, , Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
| | - Linda Vignozzi
- Department of Experimental Clinical and Biomedical Sciences "Mario Serio", University of Florence, , Florence, Italy
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, , Florence, Italy
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy
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Gerbild H, Areskoug-Josefsson K, Larsen CM, Laursen BS. Acceptability of Health Professionals' Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021; 9:100369. [PMID: 34087535 PMCID: PMC8240334 DOI: 10.1016/j.esxm.2021.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In the developing phase of the complex health intervention: Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), it is crucial to explore whether men can accept the communicative component regarding information that regular aerobe Physical Activity can reduce Erectile Dysfunction (i-PAVED). This information is provided by health professionals (HPs) in cardiac rehabilitation, where sexuality issues such as erectile dysfunction (ED) are otherwise rarely addressed. AIM To explore how acceptance of cardiac HPs' address of sexuality, ED, and i-PAVED can be identified in men's narratives. METHODS In this descriptive qualitative study, we conducted semi-structured individual interviews with 20 men (range 48-78 years of age) attending municipal cardiac secondary prevention and rehabilitation programmes on their acceptance of HPs' address of sexuality, ED, and i-PAVED. The Theoretical Framework of Acceptability components (affective attitude, burden, ethicality, intervention coherence, perceived effectiveness, opportunity costs and self-efficacy) and three temporal perspectives (retrospective, concurrent and prospective) were used in the concept-driven first step of a content analysis, which was followed by a thematically data-driven second step. MAIN OUTCOME MEASURES Men anticipated and experiential acceptance was identified in six out of seven components of Theoretical Framework of Acceptability. RESULTS Men acceptance was identified as "expression of interest," "addressing sexuality," "attitudes and values," "understandable and meaningful," "insights" and "motivation," whereas no narratives were identified in relation to the component of opportunity costs. CONCLUSION As an aspect of the development of the complex cardiovascular health care intervention PAVED, this qualitative study showed that men attending cardiac secondary prevention and rehabilitation seemed to prospectively accept the communicative component of PAVED being HPs' address of sexuality, ED, and i-PAVED, if the HPs are professional, educated and competent in the field of sexual health. Gerbild H, Areskoug-Josefsson K, Larsen CM, et al. Acceptability of Health Professionals' Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation. Sex Med 2021;9:100369.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Kristina Areskoug-Josefsson
- Faculty of Health Science, VID Specialized University, Sandnes, Norway; School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden; Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University hospital, Denmark
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Salehi F, Mangolian Shahrbabaki P, Dehghan M, Amirihosseini M. Can passive pedaling improve sexual function in patients under hemodialysis? A randomized clinical trial. Ther Apher Dial 2021; 26:130-139. [PMID: 34032376 DOI: 10.1111/1744-9987.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/28/2022]
Abstract
To investigate the effect of passive pedaling with mini bike on sexual function in patients under hemodialysis. This study was a randomized clinical trial. Thirty-seven patients undergoing hemodialysis were assigned to the intervention (n = 20) and control (n = 17) groups by the stratified block randomization method. The intervention group exercised with a mini bike that was automatic and tuned for patients during the first 2 h of dialysis, twice a week for 20 min each time, for 3 months. The International Index of Erectile Function and Female Sexual Function Index were used to assess the sexual function in the first, second, and third months during the intervention and one month after the intervention. A higher score indicates a better sexual function. Repeated measure ANOVA, Chi-square and Fisher exact tests, independent t, and Mann-Whitney U tests were used for data analysis. The SPSS software version 22 was used for data analysis. Sexual function scores of the intervention group were 35.9 at the beginning of the study, 34.1 in the first month, 37.4 in the second month, 34.8 in the third month, and 31.7 one month after the study. There was no significant difference in the scores of sexual function in the intervention group during the study. The mean scores of sexual function in the control group were 34.5, 34.4, 34.9, 33.8, and 33.9 at the beginning of the study, in the first month, in the second month, in the third month, and one month after the study, respectively (p > 0.05). There was no significant difference between the two groups in terms of sexual function scores during and after the intervention (p > 0.05). Passive pedaling with mini-bike had no effect on sexual function of hemodialysis patients.
