1
|
Andersen ML, Lavigne G, Dal Fabbro C, Tufik S. Erectile dysfunction and sleep related bruxism: An exploratory review of an improbable association. Sleep Med Rev 2024; 77:101970. [PMID: 38964237 DOI: 10.1016/j.smrv.2024.101970] [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: 12/28/2023] [Revised: 04/26/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
The World Health Organization recognizes sexual health as not merely the absence of disease, but a state of physical, mental, and social well-being in relation to one's sexuality. Achieving sexual satisfaction is pivotal for many individuals, as it significantly contributes to their quality of life. Among various sexual disorders, erectile dysfunction (ED) is notably prevalent, affecting an estimated 10-20 million men in the United States alone. This condition impacts not just the person experiencing it but also significantly influences their intimate connections with partners. Although the causes of ED are multifactorial, recent research highlights a compelling association between sleep disorders, such as sleep deprivation, obstructive sleep apnea (OSA), and insomnia, and the incidence of ED. Furthermore, engaging in night work has been observed to exacerbate the risk of developing ED. One common sleep disorder, sleep related bruxism (SRB), despite its prevalence, has not generally been associated with ED. However, there is some interesting evidence hinting at a potential relationship, including a few studies reporting a high prevalence of ED in individuals with SRB. This review delves into the epidemiological, etiological, and mechanistic links between ED and SRB, aiming to uncover potential intersections between these two conditions. These insights could pave the way for innovative research avenues, possibly exploring treatments like vasodilation medication, that might concurrently address both ED and SRB.
Collapse
Affiliation(s)
- Monica Levy Andersen
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil.
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Cibele Dal Fabbro
- Sleep Institute - São Paulo, Brazil; Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Sergio Tufik
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil
| |
Collapse
|
2
|
Mesfin T, Tekalegn Y, Adem A, Seyoum K, Geta G, Sahiledengle B, Mesfin E, Zenbaba D, Desta F, Beressa G, Tsegaye M, Ejigu N, Gomora D. Magnitude of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia: hospital-based cross-sectional study. BMC Endocr Disord 2023; 23:236. [PMID: 37880632 PMCID: PMC10601257 DOI: 10.1186/s12902-023-01489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
PURPOSE Erectile dysfunction is defined as the inability to achieve and/or maintain an erection of sufficient rigidity and duration to permit satisfactory sexual performance. The purpose of this study is to assess the prevalence of erectile dysfunction and associated factors among adult diabetic men on follow-up at Goba and Robe hospitals, Bale Zone, South East Ethiopia,2022. METHODS Hospital-based cross-sectional study design was used among 420 adult diabetic men from March 1 to April 30 using a systematic random sampling technique. An international index of erectile function questionnaire containing five questions was used to assess the outcome variable. The data were entered, edited, and coded using Epidata version 4.6 and analyzed using SPSS version 26. Bivariable and multivariable binary logistic regression analysis were performed to identify factors associated with erectile dysfunction. Adjusted odds ratios with their corresponding 95% confidence interval were computed to estimate the strength of association. Statistical significance was declared at p-value < 0.05. RESULTS The prevalence of erectile dysfunction was found to be 354 (84.3%). Multivariable logistic regression revealed that erectile dysfunction is significantly associated with old age (AOR = 12.39, 95% CI:5.10-30.08), inadequate physical activity (AOR = 4.15, 95% CI:1.33-12.97), and being rich (AOR = 2.62, 95% CI = 1.21-5.66). CONCLUSION The prevalence of erectile dysfunction in this study population is nearly nine out of ten. Age, inadequate physical activity, and wealth index were independent predictors of erectile dysfunction. Assessment and management of erectile dysfunction in diabetic clinics should be routine medical care.
Collapse
Affiliation(s)
- Telila Mesfin
- Department of Medicine, School of Health Sciences, Madda Walabu University, Goba, Ethiopia.
| | - Yohannes Tekalegn
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Ahmednur Adem
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Kenbon Seyoum
- Department of Midwifery, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Girma Geta
- Department of Midwifery, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Eshetu Mesfin
- Department of Public Health, ICAP, Addis Ababa, Ethiopia
| | - Demisu Zenbaba
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Mesfin Tsegaye
- Department of Medicine, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Neway Ejigu
- Department of Midwifery, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| | - Degefa Gomora
- Department of Midwifery, School of Health Sciences, Madda Walabu University, Goba, Ethiopia
| |
Collapse
|
3
|
Ueoka A, Sung YL, Liu X, Rosenberg C, Chen Z, Everett TH, Rubart M, Tisdale JE, Chen PS. Testosterone does not shorten action potential duration in Langendorff-perfused rabbit ventricles. Heart Rhythm 2022; 19:1864-1871. [PMID: 35716858 PMCID: PMC10081443 DOI: 10.1016/j.hrthm.2022.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Women have longer baseline QT intervals than men. Because previous studies showed that testosterone and 5α-dihydrotestosterone shorten the ventricular action potential duration (APD) in animal models, differential testosterone concentrations may account for the sex differences in QT interval. OBJECTIVE The purpose of this study was to test the hypothesis that testosterone shortens the APD in Langendorff-perfused rabbit ventricles. METHODS We performed optical mapping studies in hearts with or without testosterone administration. Acute studies included 26 hearts using 2 different protocols, including 17 without and 9 with atrioventricular (AV) block. For chronic studies, we implanted testosterone pellets subcutaneously in 7 female rabbits for 2-3 weeks before optical mapping studies during complete AV block. Six rabbits without pellet implantation served as controls. RESULTS The hearts in the acute studies were paced with a pacing cycle length (PCL) of 200-300 ms and mapped at baseline and after administration of 1 nM, 10 nM, 100 nM, and 3 μM of testosterone. There was no shortening of APD80 at any PCL. Instead, a lengthening of APD80 was noted at higher concentrations. There were no sex differences in testosterone responses. In chronic studies, heart rates were 136 ± 5 bpm before and 148 ± 9 bpm after (P = .10) while QTc intervals were 314 ± 9 ms before and 317 ± 99 ms after (P = .69) testosterone pellet implantation, respectively. Overall, ventricular APD80 in the pellet group was longer than in the control group at 300- to 700-ms PCL. CONCLUSION Testosterone does not shorten ventricular repolarization in rabbit hearts.
Collapse
Affiliation(s)
- Akira Ueoka
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yen-Ling Sung
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Xiao Liu
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carine Rosenberg
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zhenhui Chen
- The Krannert Cardiovascular Research Center and Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Thomas H Everett
- The Krannert Cardiovascular Research Center and Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael Rubart
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - James E Tisdale
- College of Pharmacy, Purdue University, Indianapolis, Indiana; Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Peng-Sheng Chen
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
| |
Collapse
|
4
|
García-Sánchez J, Mafla-España MA, Tejedor-Cabrera C, Avellán-Castillo O, Torregrosa MD, Cauli O. Plasma Aromatase Activity Index, Gonadotropins and Estrone Are Associated with Frailty Syndrome in Post-Menopausal Women with Breast Cancer. Curr Oncol 2022; 29:1744-1760. [PMID: 35323344 PMCID: PMC8947022 DOI: 10.3390/curroncol29030144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 01/04/2023] Open
Abstract
Frailty syndrome is associated with poor outcomes, morbidity and premature mortality. We performed a cross-sectional study to evaluate the presence of frailty syndrome based on Fried’s frailty phenotype in post-menopausal women with breast cancer. We further analyzed the association between frailty syndrome with geriatric assessments and the association with the concentration of gonadotropins LH and FSH, estrogens, androgens and the aromatase activity index in the blood. We enrolled 47 post-menopausal women with localized breast cancer (mean age 66.8 ± 1.3 years (range 52−83)) prior to the starting of adjuvant endocrine therapy. Patients were identified as “non-frail” (robust) or “prefrail/frail” if they fulfilled at least one frailty criteria. In order to determine associations among variables and to control for other variables potentially affecting frailty syndrome (age, comorbidity index and previous chemotherapy treatment), we performed a logistic regression analysis. The receiver operating characteristic curve was performed to assess the sensitivity and specificity of the hormonal concentration to discriminate prefrail/frail versus non-frail individuals. Significant positive associations were observed between the severity of frailty syndrome and estrone, FSH and LH concentrations and the aromatase activity index in the blood (p < 0.05). Further research into the role of hormonal biomarkers should be evaluated in follow-up studies in order to recommend their use as suitable biomarkers of frailty syndrome in breast cancer patients.
Collapse
Affiliation(s)
- Javier García-Sánchez
- Medical Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (J.G.-S.); (M.D.T.)