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Affiliation(s)
- Farzaneh Salehi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mangolian Shahrbabaki
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.,Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Yannas D, Frizza F, Vignozzi L, Corona G, Maggi M, Rastrelli G. Erectile Dysfunction Is a Hallmark of Cardiovascular Disease: Unavoidable Matter of Fact or Opportunity to Improve Men's Health? J Clin Med 2021; 10:jcm10102221. [PMID: 34065601 PMCID: PMC8161068 DOI: 10.3390/jcm10102221] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 12/14/2022] Open
Abstract
Erectile dysfunction (ED) is an early manifestation of cardiovascular (CV) disease. For this reason, men with ED should be carefully assessed for CV risk factors in order to prevent future major adverse CV events (MACE). Traditional risk factors are not found in all subjects at high CV risk. In fact, a relevant proportion of MACE occurs in men who are apparently risk factor free. In men with ED, it is important to take into account not only traditional risk factors but also unconventional ones. Several parameters that derive from good clinical assessment of subjects with ED have proven to be valuable predictors of MACE. These include family history of cardiometabolic events, alcohol abuse, fatherhood, decreased partner’s sexual interest, severe impairment in erection during intercourse or during masturbation, impaired fasting glucose, increased triglycerides, obesity even without metabolic complications, decreased penile blood flows or impaired response to an intra-cavernosal injection test. Recognizing these risk factors may help in identifying, among subjects with ED, those who merit stricter lifestyle or pharmacological interventions to minimize their CV risk. Effective correction of risk factors in ED men considered as high risk, besides reducing CV risk, is also able to improve erectile function.
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Affiliation(s)
- Dimitri Yannas
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Francesca Frizza
- Endocrinology Unit, Medical Department, Azienda Usl Maggiore-Bellaria Hospital, 40121-40141 Bologna, Italy; (F.F.); (G.C.)
| | - Linda Vignozzi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl Maggiore-Bellaria Hospital, 40121-40141 Bologna, Italy; (F.F.); (G.C.)
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Endocrinology Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Giulia Rastrelli
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
- Correspondence:
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De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, Battista F, Caretta N, Savalla F, Favero C, Garolla A, Foresta C, Ermolao A. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021; 9:100347. [PMID: 33975195 PMCID: PMC8240347 DOI: 10.1016/j.esxm.2021.100347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Vascular erectile dysfunction (ED) is a burdensome condition, associated with increased cardiovascular risk. Peak systolic velocity (PSV) represents the maximum pulse velocity in the cavernous artery measured by a penile color doppler ultrasonography (PCDU) during a pharmacologically induced erection and is considered a reliable parameter for the diagnosis of vascular ED. However, the cut-off value of standard PSV (30 cm/s) provides high sensitivity only in the diagnosis of advanced arteriogenic disease. Thus, an age-adjusted PSV (6.73 + 0.7 x age cm/s) has been proposed to offer a more accurate diagnosis of vascular ED. AIM In this study it was aimed to answer the following question: "Is there any positive association between indexes of vascular erectile dysfunction and cardiorespiratory fitness?" MAIN OUTCOME MEASURE AND METHODS 25 patients with a medical history of ED (median age 55.3 years) underwent PCDU after pharmacological stimulation. Subsequently, a functional evaluation with ECG-monitored, incremental, maximal cardiopulmonary exercise testing was performed. RESULTS Peak oxygen uptake (VO2 peak), peak oxygen uptake per body weight (VO2 peak/kg) and Watt/kg correlated with standard PSV, even when corrected for age and BMI (p < 0.05). No differences emerged in cardiopulmonary fitness between pathological and healthy patients (4 vs 21) identified using the standard PSV cut-off. Conversely, the age-adjusted PSV cut-off identified a greater number of patients as pathological (18 vs 7), presenting a significantly lower cardiopulmonary fitness, exercise capacity and efficiency when compared to patients with normal age-adjusted PSV (all p < 0.05). CONCLUSION Data showed an age and BMI independent association between vascular disfunction of cavernous artery and cardiopulmonary fitness, a known solid predictor of all-cause and disease-specific mortality. Moreover, the age-adjusted PSV better identified a subgroup of patients with vascular ED presenting impaired cardiorespiratory fitness and thus increased cardiovascular risk. De Rocco Ponce M, Vecchiato M, Neunhaeuserer D, et al. Association Between Penile Color Doppler Ultrasonography and Cardiorespiratory Fitness in Patients With Vascular Erectile Dysfunction. Sex Med 2021;9:100347.
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Affiliation(s)
- Maurizio De Rocco Ponce
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Daniel Neunhaeuserer
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy.
| | - Francesca Battista
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Nicola Caretta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Francesco Savalla
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Claudia Favero
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Andrea Ermolao
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
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Salama AB, Abdrabo MS, Abouelnaga WA. Effect of physical exercise combined with shockwave therapy on erectile dysfunction in diabetic patients. Arch Med Sci 2021; 19:1207-1213. [PMID: 37732055 PMCID: PMC10508044 DOI: 10.5114/aoms/135634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/09/2021] [Indexed: 09/22/2023] Open
Abstract
Introduction The aim of the study was to evaluate whether physical exercise (PE) in addition to extracorporeal shockwave therapy (ESWT) is more effective in improving erectile function as compared to ESWT and PE alone in diabetic patients with erectile dysfunction (ED). Material and methods Forty-five patients with type 2 diabetes mellitus (DM) and ED were divided into three equal groups: group 1 (ESWT group) received treatment with ESWT twice weekly for 6 weeks, comprising 3000 shockwaves at an energy density of 0.25 mJ/mm2 and an emission frequency of 6 Hz; group 2 (PE group) received treatment with physical exercise three times per week for 12 weeks; and group 3 (combined group) was treated using physical exercise in the form of the program followed by the PE group, plus ESWT in the form of the same parameter and protocol as that of the ESWT group. Treatment outcomes were measured by International Index of Erectile Function-5 (IIEF-5) score variations recorded at 4 and 12 weeks after the end of treatment with respect to the baseline. Results The mean IIEF-5 scores significantly improved in all groups at the 4-week follow-up without intergroup differences. At the 12-week follow-up, the mean IIEF-5 improvement and durability were significantly higher among patients in combined groups. Conclusions The combined approach of ESWT and PE provides significant advantages in erectile dysfunction improvement and durability as compared to ESWT or PE alone in diabetic patients with ED.
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Affiliation(s)
- Amr B. Salama
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran, KSA, Egypt
| | - Mohamed Samy Abdrabo
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Cairo, Egypt, Egypt
| | - Walid A. Abouelnaga
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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Gerbild H, Larsen CM, Junge T, Laursen BS, Areskoug-Josefsson K. Danish Health Professional Students' Attitudes Toward Addressing Sexual Health: A Cross-Sectional Survey. Sex Med 2021; 9:100323. [PMID: 33676228 PMCID: PMC8072180 DOI: 10.1016/j.esxm.2021.100323] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction Danish health professional (HP) students' attitudes toward addressing sexual health are unknown. Aim To investigate Danish HP students' attitudes toward addressing sexual health in their future professions, and to assess differences in perceived competences and preparedness between professional programs. Methods A Danish national survey of nursing, occupational therapy, and physiotherapy students was conducted. Totally, 1,212 students were invited to respond to an online questionnaire “The Students' Attitudes toward Addressing Sexual Health.” Main Outcome Measure The main outcome measures investigated were Danish HP students' attitudes toward addressing sexual health in their future professions, and differences in perceived competences and preparedness depending on the professional program. Results A total of 584 students (48%; nursing 44%, occupational therapy 70%, physiotherapy 43%) responded. Mean total score ranged between 63.7 and 66.3 (±8.3–8.8) classifying students in the low-end of the class: “comfortable and prepared in some situations.” No clinically relevant differences were determined between the professional programs with respect to perceived competences and preparedness to address sexual health. Conclusion In the field of addressing sexual health, most Danish HP students reported positive attitudes and a need for basic knowledge, competences, communication training, and education. H Gerbild, C M Larsen, T. Junge, B. S. Laursen, K. Areskoug-Josefsson. Danish Health Professional Students' Attitudes Toward Addressing Sexual Health: A Cross-Sectional Survey. Sex Med 2021;9:100323.