- Medical Oncology Department, Hospital Center of Wallonie Picardy, 7500 Tournai, Belgium
| | - Mayra Alejandra Mafla-España
- Frailty Research Organized Group, University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - Carlos Tejedor-Cabrera
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - Olga Avellán-Castillo
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - María Dolores Torregrosa
- Medical Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (J.G.-S.); (M.D.T.)
| | - Omar Cauli
- Frailty Research Organized Group, University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
- Correspondence:
| |
Collapse
|
5
|
Batzu L, Titova N, Bhattacharyya KB, Chaudhuri KR. The pathophysiology of sexual dysfunction in Parkinson's disease: An overview. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:21-34. [PMID: 35397787 DOI: 10.1016/bs.irn.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual dysfunction is a common, poorly recognized, poorly discussed (often because of cultural perceptions and sensitivities), bothersome and neglected aspect of the range of non-motor symptoms of Parkinson's disease (PD). The spectrum of sexual dysfunction in PD ranges from hyposexuality-based disturbances to hypersexuality-dominated behaviors in the context of drug-induced impulse control disorder. The pathophysiological mechanisms underlying PD-related sexual dysfunction, specifically for hyposexual disorders, are thus heterogeneous and still not fully understood. However, central and peripheral neural mechanisms secondary to the hallmark pathological alterations of the disease (alpha-synuclein deposition and nigrostriatal degeneration) and to the associated network and neurotransmitter dysfunctions, together with the effects of dopaminergic therapies, seem to play an important role in the development of sexual disturbances. In this chapter, we therefore review the neuroanatomical and neurophysiological basis of sexual function in humans, and we provide insights on the pathophysiological mechanisms of hyposexuality and hypersexuality in PD.
Collapse
Affiliation(s)
- Lucia Batzu
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Nataliya Titova
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation, Moscow, Russia; Department of Neurodegenerative Diseases, Federal State Budgetary Institution 'Federal Center of Brain and Neurotechnologies' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - K Ray Chaudhuri
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.
| |
Collapse
|
6
|
Loughlin KR. Sexual Dysfunction: Continuing the Pursuit of a Horizontal Desire. Urol Clin North Am 2021; 48:xiii-xiv. [PMID: 34602181 DOI: 10.1016/j.ucl.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kevin R Loughlin
- Vascular Biology Research Program at Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
| |
Collapse
|
7
|
Aggarwal V, Menon AS, Verma V. Prevalence of Testosterone Deficiency in Elderly Male and its Association with Frailty and Mobility at a Tertiary Care Centre. Indian J Endocrinol Metab 2021; 25:337-341. [PMID: 35136742 PMCID: PMC8793956 DOI: 10.4103/ijem.ijem_289_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/17/2021] [Accepted: 09/08/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Several cross-sectional and prospective longitudinal studies have shown a progressive decline in Serum (S) Testosterone levels with an increase in age. The clinical consequence of this decline in S Testosterone is not clear from the prevailing data. Several ageing features like decreased libido, Osteo-sarcopenia, anemia, and depressed mood may be associated with reduced androgen levels in elderly males. This study was aimed to study the prevalence of androgen deficiency in elderly males more than 60 years of age presenting to the outpatient department of a tertiary care hospital and its association with frailty and mobility. METHODS A cross-sectional observational study was conducted over two years at a tertiary care hospital in Pune, India. The participants underwent a detailed history and physical examination. Biochemical tests and S total testosterone estimation was done. Mobility was estimated by calculating the time taken to perform the Timed Up and Go test (TUGT). Frailty was calculated by Fried's frailty index. Data are presented as mean ± standard deviation, and a comparison between the groups was made using Mann-Whitney U-test. The categorical variables are presented in frequencies along with respective percentages and were compared using the Chi-square or Fisher's exact test. The data was analyzed using SPSS version 22. A P <.05 was considered statistically significant in all the tests. RESULTS The mean age of the study participants was 68.37 ± 6.3 years, with a range of 60-88 years. The mean S total testosterone levels were 3.95 ± 2.06 ng/ml with a range of 0.04-25.36 ng/ml. As per the study definition, Ninety-two (21.67%) participants had testosterone deficiency. Three hundred and thirty-three (78.5%) participants had impaired motility represented by a TUGT time of more than 12 seconds. The Frailty index calculated revealed 94 (22.2%) of the study participants to be normal, 263 (62%) to be vulnerable, and 67 (15.8%) of the patients to be frail. CONCLUSION The prevalence of testosterone deficiency in the elderly male population was 21.67%. However, there was no association of testosterone deficiency with frailty or impaired mobility. Furthermore, testosterone deficiency was not associated with BMI and hemoglobin levels. In the elderly, testosterone deficiency is associated with low bone mass and therefore imply an increased risk of osteoporotic fractures.
Collapse
Affiliation(s)
- Vivek Aggarwal
- Department of Geriatric Medicine, Armed Forces Medical College Sholapur Road, Pune, Maharashtra, India
| | - Anil S. Menon
- Internal Medicine and Endocrinologist, Armed Forces Medical College Sholapur Road, Pune, Maharashtra, India
| | - Vishesh Verma
- Internal Medicine and Endocrinologist, Armed Forces Medical College Sholapur Road, Pune, Maharashtra, India
| |
Collapse
|
8
|
Ismail L, Materwala H, Al Kaabi J. Association of risk factors with type 2 diabetes: A systematic review. Comput Struct Biotechnol J 2021; 19:1759-1785. [PMID: 33897980 PMCID: PMC8050730 DOI: 10.1016/j.csbj.2021.03.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 12/14/2022] Open
Abstract
Diabetes is the leading cause of severe health complications and one of the top 10 causes of death worldwide. To date, diabetes has no cure, and therefore, it is necessary to take precautionary measures to avoid its occurrence. The main aim of this systematic review is to identify the majority of the risk factors for the incidence/prevalence of type 2 diabetes mellitus on one hand, and to give a critical analysis of the cohort/cross-sectional studies which examine the impact of the association of risk factors on diabetes. Consequently, we provide insights on risk factors whose interactions are major players in developing diabetes. We conclude with recommendations to allied health professionals, individuals and government institutions to support better diagnosis and prognosis of the disease.
Collapse
Affiliation(s)
- Leila Ismail
- Intelligent Distributed Computing and Systems Research Laboratory, Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, Abu Dhabi, 15551, United Arab Emirates
| | - Huned Materwala
- Intelligent Distributed Computing and Systems Research Laboratory, Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain, Abu Dhabi, 15551, United Arab Emirates
| | - Juma Al Kaabi
- College of Medicine and Health Sciences, Department of Internal Medicine, United Arab Emirates University, Al Ain, Abu Dhabi 15551, United Arab Emirates
- Mediclinic, Al Ain, Abu Dhabi, United Arab Emirates
| |
Collapse
|
9
|
Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, Lopes Dos Santos Lobato B, da Silva Pedroso J, de Tubino Scanavino M. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021; 9:100280. [PMID: 33429240 PMCID: PMC7930860 DOI: 10.1016/j.esxm.2020.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/11/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Sexual disorders are the most neglected nonmotor symptoms in Parkinson's disease (PD). Although doctors seek greater priority to motor manifestations, which are the basis for the diagnosis of PD, the nonmotor symptoms deserve to be highlighted as much as the motor problems because of their strong presence and discomfort in the patients, causing the important impairment in the quality of life (QoL) of the individual with PD. Aim Provide the prevalence of sexual disorders among patients with PD and alert the medical profession to investigate and be familiar with problems related to QoL and sexual disorders in PD. Methods This is a large literature review on sexual disorders in PD and impaired QoL. Main Outcome Measures Sexual disorders in PD and prevalence between genders have been described in epidemiological studies. Neuroanatomy, pathophysiology, risk factors, QoL, and etiologies were reviewed. Results The estimate of the prevalence of sexual dysfunction in the form of compulsive sexual behavior in PD is higher in men by 5.2% than in women by 0.5%. This diagnosis is a determinant of intense and persistent suffering and is related to several health problems of a social, economic, personal, family, psychological, and occupational nature, which can even culminate in sexual abuse. It is most commonly associated with the use of drugs commonly used in PD therapy in 98.1% of cases. In addition to this serious public health problem, another common condition of sexual dysfunction occur with the decreased libido by loss of the neurotransmitter dopamine proper of the pathophysiology of PD. Conclusion The presence of sexual disorders in PD should be tracked and monitored because of its harmful consequences, whether due to increased sexual behavior or associated psychological distress, as well as the impacts on QoL. Early recognition and adequate treatment of PD in its fullness and richness of associated symptoms are essential for improving QoL. Santa Rosa Malcher CM, Roberto da Silva Gonçalves Oliveira K, Fernandes Caldato MC, et al. Sexual Disorders and Quality of Life in Parkinson's Disease. Sex Med 2021;9:100280.