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Affiliation(s)
- Helle Gerbild
- Health Science Research Centre, UCL University College, Odense, Denmark; Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Camilla Marie Larsen
- Health Science Research Centre, UCL University College, Odense, Denmark; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark, Odense, Denmark
| | - Tina Junge
- Health Science Research Centre, UCL University College, Odense, Denmark; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Kristina Areskoug-Josefsson
- School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden; Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway; VID Specialized University, Faculty of Health Studies, Oslo, Norway
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Leitão AE, Vieira MCDS, Pelegrini A, da Silva EL, Guimarães ACDA. A 6-month, double-blind, placebo-controlled, randomized trial to evaluate the effect of Eurycoma longifolia (Tongkat Ali) and concurrent training on erectile function and testosterone levels in androgen deficiency of aging males (ADAM). Maturitas 2020; 145:78-85. [PMID: 33541567 DOI: 10.1016/j.maturitas.2020.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Androgen deficiency of aging males (ADAM) largely manifests as sexual symptoms. Erectile dysfunction is one of the most common symptoms of ADAM. AIM To ascertain the effect of concurrent training and supplementation with Eurycoma longifolia on erectile function and testosterone levels in men with ADAM, and the association of erectile function with levels of total testosterone. METHODS 6-month, randomized, double-blind, placebo-controlled four-arm clinical. 45 men (47.38 ± 5.03 years) were randomized into 4 groups (G1: control + placebo; G2: control + Eurycoma longifolia; G3: concurrent training + placebo; G4: concurrent training + Eurycoma longifolia). 22 received a 200 mg supplement of Eurycoma longifolia and 23 underwent the intervention with concurrent training, 3 times a week for 60 min at progressive intensity. OUTCOMES International Index of Erectile Function (IIEF-5), Aging Male Scale (AMS) and total testosterone. RESULTS Erectile function demonstrated improvements in both interventions; however, the most significant results were obtained by men allocated to concurrent training + Eurycoma longifolia. CLINICAL IMPLICATIONS A 200 mg supplement of Eurycoma longifolia and the practice of concurrent training for 6 months significantly improved the erectile function of men with ADAM. STRENGTHS & LIMITATIONS The study's design stands out as a strength, in addition to the six-month intervention. The main limitation is the study not having groups that used only Eurycoma longifolia and only concurrent training. CONCLUSION The combination of Eurycoma longifolia and concurrent training improved erectile function and increased total testosterone levels in men with ADAM.
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Affiliation(s)
- Alice Erwig Leitão
- University of Santa Catarina State, Universidade do Estado de Santa Catarina Florianopolis, Santa Catarina, Brazil.
| | | | - Andreia Pelegrini
- University of Santa Catarina State, Universidade do Estado de Santa Catarina Florianopolis, Santa Catarina, Brazil
| | - Edson Luiz da Silva
- Federal University of Santa Catarina, Universidade Federal de Santa Catarina, Brazil
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Sivaratnam L, Selimin DS, Abd Ghani SR, Nawi HM, Nawi AM. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2020; 18:121-143. [PMID: 33223424 DOI: 10.1016/j.jsxm.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Erectile dysfunction (ED) is a common problem among men across the world. It is usually multifactorial in origin. Behavioral factors can be related to the development of ED and related to many other chronic diseases. It impacts not only the sexual function but also the psychology and their overall quality of life. AIM To determine the association of the behavior factors in relation to ED and to identify the risk and protective factors. METHOD A systematic review search based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis was conducted. The primary databases PubMed, PlosOne, Oxford Academic, SCOPUS, and Ovid were accessed using specific keyword searches. Quality of articles was assessed by using Newcastle-Ottawa Assessment Scale according to the study design. OUTCOME Evaluation of the relationship between behavioral factors and ED. RESULTS 24 studies were identified from the 5 databases which met the predetermined criteria. Overall, the study population include adult male age between 18 and 80 years. The sample size of the studies ranges from 101 to the largest sample size of 51,329. Smoking, alcohol, and drugs usage are found to be risk factors for ED. Meanwhile, dietary intake, physical activity, and intimacy are the protective factors for ED. CLINICAL IMPLICATION The findings from this review may aid clinicians to aim for early detection of ED by screening their risk factors and providing early treatment. This can also be used to promote awareness to the community on the sexual health and factors that can affect their sexual function. STRENGTH & LIMITATION This study looks at all types of behavioral factors that may affect ED; however, there was a substantial heterogeneity detected across the selected study factors. Furthermore, the lack of PROSPERO registration is also a limitation in this study. CONCLUSION Overall, smoking, dietary intake, alcohol consumption, drugs, and physical activities are modifiable risk factors for ED in men. Therefore, it is crucial to promote healthy lifestyle and empower men to prevent ED and early detection of ED for early treatment. Sivaratnam L, Selimin DS, Abd Ghani SR, et al. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2021;18:121-143.
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Affiliation(s)
- Lavanyah Sivaratnam
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Diana Safraa Selimin
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Siti Rasidah Abd Ghani
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Haniff Mohd Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
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Carneiro F, Saito OC, Miranda EP. Standardization of penile hemodynamic evaluation through color duplex-doppler ultrasound. ACTA ACUST UNITED AC 2020; 66:1180-1186. [PMID: 33027442 DOI: 10.1590/1806-9282.66.9.1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/22/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The vascular evaluation of the erectile function through Color Duplex-Doppler Ultrasound (CDDU) of the penis can benefit the therapeutic decision-making process. Unfortunately, there is no standard procedure for CDDU conduction, a fact that results in high result-interpretation variability. OBJECTIVE The aims of this review are to promote greater standardization during CDDU of the penis and discuss the fundamental principles for its accurate conduction. METHODS CDDU is initially conducted with the penis in the flaccid state; the whole penis must be assessed (images at B mode) with a high-frequency linear transducer (7.5-18 MHz). Intracavernous injection of vasodilating agents (prostaglandin E1, papaverine, phentolamine) is performed to induce a rigid erection. Serial measurements at different times should be taken during the CDDU session and penile rigidity must be assessed in each evaluation. RESULTS It is important to monitor the erection response after the vasoactive agent (hardness scale), and scanning during the best-quality erection should be contemplated. Manual self-stimulation, audiovisual sexual stimulation (AVSS), and vasoactive agent re-dosing protocols must be taken into account to reduce the influence of psychogenic factors and to help the patient to get the hardest erection possible. Such measurements contribute to the maximal relaxation of the erectile tissue, so the hemodynamic parameters are not underestimated. CONCLUSIONS CDDU is a relevant specialized tool to assess patients with erectile dysfunction; therefore, this guideline will help to standardize and establish uniformity in its conduction and interpretation, taking into consideration the complexity and heterogeneity of CDDU evaluations of the penis.