Collapse
|
10
|
Cannarella R, Condorelli RA, Barbagallo F, La Vignera S, Calogero AE. Endocrinology of the Aging Prostate: Current Concepts. Front Endocrinol (Lausanne) 2021; 12:554078. [PMID: 33692752 PMCID: PMC7939072 DOI: 10.3389/fendo.2021.554078] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 01/05/2021] [Indexed: 12/11/2022] Open
Abstract
Benign prostate hyperplasia (BPH), one of the most common diseases in older men, adversely affects quality-of-life due to the presence of low urinary tract symptoms (LUTS). Numerous data support the presence of an association between BPH-related LUTS (BPH-LUTS) and metabolic syndrome (MetS). Whether hormonal changes occurring in MetS play a role in the pathogenesis of BPH-LUTS is a debated issue. Therefore, this article aimed to systematically review the impact of hormonal changes that occur during aging on the prostate, including the role of sex hormones, insulin-like growth factor 1, thyroid hormones, and insulin. The possible explanatory mechanisms of the association between BPH-LUTS and MetS are also discussed. In particular, the presence of a male polycystic ovarian syndrome (PCOS)-equivalent may represent a possible hypothesis to support this link. Male PCOS-equivalent has been defined as an endocrine syndrome with a metabolic background, which predisposes to the development of type II diabetes mellitus, cardiovascular diseases, prostate cancer, BPH and prostatitis in old age. Its early identification would help prevent the onset of these long-term complications.
Collapse
|
11
|
Lee KW, Bae SR, Jeong HC, Choi JB, Choi SW, Bae WJ, Kim SJ, Cho HJ, Ha US, Hong SH, Kim SW. A randomized, controlled study of treatment with ojayeonjonghwan for patients with late onset hypogonadism. Aging Male 2020; 23:264-271. [PMID: 30039982 DOI: 10.1080/13685538.2018.1480599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Objectives: We investigate the effects of Ojayeonjonghwan (KH-204) in men with late-onset hypogonadism (LOH) symptoms.Material and methods: Initial PSA, testosterone, lipid profile and questionnaires about LOH-related symptoms were checked. After 8 weeks of the treatment (control or KH-204), questionnaires and serological tests were repeated to evaluate the efficacy of the agent. The changes of variables in each group and the difference between two groups were compared.Results: A total of 78 men were enrolled, and randomly assigned to the control group (n = 39) or KH-204 group (n = 39). Baseline characteristics of both group are comparable. AMS total score of control and KH-204 group were both improved at 8 weeks (p = .010, <.001), and there was a statistically significant difference between the two groups (favorable in KH-204 group, p = .006). At 8 weeks, total IIEF score of control and KH-204 group were both improved, and there was no statistically significant difference in the degree of improvement between the two groups (p = .303). There was no statistically significant difference of laboratory findings, in intra-group changes and inter-group comparisons.Conclusions: KH-204 was found to be effective in all LOH symptoms without changing of laboratory results. KH-204 may be safely used for treatment of male with LOH-related symptoms.
Collapse
Affiliation(s)
- Kyu Won Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Rak Bae
- Department of Urology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Cheol Jeong
- Department of Urology, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University of Korea, Seoul, Republic of Korea
| | - Jin Bong Choi
- Department of Urology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae Woong Choi
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woong Jin Bae
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su Jin Kim
- Department of Urology, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Hyuk Jin Cho
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sae Woong Kim
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
12
|
Zhou SJ, Zhao MJ, Yang YH, Guan D, Li ZG, Ji YD, Zhang BL, Shang X, Xiong C, Gu YQ. The Epidemiological Characteristics of Late-Onset Hypogonadism in Chinese Middle-Aged and Elderly Men: Two Cross-Sectional Studies in the Same Community. Am J Mens Health 2020; 14:1557988320977991. [PMID: 33305661 PMCID: PMC7734522 DOI: 10.1177/1557988320977991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/07/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to investigate the prevalence and epidemiological characteristics of late-onset hypogonadism (LOH) in middle-aged and elderly Chinese men. Two cross-sectional studies were conducted at 5-year intervals in community-dwelling men living in the same area. A total of 1472 (Study 1, S1) and 944 (Study 2, S2) men aged 40-69 years old were recruited as subjects. Subjects were evaluated through combining serum reproductive hormone levels with the Androgen Deficiency in Aging Males (ADAM) questionnaire and the Aging Males' Symptoms (AMS) scale. A significant difference was found in mean testosterone deficiency (TD) prevalence between S1 and S2, using either serum total testosterone (TT; 14.02% vs. 6.36%) or serum calculated free testosterone (cFT; 43.69% vs. 16.53%) cutoff values. According to the S1 or S2 data, the mean prevalence of LOH was 37.85%/15.47% in the positive ADAM test and 15.42%/9.43% in the positive AMS test (p < .01). According to classifications of TD based on gonadal status, the prevalence of secondary TD (27.34%) was higher than the primary (16.36%) and compensated (15.42%) TD in S1 (p < .01). However, there were significant differences among the prevalence of primary (6.89%), secondary (9.64%), and compensated (27.65%) TD in S2 (p < .05). Different types of testosterone levels, TD cutoff values, and questionnaires influenced the prevalence of TD and LOH. The serum FT cutoff value was an optimal threshold for evaluating and diagnosing TD and LOH, whose prevalence increased gradually with male aging.
Collapse
Affiliation(s)
- Shan-Jie Zhou
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Peking University International Hospital, Beijing, China
| | - Ming-Jia Zhao
- Department of Reproduction and Genetics, Tangshan Maternity and Child Health Care Hospital, Tangshan, China
| | - Yi-Hong Yang
- Reproductive Medicine Centre, Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Di Guan
- Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhi-Guang Li
- Department of Internal Medicine-Neurology, General Hospital of Jizhong Energy Xingtai Mining Group Co. Ltd., Xingtai, China
| | - Yu-Dang Ji
- Department of Andrology, Fucheng Technical Service Center of Family Planning, Hengshui, China
| | - Bao-Long Zhang
- Department of Andrology, Fucheng Technical Service Center of Family Planning, Hengshui, China
| | - Xue‑Jun Shang
- Department of Andrology, Nanjing General Hospital of Nanjing Command, PLA, Nanjing, China
| | - Cheng‑Liang Xiong
- Family Planning Research Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi-Qun Gu
- National Health and Family Planning Key Laboratory of Male Reproductive Health, Department of Male Clinical Research, National Research Institute for Family Planning, Beijing, China
| |
Collapse
|
13
|
Cannarella R, Barbagallo F, Condorelli RA, Aversa A, La Vignera S, Calogero AE. Osteoporosis from an Endocrine Perspective: The Role of Hormonal Changes in the Elderly. J Clin Med 2019; 8:jcm8101564. [PMID: 31581477 PMCID: PMC6832998 DOI: 10.3390/jcm8101564] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/09/2019] [Accepted: 09/25/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction: Osteoporosis is increasingly prevalent in the elderly, with fractures mostly occurring in women and men who are older than 55 and 65 years of age, respectively. The aim of this review was to examine the evidence regarding the influence of hormones on bone metabolism, followed by clinical data of hormonal changes in the elderly, in the attempt to provide possible poorly explored diagnostic and therapeutic candidate targets for the management of primary osteoporosis in the aging population. Material and methods: An extensive Medline search using PubMed, Embase, and Cochrane Library was performed. Results: While the rise in Thyroid-stimulating hormone (TSH) levels has a protective role on bone mass, the decline of estrogen, testosterone, Insulin-like growth factor 1 (IGF1), and vitamin D and the rise of cortisol, parathyroid hormone, and follicle-stimulating hormone (FSH) favor bone loss in the elderly. Particularly, the AA rs6166 FSH receptor (FSHR) genotype, encoding for a more sensitive FSHR than that encoded by the GG one, is associated with low total body mass density (BMD), independently of circulating estrogen. A polyclonal antibody with a FSHR-binding sequence against the β-subunit of murine FSH seems to be effective in ameliorating bone loss in ovariectomized mice. Conclusions: A complete hormonal assessment should be completed for both women and men during bone loss evaluation. Novel possible diagnostic and therapeutic tools might be developed for the management of male and female osteoporosis.
Collapse
Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| |
Collapse
|
14
|
Mota RL, Fonseca R, Santos JC, Covita AM, Marques N, Matias P, Simões H, Ramos C, Machado D, Cardoso J. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019; 16:1018-1028. [PMID: 31010779 DOI: 10.1016/j.jsxm.2019.03.266] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/10/2019] [Accepted: 03/20/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION 10% of the world's population suffers from chronic kidney disease. Kidney transplants provide an improvement in the quality of life of those patients. Sexual dysfunction is common after kidney transplantation, and its etiology is presumed to be multifactorial. It has a negative impact on sexual satisfaction and health-related quality-of-life. The integration of a new organ into the body can imply an adjustment of body image, which may eventually have a negative influence on intimacy and sexual behaviors. AIM To evaluate male sexual function, sexual satisfaction, and body image satisfaction among a convenience sample of patients who have had a kidney transplant. METHODS This is a cross-sectional study that included 460 patients, from a single healthcare center, who had undergone a kidney transplant procedure >4 weeks ago. A total of 112 respondents (mean = 55.5 years, SD = 11.4) answered the questionnaires properly. MAIN OUTCOME MEASURES All recruited patients answered a self-reported sociodemographic questionnaire, in addition to the International Index of Erectile function, the New Scale of Sexual Satisfaction, the Brief Symptom Inventory, and the Body Image Scale. RESULTS A correlation was found between sexual function and sexual satisfaction (r = 0.598, P < .001, n = 112), as well as between body image satisfaction and sexual function (r = -0.193, P = .042, n = 112). The length of time after a kidney transplant (≤ or >36 months) was not associated with a difference in sexual functioning or sexual satisfaction. CLINICAL IMPLICATIONS This study showed the obvious implications of sexual function on sexual satisfaction, which should alert healthcare professionals to the importance of identifying and managing sexual dysfunction in patients with chronic kidney disease, to optimize their global and sexual health satisfaction. STRENGTH & LIMITATIONS This study identified a high prevalence of sexual dysfunction among kidney transplant recipients. This should reinforce the need for the medical community to evaluate the quality-of-life domains of patients with chronic disease. There is still a lack of information concerning any longitudinal evaluation of kidney transplant patients' sexual function and the effects that this surgery has on sexuality. CONCLUSIONS This study corroborated the severe effects that kidney transplant patients often report regarding their sexuality. Among the patients who participated in the study, sexual function proved to be relevant in relation to sexual satisfaction. Mota RL, Fonseca R, Santos JC, et al. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019;16:1018-1028.
Collapse
Affiliation(s)
- Renato Lains Mota
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal.
| | - Rita Fonseca
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | - José Carlos Santos
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | - Ana Mateus Covita
- Urology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Lisbon, Portugal
| | | | - Patricia Matias
- Nephrology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Carnaxide, Portugal
| | - Hélder Simões
- Endocrinology Department at Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
| | - Catarina Ramos
- Instituto Universitário Egas Moniz, ISPA- Instituto Universitário; ISPA - Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Domingos Machado
- Nephrology Department at Centro Hospitalar de Lisboa Ocidental, EPE, Carnaxide, Portugal
| | - Jorge Cardoso
- Instituto Universitário Egas Moniz, ISPA- Instituto Universitário; ISPA - Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| |
Collapse
|
15
|
Nagy MW, Gruber S, McConnell M. Implementation of a Pilot Pharmacist Testosterone Therapy Management Service. J Pharm Pract 2019; 33:654-660. [PMID: 30791810 DOI: 10.1177/0897190019830251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Recent literature findings suggest that opportunities exist to optimize testosterone replacement therapy management. OBJECTIVE To evaluate the impact of a pilot clinical pharmacist testosterone therapy management service in a Veterans Affairs primary care setting. METHODS A 6-month, single-clinic, prospective cohort quality improvement project included male patients with an active prescription for testosterone. Patients were excluded if they switched primary care providers or were managed by a specialty clinic. After diagnosis, primary care providers had the option of referring patients for clinical pharmacist testosterone replacement therapy management. The project investigated the impact of pharmacist management on adherence to guideline-defined baseline and therapeutic monitoring, prior authorization workload, time saved by primary care providers, and clinical pharmacist interventions. RESULTS Sixty patients split between pharmacist management (N = 35) and nonpharmacist management (N = 25) cohorts. Monitoring of baseline parameters was significantly improved with clinical pharmacist management (54% vs 20%, P = 0.0006). Improved baseline monitoring decreased prior authorization team workload as requests were approved on the first submission at a higher rate (100% vs 75.4%, P = 0.06). Pharmacist management increased therapeutic monitoring for assessing symptom improvement (96% vs 26%, P < 0.001), monitoring of testosterone levels (96% vs 61%, P = 0.003), and safety monitoring with complete blood counts (100% vs 83%, P = 0.04). A total of 42 pharmacist-patient encounters saved over 600 minutes of primary care provider time. CONCLUSION Clinical pharmacist involvement enhances therapeutic monitoring for male hypogonadism leaving room for expansion of clinical pharmacy services within testosterone replacement therapy management.
Collapse
Affiliation(s)
- Michael W Nagy
- William S. Middleton Memorial Veteran Affairs Hospital, Madison, WI, USA.,Clinical Sciences Department, Medical College of Wisconsin School of Pharmacy, Milwaukee, WI, USA
| | - Stephanie Gruber
- William S. Middleton Memorial Veteran Affairs Hospital, Madison, WI, USA.,15533University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| | - Macy McConnell
- William S. Middleton Memorial Veteran Affairs Hospital, Madison, WI, USA.,15533University of Wisconsin-Madison School of Pharmacy, Madison, WI, USA
| |
Collapse
|
16
|
Park K, Chung HS. Sexual health and sexual activity in the elderly. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2019. [DOI: 10.5124/jkma.2019.62.6.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Advance Institute of Aging Science, Chonnam National Unviersity, Gwangju, Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- Advance Institute of Aging Science, Chonnam National Unviersity, Gwangju, Korea
| |
Collapse
|
17
|
Male Sexual Dysfunction and Hypogonadism Guidelines for the Aging Male. Eur Urol Focus 2018; 3:514-516. [PMID: 29331623 DOI: 10.1016/j.euf.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/04/2017] [Indexed: 12/21/2022]
Abstract
Cognitive and somatiform changes occur with ageing and are often attributed to late-onset hypogonadism. Testosterone replacement in older men remains controversial despite increasing evidence of symptomatic and clinical benefit in relation to improvements in sexual dysfunction, muscle mass, and diabetic control. The controversial areas related to cardiovascular safety and risk of prostate cancer need to be considered.
Collapse
|
18
|
Ozcan L, Polat EC, Kocaaslan R, Onen E, Otunctemur A, Ozbek E. Effects of taking tadalafil 5 mg once daily on erectile function and total testosterone levels in patients with metabolic syndrome. Andrologia 2017; 49. [PMID: 28295481 DOI: 10.1111/and.12751] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2016] [Indexed: 01/14/2023] Open
Abstract
We aimed to evaluate the efficacy of tadalafil 5 mg once-daily treatment on testosterone levels in patients with erectile dysfunction (ED) accompanied by the metabolic syndrome. A total of 40 men with metabolic syndrome were evaluated for ED in this study. All the patients received 5 mg tadalafil once a day for 3 months. Erectile function was assessed using the five-item version of the International Index of Erectile Function (IIEF) questionnaire. Serum testosterone, follicle-stimulating hormone and luteinising hormone levels were also evaluated, and blood samples were taken between 08.00 and 10.00 in the fasting state. All participants have three or more criteria of metabolic syndrome. At the end of 3 months, mean testosterone values and IIEF scores showed an improvement from baseline values (from 3.6 ± 0.5 to 5.2 ± 0.3, from 11.3 ± 1.9 to 19 ± 0.8 respectively). After the treatment, serum LH levels were decreased (from 5.6 ± 0.6 to 4.6 ± 0.5). There was significantly difference in terms of baseline testosterone and luteinising hormone values and IIEF scores (p < .05). Based on our findings, we recommend tadalafil 5 mg once daily in those men with erectile dysfunction especially low testosterone levels accompanied by metabolic syndrome.
Collapse
Affiliation(s)
- L Ozcan
- Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - E C Polat
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - R Kocaaslan
- Department of Urology, Medical Faculty, Kafkas University, Kars, Turkey
| | - E Onen
- Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - A Otunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - E Ozbek
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
19
|
Kałka D, Karpiński Ł, Gebala J, Rusiecki L, Biełous-Wilk A, Krauz ES, Piłot M, Womperski K, Rusiecka M, Pilecki W. Sexual health of male cardiac patients - present status and expectations of patients with coronary heart disease. Arch Med Sci 2017; 13:302-310. [PMID: 28261282 PMCID: PMC5332461 DOI: 10.5114/aoms.2017.65332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/17/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. MATERIAL AND METHODS One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. RESULTS Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level (p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). CONCLUSIONS The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life.