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Affiliation(s)
- Felipe Carneiro
- Departamento de Radiologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Osmar Cassio Saito
- Departamento de Radiologia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Eduardo P Miranda
- Departamento de Urologia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
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Çevikelli-Yakut ZA, Özçelik R, Çevik Ö, Şener TE, Şener G. Exercise and caloric restriction improve cardiovascular and erectile function in rats with metabolic syndrome. Int J Impot Res 2020; 33:844-853. [PMID: 33009496 DOI: 10.1038/s41443-020-00356-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study is to examine the possible benefits of exercise and caloric restriction (CR) on cardiovascular hemodynamics, erectile function, and antioxidant system in metabolic syndrome (MS). Sixty male Spraque-Dawley rats were divided into five groups; control, MS, MS + CR, MS + exercise (EXC), and MS + CR + EXC. To induce MS, 10% fructose solution was applied for 3 months. Thereafter, in CR groups calorie was restricted 40% and in EXC groups swimming was performed for 6 weeks. Body weight, blood glucose, and blood pressure (BP) levels were measured before and after MS induction and at the end of the experiment. After decapitation, tumor necrosis factor (TNF)-α, adiponectin (ADP), and plasminogen activator inhibitor (PAI)-1 levels were investigated in blood, oxidative stress parameters were examined in heart, aorta, and corpus cavernosum (CC) tissues. Isometric contraction in isolated tissue bath was studied in aorta and CC tissues. Animals subjected to exercise and CR had decreased BP and blood glucose levels. Impaired contraction-relaxation responses in MS group were improved with exercise and CR. MS-induced increase in TNF-α, PAI-1, malondialdehyde (MDA), and decrease in ADP, glutathione (GSH), and superoxide dismutase (SOD) were normalized with exercise and CR. Exercise and CR may be beneficial against changes in cardiovascular hemodynamics caused by MS.
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Affiliation(s)
- Zatiye Ayça Çevikelli-Yakut
- Department of Pharmacology, School of Pharmacy, Marmara University, İstanbul, Turkey.,Department of Pharmacognosy, School of Pharmacy, Trakya University, Edirne, Turkey
| | - Reyhan Özçelik
- Department of Pharmacology, School of Pharmacy, Marmara University, İstanbul, Turkey
| | - Özge Çevik
- Department of Biochemistry, School of Medicine, Aydın Adnan Menderes University, Aydın, Turkey
| | - Tarık Emre Şener
- Department of Urology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Göksel Şener
- Department of Pharmacology, School of Pharmacy, Marmara University, İstanbul, Turkey.
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Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 2020; 51:2375-2390. [PMID: 31626055 DOI: 10.1249/mss.0000000000002116] [Citation(s) in RCA: 1302] [Impact Index Per Article: 325.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue. METHODS A second Roundtable was convened in 2018 to advance exercise recommendations beyond public health guidelines and toward prescriptive programs specific to cancer type, treatments, and/or outcomes. RESULTS Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should "avoid inactivity." Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain. CONCLUSIONS The proposed recommendations should serve as a guide for the fitness and health care professional working with cancer survivors. More research is needed to fill remaining gaps in knowledge to better serve cancer survivors, as well as fitness and health care professionals, to improve clinical practice.
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Affiliation(s)
- Kristin L Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, CANADA
| | - Kerri M Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health Sciences University, Portland, OR
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Clinic, Heidelberg, GERMANY
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anna L Schwartz
- School of Nursing, Northern Arizona University, Flagstaff, AZ
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, CANADA
| | - David S Zucker
- Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, WA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Lynn H Gerber
- Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA.,Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA
| | | | - Alpa V Patel
- Epidemiology Research, American Cancer Society, Atlanta, GA
| | - Trisha F Hue
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Frank M Perna
- Division of Cancer Control and Population Sciences, Behavioral Research Program, Health Behaviors Research Branch, National Cancer Institute, Rockville, MD
| | - Kathryn H Schmitz
- Public Health Science, Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA
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Muqtader A M, Fatima F, Khalid Anw M, F. Aldawsa M, A. Soliman G, H. Fayed M. Development and Characterization of Spray-dried Amorphous Solid Dispersion of Sildenafil: In vivo Evaluation. INT J PHARMACOL 2020. [DOI: 10.3923/ijp.2020.460.469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Balasubramanian A, Yu J, Breyer BN, Minkow R, Eisenberg ML. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists. J Sex Med 2020; 17:919-929. [PMID: 32156585 DOI: 10.1016/j.jsxm.2020.01.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/15/2020] [Accepted: 01/23/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bicycle riding's impact on erectile function remains a topic of great interest given cycling's popularity as a mode of transportation and exercise. AIM We evaluated risk factors for sexual dysfunction in male cyclists with the primary intention of determining if genital/pelvic pain and numbness are associated with erectile dysfunction (ED). METHODS We surveyed male cyclists using an online anonymous questionnaire. Cyclists were queried on their demographics, cycling experience, and sexual function using the Sexual Health Inventory for Men (SHIM). ED was diagnosed when a completed SHIM score was <22. Regression analysis was used to evaluate the risk of ED in men with genital/pelvic pain or numbness after riding. The survey was designed in the United States. OUTCOMES Quantitative characterization of cycling habits, onset and timing of genital pain and numbness, and SHIM score. RESULTS A total of 1635 participants completed the survey. A majority of men were over the age of 50 (58%, 934/1,607), Caucasian (88%, 1,437/1,635), had been active cyclists for over 10 years (63%, 1,025/1,635) and used road bikes (97%, 1,578/1,635). Overall, 22%, 30%, and 57% of men reported ED, genital pain, and genital numbness, respectively. While controlling for cohort demographics, body mass index, cycling intensity and equipment, and medical comorbidities, no saddle characteristics were associated with the risk of developing genital numbness. However, men reporting penile numbness were at higher risk of reporting ED (odds ratio [OR] = 1.453, P = .048). In addition, quicker onset of numbness and resolution of numbness within a day was associated with impaired erectile function. For example, numbness occurring less than 1 hour after cycling had greater odds of leading to ED than numbness after 5 hours (OR = 2.002, P = .032). Similarly, genital pain occurring less than 1 hour (OR = 2.466, P = .031) after cycling was associated with higher ED risk. STRENGTHS & LIMITATIONS Strengths include a large sample size of high-intensity cyclists and validated questionnaire use. Limitations include reliance on anonymous self-reported survey data and minimal inquiry into the riding preferences and terrain traversed by cyclists. CONCLUSIONS Pelvic pain and numbness are common complaints among male riders in the United States. Men with such complaints are more likely to also report ED especially if it occurs earlier in the ride. Although direction of causality and temporality are uncertain, alleviation of factors resulting in pelvic discomfort may reduce cycling's impact on sexual function. Such interventions are critical given that cycling for both active travel and aerobic exercise confers numerous health benefits. Balasubramanian A, Yu J, Breyer BN, et al. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists. J Sex Med 2020;17:919-929.
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Affiliation(s)
| | - Justin Yu
- Baylor College of Medicine, Houston, TX, USA
| | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | | | - Michael L Eisenberg
- Department of Urology, Stanford University, Stanford, CA, USA; Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
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Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study. J Sex Med 2020; 17:665-677. [PMID: 32089483 DOI: 10.1016/j.jsxm.2020.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/27/2019] [Accepted: 01/21/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Unhealthy lifestyle and aging negatively impact sexuality; consequently, the prevalence of sexual problems increases sharply in middle-aged adults, but the determinants of low sexual desire and sexual dysfunction are not fully elucidated. AIMS To investigate the association of cardiometabolic profile, free testosterone plasma levels, body composition, physical fitness, and S-Klotho plasma levels with sexual desire and sexual function in middle-aged sedentary adults. METHODS Seventy-four (39 women) sedentary middle-aged adults (45-65 years old) were recruited for the present cross-sectional study. OUTCOMES The blood samples were collected in the morning (12 h of fasting) to determine cardiometabolic biomarkers and free testosterone and S-Klotho plasma levels. The cardiometabolic risk score was calculated based on the International Diabetes Federation's clinical criteria, quantitative insulin sensitivity check index, and homeostatic model assessment of insulin resistance index. A dual-energy X-ray absorptiometry scanner was used to determine the lean mass index (LMI) and the fat mass index. Maximal oxygen uptake was determined by a maximum treadmill test using indirect calorimetry. Muscular strength was measured with knee extensor isokinetic dynamometry (60° s-1). Sexual desire was assessed