Collapse
Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
- Center of Men’s Health, Wroclaw, Poland
| | - Łukasz Karpiński
- Center of Men’s Health, Wroclaw, Poland
- Center of Cardiac Prevention and Rehabilitation CREATOR, Wroclaw, Poland
| | | | - Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Biełous-Wilk
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Ewa S. Krauz
- Department of Cardiac Rehabilitation, Lower Silesian Heart Diseases Centre “Medinet”, Wroclaw, Poland
| | - Magdalena Piłot
- Department of Cardiac Rehabilitation, Centre of Cardiac Rehabilitation and Cardiac Prevention, Glucholazy, Poland
| | - Krzysztof Womperski
- Department of Cardiac Rehabilitation, Hospital of the Ministry of Interior, Glucholazy, Poland
| | - Małgorzata Rusiecka
- Department of Oncology and Gynaecologic Oncology, Medical University of Wroclaw, Wroclaw, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| |
Collapse
|
20
|
The Utility of Sex Hormone-Binding Globulin in Hypogonadism and Infertile Males. J Urol 2017; 197:1326-1331. [PMID: 28087298 DOI: 10.1016/j.juro.2017.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE We sought to determine the role of sex hormone-binding globulin in patients with male infertility. MATERIALS AND METHODS We retrospectively reviewed the records of 168 males seen at a fertility clinic from 2012 to 2014 to investigate the accuracy of total testosterone in the biochemical diagnosis of hypogonadism using calculated bioavailable testosterone as the reference value. We used multivariable analysis to assess sex hormone-binding globulin as an independent predictor of infertility. RESULTS Computations using calculated bioavailable testosterone as a standard in the measurement of definitive biochemical hypogonadism (less than 156 ng/dl) revealed 81% sensitivity, 83% specificity, 81% positive predictive value and 82% negative predictive value for diagnosing hypogonadism with total testosterone alone. Of the 90 men with total testosterone greater than 300 ng/dl, 20% had low bioavailable testosterone less than 156 ng/dl, 52% had borderline low bioavailable testosterone less than 210 ng/dl and only 48% could be considered biochemically eugonadal according to calculated bioavailable testosterone. Of the 80 patients with total testosterone less than 300 ng/dl, 19% had free testosterone levels greater than 6.5 ng/dl and, thus, could be considered to be eugonadal. By a magnitude similar to that of follicle-stimulating hormone, sex hormone-binding globulin independently predicted decreased sperm concentration (p = 0.0027) and motility (p = 0.0447). After excluding men with azoospermia, only sex hormone-binding globulin levels differed significantly in classically hypogonadal men (group 1-total testosterone less than 300 ng/dl) and those missed but hypogonadal (group 2-calculated bioavailable testosterone less than 210 ng/dl) (p = 0.0001). At a more stringent cutoff of calculated bioavailable testosterone less than 156 ng/dl, sperm motility was significantly different for groups 1 and 2 (p = 0.014). CONCLUSIONS Adding sex hormone-binding globulin to total testosterone serum testing facilitates more accurate diagnosis with free testosterone and calculated bioavailable testosterone, and clinical implications of decreased semen parameters to a magnitude similar to that of follicle-stimulating hormone. This warrants further study of the role of sex hormone-binding globulin in male infertility.
Collapse
|
21
|
Jaworski PED, Ramos A, Nicoleit AR, Bacarin LFDA, Olivo P. Importance of abdominal circumference and body mass index values in predicting male hypogonadism - A practical approach. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:76-80. [PMID: 27598980 PMCID: PMC10522126 DOI: 10.1590/2359-3997000000203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/25/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to correlate the values of abdominal circumference (AC) and body mass index (BMI) with the levels of total testosterone (TT), free testosterone (FT) and sexual hormone binding globulin (SHBG). We aimed to analyze the association between the anthropometric values and variations in the hormonal levels. SUBJECTS AND METHODS A transversal prospective study was conducted. A total of 159 patients were included in the study. RESULTS BMI was inversely correlated with TT and SHBG (p = 0.02 and p = 0.006, respectively). AC was also inversely correlated withTT and SHBG (p = 0.006 and p < 0.0001, respectively). However, BMI did not correlate signicantly with these hormonal levels after adjusting for age. CONCLUSION This finding led to the conclusion that AC had a stronger inverse correlation than BMI with TT and SHBG. Our data suggested that AC alone can be used as an anthropometric parameter to help simplify the identification of men with low serum TT levels.
Collapse
Affiliation(s)
- Paulo Eduardo Dietrich Jaworski
- Departamento de UrologiaHospital Universitário Evangélico de CuritibaCuritibaPRBrasilDepartamento de Urologia, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil
| | - Anderson Ramos
- Departamento de UrologiaHospital Universitário Evangélico de CuritibaCuritibaPRBrasilDepartamento de Urologia, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil
| | - Arthur Radaelli Nicoleit
- Departamento de UrologiaHospital Universitário Evangélico de CuritibaCuritibaPRBrasilDepartamento de Urologia, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil
| | - Luis Fernando de Almeida Bacarin
- Faculdade de MedicinaFaculdade Evangélica do ParanáCuritibaPRBrasilFaculdade de Medicina, Faculdade Evangélica do Paraná (Fepar), Curitiba, PR, Brasil
| | - Pedro Olivo
- Faculdade de MedicinaFaculdade Evangélica do ParanáCuritibaPRBrasilFaculdade de Medicina, Faculdade Evangélica do Paraná (Fepar), Curitiba, PR, Brasil
| |
Collapse
|
22
|
Carpenter JS, Jones SMW, Studts CR, Heiman JR, Reed SD, Newton KM, Guthrie KA, Larson JC, Cohen LS, Freeman EW, Jane Lau R, Learman LA, Shifren JL. Female Sexual Function Index Short Version: A MsFLASH Item Response Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1897-1905. [PMID: 27502350 PMCID: PMC5053877 DOI: 10.1007/s10508-016-0804-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 06/15/2016] [Accepted: 06/28/2016] [Indexed: 05/25/2023]
Abstract
The Female Sexual Function Index (FSFI) is a psychometrically sound and popular 19-item self-report measure, but its length may preclude its use in studies with multiple outcome measures, especially when sexual function is not a primary endpoint. Only one attempt has been made to create a shorter scale, resulting in the Italian FSFI-6, later translated into Spanish and Korean without further psychometric analysis. Our study evaluated whether a subset of items on the 19-item English-language FSFI would perform as well as the full-length FSFI in peri- and postmenopausal women. We used baseline data from 898 peri- and postmenopausal women recruited from multiple communities, ages 42-62 years, and enrolled in randomized controlled trials for vasomotor symptom management. Goals were to (1) create a psychometrically sound, shorter version of the FSFI for use in peri- and postmenopausal women as a continuous measure and (2) compare it to the Italian FSFI-6. Results indicated that a 9-item scale provided more information than the FSFI-6 across a spectrum of sexual functioning, was able to capture sample variability, and showed sufficient range without floor or ceiling effects. All but one of the items from the Italian 6-item version were included in the 9-item version. Most omitted FSFI items focused on frequency of events or experiences. When assessment of sexual function is a secondary endpoint and subject burden related to questionnaire length is a priority, the 9-item FSFI may provide important information about sexual function in English-speaking peri- and postmenopausal women.
Collapse
Affiliation(s)
- Janet S Carpenter
- Department of Science of Nursing Care, School of Nursing, Indiana University, Indianapolis, IN, USA.
- School of Nursing, Indiana University, 600 Barnhill Drive NU 340G, Indianapolis, IN, 46202, USA.
| | | | - Christina R Studts
- Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Julia R Heiman
- Psychological & Brain Sciences, The Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Susan D Reed
- Departments of Obstetrics/Gynecology and Epidemiology, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Katherine A Guthrie
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Joseph C Larson
- Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lee S Cohen
- Center for Women's Mental Health, Massachusetts General Hospital, Boston, MA, USA
| | - Ellen W Freeman
- Departments of Obstetrics/Gynecology and Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - R Jane Lau
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Lee A Learman
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Jan L Shifren
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| |
Collapse
|
23
|
Otunctemur A, Ozbek E, Sahin S, Ozcan L, Dursun M, Polat EC, Cekmen M, Ozsoy OD, Erkoc M, Danis E, Bozkurt M. Low serum insulin-like growth factor-1 in patients with erectile dysfunction. Basic Clin Androl 2016; 26:1. [PMID: 26823979 PMCID: PMC4730635 DOI: 10.1186/s12610-015-0028-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/18/2015] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Endothelial dysfunction and microvascular damage play a crurical role in the pathogenesis of erectile dysfunction (ED). Insulin-like growth factor-1 (IGF-1) is one of the growth factors that have a wide range of biologic effects. IGF-1 is an important mediator of cell growth, differentiation and transformation in various tissues. The purpose of the current study was to determine the association between IGF-1 levels and ED. MATERIALS AND METHODS All men were evaluated for ED and divided into two groups: 80 patients suffering from ED for > 1 year and 80 subjects without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. IGF-1 levels were measured in serum by an automated chemiluminescence immunoassay. The relationship between IGF-1 levels and ED scores in patients was statistically evaluated. RESULTS The mean age of patients in ED group was 60.4 ± 11.3 years and 55.4 ± 9.6 in control group. The plasma IGF-1 levels were significantly lower in ED than in control group (96.5 ± 38.3 and 132.5 ± 53.3 ng/ mL, respectively, P < 0.001). The IGF-1 levels were positively correlated with ED score (r = 0.623, P < 0.01). CONCLUSION In this study serum IGF-1 levels were found to be associated with endothelial dysfunction that predicts ED. Serum IGF-1 level appears to be a specific predictor of ED, and it might be used in early prediction of ED in male population.
Collapse
Affiliation(s)
- Alper Otunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Emin Ozbek
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Suleyman Sahin
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Levent Ozcan
- Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Murat Dursun
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Emre Can Polat
- Department of Urology, Istanbul Medipol University, School of Medicine, Istanbul, Turkey
| | - Mustafa Cekmen
- Department of Biochemistry, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Ozgur Doga Ozsoy
- Department of Biochemistry, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Mustafa Erkoc
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Eyup Danis
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Muammer Bozkurt
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
24
|
Kałka D, Domagała Z, Rakowska A, Womperski K, Franke R, Sylwina-Krauz E, Stanisz J, Piłot M, Gebala J, Rusiecki L, Pilecki W. Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease. Int J Impot Res 2015; 28:14-9. [DOI: 10.1038/ijir.2015.26] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 04/28/2015] [Accepted: 08/12/2015] [Indexed: 11/09/2022]
|
25
|
Tok A, Eminaga O, Burghaus L, Herden J, Akbarov I, Engelmann U, Wille S. Age-stratified cut-off points for the nocturnal penile tumescence measurement using Nocturnal Electrobioimpedance Volumetric Assessment (NEVA(®) ) in sexually active healthy men. Andrologia 2015; 48:631-6. [PMID: 26498135 DOI: 10.1111/and.12492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2015] [Indexed: 11/29/2022] Open
Abstract
The current nocturnal penile tumescence (NPT) measurement is based on standard cut-off levels defined regardless of age. This study was conducted to provide age-stratified cut-off points for NPT measurement. Forty sexually active healthy men between 20 and 60 years old were enrolled and divided equally into four groups defined by age (20-29, 30-39, 40-49 and 50-60 years.). None of the candidates had sexual dysfunction or sleep disturbance or used supportive medication to enhance sexual function. Erectile function was evaluated by using the 5-item version of the international index of erectile function (IIEF-5). NPT was observed using the nocturnal electrobioimpedance volumetric assessment (NEVA(®) ). The NPT values of healthy men aged 20-60 years varied from 268.7% to 202.3%. The NPT differed significantly between age groups (P < 0.0009); however, no significant differences between men aged 30-39 and 40-49 (P = 0.593) were observed. Age was weakly associated with IIEF-5 scores (P = 0.004), whereas a strong and negative correlation between age and NPT (P < 0.0001) was found. IEF-5 scores were not significantly associated with NPT (P = 0.95). Therefore, the standard values for NPT testing should be considered in the evaluation of the nocturnal penile activity of men of all ages.
Collapse
Affiliation(s)
- A Tok
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - O Eminaga
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - L Burghaus
- Department of Neurology, University Hospital of Cologne, Cologne, Germany
| | - J Herden
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - I Akbarov
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - U Engelmann
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - S Wille
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| |
Collapse
|
26
|
Koehn J, Crodel C, Deutsch M, Kolominsky-Rabas PL, Hösl KM, Köhrmann M, Schwab S, Hilz MJ. Erectile dysfunction (ED) after ischemic stroke: association between prevalence and site of lesion. Clin Auton Res 2015; 25:357-65. [PMID: 26374302 DOI: 10.1007/s10286-015-0313-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/25/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE Stroke may cause or worsen erectile dysfunction (ED). Post-stroke ED prevalence and association with stroke location are not well established. Therefore, we assessed post-stroke ED prevalence in relation to ischemic lesion locations and stroke severity. METHODS In 57 men (62.6 ± 10.5 years) who had ischemic stroke within 24 months prior to evaluation, we used the five-item International Index of Erectile Function questionnaire (IIEF5) to evaluate ED prevalence after stroke and retrospectively 3 months prior to stroke. IIEF5 scores range from 5 to 25; scores below 22 indicate ED. We estimated stroke severity upon hospital admission, using the National Institute of Health Stroke Scale (NIHSS), and determined stroke location from cranial computed tomography or magnetic resonance imaging. We compared pre- and post-stroke results with those of 22 control persons (61.7 ± 11.2 years), calculated correlations between IIEF5 scores and NIHSS scores, and compared ED prevalence with stroke locations (significance: p < 0.05). RESULTS ED was reported by 45/57 patients after stroke, 26/57 patients before stroke, and 6/22 control persons. Patients' IIEF5 values were significantly lower [median 16 interquartile range (IQR) 3.5-20.5] after than before stroke (median 23, IQR 19.0-24.0) and lower than in controls (median 24, IQR 19.8-25.0). Pre- and post-stroke IIEF5 scores did not correlate with the patients' NIHSS scores at stroke onset (p > 0.05). ED was associated with middle cerebral artery infarction in 27/34, posterior cerebral artery infarction in 4/5, anterior cerebral artery infarction in 1/1, basal ganglia infarction in 3/3, brain stem infarction in 8/10, cerebellar infarction in 2/5, and lesions in more than one region in 1/1 patients. CONCLUSIONS Disruption of the central network assuring erection might contribute to increased ED severity and prevalence after stroke. Anti-erectile effects of functional and psychological impairment or medication added after stroke may also contribute to ED but must be evaluated in larger patients groups.
Collapse
Affiliation(s)
- Julia Koehn
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Carl Crodel
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Martina Deutsch
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Peter L Kolominsky-Rabas
- Erlangen Stroke Project (ESPro), Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Katharina M Hösl
- Department of Psychiatry, Addiction Psychiatry, Psychotherapy and Psychosomatic Medicine, Klinikum am Europakanal, Erlangen, Germany
| | - Martin Köhrmann
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Stefan Schwab
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Max J Hilz
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
| |
Collapse
|
27
|
Alfaraj SS, Yunus F. Advancing paternal age does not affect in-vitro fertilization (IVF) outcomes in a Saudi population. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2015. [DOI: 10.1016/j.mefs.2014.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
28
|
Ruzek L, Konecny T, Soucek F, Konecny D, Mach L, Ommen SR, Kopecky SL, Nishimura RA. Phosphodiesterase 5 Inhibitor Use in Men With Hypertrophic Cardiomyopathy. Am J Cardiol 2015; 116:618-21. [PMID: 26141201 DOI: 10.1016/j.amjcard.2015.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
Abstract
The prevalence of sexual dysfunction (SD) in men with hypertrophic cardiomyopathy (HC) remains unknown, yet its clinical relevance may be high given that its treatment-phosphodiesterase 5 inhibitors (PDE5i)-can increase the left ventricular outflow tract pressure gradient. In this retrospective study, we evaluated the medical records of consecutively seen men with HC for the evidence of SD (defined as SD diagnosis noted in the medical record, the use of medications unique for SD, or SD reported by the patient on a routine clinical questionnaire). Of the 283 consecutively seen men with HC (mean age 52.9 ± 14.1 years), 63 patients (22%) with SD were identified. Of those with SD, 38% were recorded as regularly using PDE5i. In conclusion, SD and the use of PDE5i present a relatively common occurrence in men with HC, and further studies are needed to develop an evidence-guided algorithm for safe implementation of SD therapies in this most common inherited cardiomyopathy.
Collapse
Affiliation(s)
- Lukas Ruzek
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic; Department of Anesthesiology and Intensive Care, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Tomas Konecny
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
| | - Filip Soucek
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Dana Konecny
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Lukas Mach
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Steve R Ommen
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Stephen L Kopecky
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Rick A Nishimura
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
29
|
Gurtner K, Saltzman A, Hebert K, Laborde E. Erectile Dysfunction: A Review of Historical Treatments With a Focus on the Development of the Inflatable Penile Prosthesis. Am J Mens Health 2015. [PMID: 26206161 DOI: 10.1177/1557988315596566] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Erectile dysfunction has been a concern for men since the beginning of written history. For many men it can lead to severe psychological distress and humiliation. The treatment of erectile dysfunction has advanced significantly over the past 200 years. Men today are presented with many more viable therapy options leading to improved efficacy and more satisfactory sex lives. The objective of this article is to explore historical options for the treatment of erectile dysfunction, with particular emphasis on the development and progression of the inflatable penile prosthesis.