with the Sexual Desire Inventory 2. Sexual function was assessed with the Massachusetts General Hospital-Sexual Functioning Questionnaire. RESULTS After age adjustment, free testosterone plasma levels were associated with solitary sexual desire in women (R2 = 0.193, β = 0.342, P = .044). The LMI was associated with solitary sexual desire in men (R2 = 0.258, β = 0.445, P = .024) and sexual function in women (R2 = 0.470, β = -0.607, P < .001). S-Klotho plasma levels were associated with solitary sexual desire and sexual function in men (R2 = 0.412, β = 0.817, P = .001; R2 = 0.193, β = -0.659, P = .021, respectively) and with dyadic sexual desire and sexual function in women (R2 = 0.270, β = 0.508, P = .020; R2 = 0.467, β = -0.676, P < .001, respectively). CLINICAL IMPLICATIONS S-Klotho plasma levels may represent a potential new biomarker for sexual desire and sexual function. Lean body mass development may benefit sexual desire and sexual function. STRENGTHS AND LIMITATIONS Strengths include the analysis of novel and diverse biomarkers of health for sexual desire and sexual function. Limitations include the cross-sectional design and a relatively small sample size; thus, results should be interpreted cautiously and in the study population context. CONCLUSION S-Klotho plasma levels were strongly associated with dyadic sexual desire, solitary sexual desire, and sexual function in sedentary middle-aged adults. The LMI was also positively associated with solitary sexual desire and sexual function in men and women, respectively. Dote-Montero M, De-la-O A, Castillo MJ, et al. Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study. J Sex Med 2020;17:665-677.
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Vear NK, Coombes JS, Bailey TG, Skinner TL. The Interplay between Vascular Function and Sexual Health in Prostate Cancer: The Potential Benefits of Exercise Training. Med Sci (Basel) 2020; 8:medsci8010011. [PMID: 32053955 PMCID: PMC7151583 DOI: 10.3390/medsci8010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer and its associated treatments can cause significant and lasting morbidities, such as cardiovascular and sexual dysfunctions. Various interventions have attempted to prevent or mitigate these dysfunctions. This review summarises the available evidence on the effects of exercise training on markers of cardiovascular disease (as assessed via vascular health outcomes) and sexual health in this prevalent cancer population. Current studies predominantly report blood pressure outcomes as a marker of vascular health, as well as various questionnaires assessing sexual health parameters, in men on active treatment (i.e., hormone or radiation therapies) or post-treatment. Preliminary evidence suggests that exercise interventions may elicit improvements in sexual function, but not blood pressure, in these populations. Future studies in more advanced and varied prostate cancer populations (i.e., those on chemotherapies or immunotherapies, or undergoing active surveillance) are required to ascertain the duration, intensity and frequency of exercise that optimises the effects of exercise training on cardiovascular and sexual dysfunctions (and their relationship) in men during and following treatment for prostate cancer.
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Kretchy IA, Boima V, Agyabeng K, Koduah A, Appiah B. Psycho-behavioural factors associated with medication adherence among male out-patients with hypertension in a Ghanaian hospital. PLoS One 2020; 15:e0227874. [PMID: 31995606 PMCID: PMC6988959 DOI: 10.1371/journal.pone.0227874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/01/2020] [Indexed: 11/18/2022] Open
Abstract
Medication adherence is a key health outcome that reflects the health and general well-being of patients with hypertension. Challenges with adherence are common and associated with clinical, behavioural and psychosocial factors. This study sought to provide data on the extent of medication adherence among male patients with hypertension and their biopsychosocial predictors. Patient and clinical characteristics, psychological distress, insomnia and sexual dysfunction were hypothesized to predict outcomes of medication adherence. Utilizing quantitative data from a hospital-based cross-sectional study from 358 male out-patients with hypertension attending a tertiary hospital in Ghana, medication adherence was associated with age, marital status, educational level, income, duration of diagnosis, number of medications taken and sexual dysfunction. These findings support the need for biopsychosocial interventions aiming at promoting adherence while taking these factors into consideration for the benefit of improving the health and general well-being of male patients with hypertension.
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Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Korle-Bu, Ghana
- * E-mail: ,
| | - Kofi Agyabeng
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bernard Appiah
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M Health Science Center, TAMU, College Station, Texas, United States of America
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