Collapse
Affiliation(s)
- Kristen Gurtner
- 1 Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | | | - Eric Laborde
- 2 Ochsner Clinic Foundation, New Orleans, LA, USA
| |
Collapse
|
30
|
Nitkowska M, Tomasiuk R, Czyżyk M, Friedman A. Prolactin and sex hormones levels in males with Parkinson's disease. Acta Neurol Scand 2015; 131:411-6. [PMID: 25399742 DOI: 10.1111/ane.12334] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND The role that oestradiol and testosterone play in Parkinson's disease and their potential to influence the course of the disease has been covered in medical literature. The aim of this work was to compare oestradiol, testosterone, sex hormone-binding protein and prolactin blood levels in males affected with Parkinson's disease and in an age-matched control group, and to show possible dependence between concentrations of plasma hormones and the progression of symptoms of Parkinson's disease. METHODS The plasma levels of oestradiol, testosterone, prolactin and sex hormone-binding protein were examined in 36 patients affected with Parkinson's disease and in 69 age-matched control subjects, using chemiluminescent reactions. Patients with Parkinson's disease were examined using scales assessing their clinical state. RESULTS The level of prolactin was higher in the affected group. Concentrations of oestradiol and testosterone in the control group exceeded those found in patients. The level of sex hormones was positively correlated with better mood and quality of life in patients affected with Parkinson's disease; prolactin levels correlated negatively with sex steroid concentrations. CONCLUSIONS Lower blood levels of sex steroids and higher concentrations of prolactin and its antigonadotrophic activity in males affected with Parkinson's disease may result in a bigger susceptibility to the disease in men. The level of hormones may influence patients' cognition, mood and quality of life.
Collapse
Affiliation(s)
- M. Nitkowska
- Department of Neurology; Medical University of Warsaw; Mazowiecki Szpital Bródnowski; Warsaw Poland
| | - R. Tomasiuk
- Biochemistry Laboratory; Mazowiecki Szpital Bródnowski; Warsaw Poland
| | - M. Czyżyk
- Department of Physiotherapy; Mazowiecki Szpital Bródnowski; Warsaw Poland
| | - A. Friedman
- Department of Neurology; Medical University of Warsaw; Mazowiecki Szpital Bródnowski; Warsaw Poland
| |
Collapse
|
31
|
Kaya E, Sikka SC, Gur S. A comprehensive review of metabolic syndrome affecting erectile dysfunction. J Sex Med 2015; 12:856-75. [PMID: 25675988 DOI: 10.1111/jsm.12828] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is the most important public health issue threatening the health of men and women all over the world. Its current prevalence (i.e., approximately 30%) is continuously increasing. MetS by itself is considered a risk factor for erectile dysfunction (ED). AIM To focus on the definition epidemiology, pathogenesis, and possible mechanistic links between MetS and ED in order to provide guidelines for treating such individuals. METHODS The search strategies yielded total records screened from PubMed. MAIN OUTCOME MEASURES Regardless of the definition, MetS consists of insulin resistance, hypertension, dyslipidemia, and obesity. MetS is not an end disease but is a disorder of energy utilization and storage. RESULTS The prevalence of ED in patients with MetS is almost twice than in those without MetS, and about 40% of patients with ED have MetS. An important mechanism linking MetS and ED is hypogonadism. CONCLUSIONS Recognizing through ED, underlying conditions such as hypogonadism, diabetes and MetS might be a useful motivation for men to improve their health-related choices. The clinical management of MetS can be done by therapeutic interventions that include lifestyle modifications, hormone replacement alone or in combination with phosphodiesterase 5 inhibitors, and other pharmacological treatments.
Collapse
Affiliation(s)
- Ecem Kaya
- Departments of Biochemistry and Pharmacology, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | | | | |
Collapse
|
32
|
Rotter I, Kosik-Bogacka D, Dołęgowska B, Skonieczna-Żydecka K, Pawlukowska W, Laszczyńska M. Analysis of relationships between the concentrations of total testosterone and dehydroepiandrosterone sulfate and the occurrence of selected metabolic disorders in aging men. Aging Male 2015; 18:249-55. [PMID: 26375874 DOI: 10.3109/13685538.2015.1077507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The evaluation of relationships between the concentrations of dehydroepiandrosterone sulfate (DHEAS) and total testosterone (TT) and the occurrence of metabolic disorders, including metabolic syndrome (MetS). METHOD The participants were subjected to anthropometric measurements and were tested for DHEAS, TT, lipid parameters and carbohydrate parameters. RESULT We observed a lower concentration of DHEAS in the men with hypertension (HT) compared to those without HT. In the men with MetS, HT, overweight and obesity, the concentration of TT was lower than in the men without these problems. We found statistically significant positive correlations (DHEAS- total cholesterol [TCh], DHEAS- low-density lipoprotein [LDL], TT- high-density lipoprotein [HDL], TT-waist-to-hip ratio [WHR]) and negative correlations (DHEAS-age, TT-body weight, TT- body mass index [BMI], TT-abdominal circumference [AC], TT-hip circumference [HC], TT- triglyceride [TG], TT- fasting plasma glucose [FPG], TT- serum insulin levels [I], TT- Homeostasis Model Assessment-Insulin Resistance [HOMA-IR]). Using logistic regression it was ascertained that lower TT levels increase the risk of HT, and were also associated with obesity. CONCLUSION Our research indicates relationships between TT and the occurrence of MetS and its individual components. Excess body weight in men is a factor associated with lower TT levels. It seems necessary to determine TT in men with MetS and overweight or obesity. DHEAS did not show any significant relations with MetS and its parameters. Age was the most crucial factor responsible for the decrease in DHEAS.
Collapse
Affiliation(s)
| | | | | | | | | | - Maria Laszczyńska
- e Department of Histology and Developmental Biology , Pomeranian Medical University , Szczecin , Poland
| |
Collapse
|
33
|
Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S. Diagnosing and managing low serum testosterone. Proc AMIA Symp 2014; 27:321-4. [PMID: 25484498 PMCID: PMC4255853 DOI: 10.1080/08998280.2014.11929145] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Measuring testosterone levels became easier in the 1970s, and it wasn't long before levels were being checked in men across all age groups. At that time, several authors reported an age-associated decline of serum testosterone levels beginning in the fourth or fifth decades of life. Other studies found that the decline in testosterone with age might be more related to comorbidities that develop in many aging men. Aggressive marketing campaigns by pharmaceutical companies have led to increased awareness of this topic, and primary care physicians are seeing more patients who are concerned about "low T." Unfortunately, testosterone replacement therapy has not been straightforward. Many men with low testosterone levels have no symptoms, and many men with symptoms who receive treatment and reach goal testosterone levels have no improvement in their symptoms. The actual prevalence of hypogonadism has been estimated to be 39% in men aged 45 years or older presenting to primary care offices in the United States. As the US population ages, this number is likely to increase. This article, targeted to primary care physicians, reviews the concept of late-onset hypogonadism, describes how to determine the patients who might benefit from therapy, and offers recommendations regarding the workup and initiation of treatment.
Collapse
Affiliation(s)
- Ana Marcella Rivas
- Departments of Internal Medicine (Rivas, Mulkey, Yarbrough) and Endocrinology (Lado-Abeal), Texas Tech University Health Science Center, Lubbock, Texas
| | - Zachary Mulkey
- Departments of Internal Medicine (Rivas, Mulkey, Yarbrough) and Endocrinology (Lado-Abeal), Texas Tech University Health Science Center, Lubbock, Texas
| | - Joaquin Lado-Abeal
- Departments of Internal Medicine (Rivas, Mulkey, Yarbrough) and Endocrinology (Lado-Abeal), Texas Tech University Health Science Center, Lubbock, Texas
| | - Shannon Yarbrough
- Departments of Internal Medicine (Rivas, Mulkey, Yarbrough) and Endocrinology (Lado-Abeal), Texas Tech University Health Science Center, Lubbock, Texas
| |
Collapse
|
34
|
Otunctemur A, Sahin S, Ozbek E, Cekmen M, İnal A, Tulubas F, Dursun M, Besiroglu H, Koklu I. Lipoprotein-associated phospholipase A2 levels are associated with erectile dysfunction in patients without known coronary artery disease. Andrologia 2014; 47:706-10. [PMID: 25091174 DOI: 10.1111/and.12322] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 12/22/2022] Open
Abstract
Endothelial dysfunction and microvascular damage play a crucial role in the pathogenesis of erectile dysfunction (ED). Lp-PLA2 is a calcium-independent member of the phospholipase A2 family and hydrolyses oxidised phospholipids on low-density lipoprotein (LDL) particles that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between Lp-PLA2 levels and ED in patients without known coronary artery disease (CAD). All patients were evaluated for ED and divided into two groups: 88 patients suffering from ED for >1 year were enrolled as an experimental group and 88 patients without ED were enrolled as a control group in this study. Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of Lp-PLA2 were measured in serum by colorimetric assay. The relationship between Lp-PLA2 levels and ED in patients was evaluated statistically. The mean age of patients with ED group was 59.4 ± 11.32 and 55.8 ± 9.67 in the control group. Plasma Lp-PLA2 levels were significantly higher in ED than in the control group (220.3 ± 66.90 and 174.8 ± 58.83 pg ml(-1) , respectively, P < 0.001). The Lp-PLA2 levels were negatively correlated with score of ED (r = -0.482, P < 0.05). In logistic regression analysis, enhanced plasma Lp-PLA2 levels result in approximately 1.2-fold increase in ED [1.22 (1.25-2.76)]. In this study, serum Lp-PLA2 levels were found to be associated with endothelial dysfunction predictive of ED. Serum Lp-PLA2 level appears to be a specific predictor of ED, and it may be used in early prediction of ED in the male population.
Collapse
Affiliation(s)
- A Otunctemur
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - S Sahin
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - E Ozbek
- Department of Urology, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey
| | - M Cekmen
- Department of biochemistry, Kocaeli University, Kocaeli, Turkey
| | - A İnal
- Istanbul Medical Application and Research Center, Baskent University, Istanbul, Turkey
| | - F Tulubas
- Department of Biochemistry, Namik Kemal University, Tekirdag, Turkey
| | - M Dursun
- Department of Urology, Bahcelievler Government Hospital, Istanbul, Turkey
| | - H Besiroglu
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - I Koklu
- Department of Urology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
35
|
Erectile dysfunction in the cardiology practice-a patients' perspective. Am Heart J 2014; 167:178-85. [PMID: 24439978 DOI: 10.1016/j.ahj.2013.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/28/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is an independent risk factor for cardiovascular events sharing mutual risk factors with coronary artery disease. Several guidelines for the management of ED in cardiovascular disease have been proposed, recommending cardiologists to routinely inquire about erectile function. However, males' specific needs and wishes regarding sexual health care in cardiology are unknown. We sought to identify male patients' view concerning possible improvements in sexual health care and preferred forms of sexual counseling in the cardiology practice. METHODS This is a cross-sectional multicentered survey study among randomly selected males visiting a cardiologist. RESULTS Of 388 respondents, 296 questionnaires were eligible for analysis. Mean age of respondents was 62.9 years. Overall, 56% (n = 165) had ED, with up to 86% in patients with heart failure. Mean bother experienced due to ED was 5.93 (±2.57) on a 0 to 10 scale. Most respondents indicated to feel comfortable discussing sexual health with the cardiologists (88%). Of men with ED (n = 165), 46% would like to have a conversation with the cardiologist about possibilities to improve sexual function, 55% would be helped if questions could be asked during consultation with a specialized nurse, and 58% would appreciate written information. Of all respondents (n = 296), 28% ever tried a phosphodiesterase inhibitor; 4% received the prescription of the cardiologists. CONCLUSIONS Erectile dysfunction is highly prevalent in patients with a variety of cardiovascular diagnosis and care for sexual function is mandatory. Patients indicated that above consultation with the cardiologist, both consultation with a specialized nurse and written information would be helpful.
Collapse
|
36
|
Gonzáles AI, Sties SW, Wittkopf PG, de Mara LS, Ulbrich AZ, Cardoso FL, de Carvalho T. Validation of the International Index of Erectile Function (IIFE) for use in Brazil. Arq Bras Cardiol 2013; 101:176-82. [PMID: 23842798 PMCID: PMC3998151 DOI: 10.5935/abc.20130141] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 11/28/2012] [Accepted: 04/16/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. OBJECTIVE Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. METHODS The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. RESULTS The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. CONCLUSION The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.
Collapse
Affiliation(s)
- Ana Inês Gonzáles
- Universidade do Estado de Santa Catarina, Florianópolis, SC - Brazil
| | | | | | | | | | | | - Tales de Carvalho
- Universidade do Estado de Santa Catarina, Florianópolis, SC - Brazil
| |
Collapse
|
37
|
Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, Das S, Sidi H. Risk Factors of Erectile Dysfunction in Patients Receiving Methadone Maintenance Therapy. J Sex Med 2013; 10:2069-76. [DOI: 10.1111/jsm.12105] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
38
|
Yao F, Liu L, Zhang Y, Huang Y, Liu D, Lin H, Liu Y, Fan R, Li C, Deng C. Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men. Clin Res Cardiol 2013; 102:645-51. [PMID: 23681359 DOI: 10.1007/s00392-013-0577-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 04/30/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction (ED) without well-known etiology in young men under the age of 40 years. METHODS 192 patients and 33 normal controls were enrolled. ED was evaluated by using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Traditional cardiovascular risk factors, hormone levels, and vascular parameters were measured. Insulin resistance (IR) was measured by homeostasis model assessment (HOMA). RESULTS Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls. The brachial artery endothelium-dependent flow-mediated vasodilation (FMD) values were significantly lower in ED patients. By multivariate logistic regression analysis, FMD, SBP, Hs-CRP and HOMA-IR were significantly associated with ED. In receiver-operating characteristic (ROC) analysis, FMD was a significant predictor of ED (area under the curve (AUC) 0.933, p < 0.001). The cutoff value of FMD <10.4 % had sensitivity of 81.3 % and specificity of 100 %. HOMA-IR was also proven to be predictor of ED (AUC of HOMA-IR 0.759, p < 0.001). CONCLUSIONS ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology. Measurement of FMD, HOMA-IR can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early in young men.
Collapse
Affiliation(s)
- Fengjuan Yao
- Department of Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Erectile dysfunction (ED) affects millions of men worldwide with implications that go far beyond sexual activity. ED is now recognised as an early marker of cardiovascular disease, diabetes mellitus (DM) and depression. The risk factors that are associated with ED (sedentary lifestyle, obesity, smoking, hypercholesterolaemia and the metabolic syndrome) are very similar to those for cardiovascular disease (CVD). Arguably, the awareness of ED as a symptomatic entity in the post-Viagra™ age is on the rise. Nevertheless, ED is commonly missed when evaluating patients in the hospital setting, either because of lack of consideration or awareness, or through simple embarrassment (of both clinician and patient). This article provides an overview of the aetiology, assessment and importance of ED and hopes to promote its consideration in day-to-day clinical practice.
Collapse
Affiliation(s)
- Paul Grant
- Maidstone & Tunbridge Wells Hospitals Trust, UK.
| | | | | | | |
Collapse
|
40
|
Ejike C, Ezeanyika L. A Telfairia Occidentalis Seed-incorporated Diet May Be Useful in Inhibiting the Induction of Experimental Andropause. Ann Med Health Sci Res 2012; 2:41-5. [PMID: 23209990 PMCID: PMC3507126 DOI: 10.4103/2141-9248.96936] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Andropause, a prevalent pathology of men, results from an imbalance in steroid hormone concentrations that often is associated with aging, and reduces the quality of life of the sufferer. This study investigates the usefulness of a diet containing 15% Telfairia occidentalis seeds in the inhibition of the induction of experimental andropause. Materials and Methods: Twenty male rats were divided into four equal groups. Rats in the test group received dihydrotestosterone and estradiol valerate (ratio 10:1) subcutaneously every other day for 28 days and were placed on the test diet. Those in control I received the hormones, but not the test diet. Rats in controls II and III received olive oil (vehicle) and were placed on the test diet and normal diet, respectively. Testes weights and relative weights, serum testosterone concentrations, and testosterone concentration per gram of testicular tissue were measured or determined in all rats using standard protocols. Data were analyzed and differences between means separated using one-way analysis of variance. Results: Rats in the test group had slightly larger mean relative testes weights compared to those in control I, though both were significantly (P<0.001) smaller than the values obtained in controls II and III, respectively. Rats in the test group had significantly higher (P=0.034) serum testosterone concentrations relative to the control I group 6.9(0.3) ng/ml vs. 4.7(0.1) ng/ml, while the testosterone relative to testes weight values (ng/ml/g) of the test group was 16.8(3.4), and for controls I, II, and III the values were 12.3(1.4), 5.5(0.4), and 4.6(0.7), respectively. The differences between the test and control groups were all significant (P=0.04 in control I, and <0.001 in controls II and III). Conclusion: The test diet resulted in a modest reduction of biochemical castration and an improvement in secretory capacity of the testes of the test rats, relative to the control group that received the hormones but was placed on a normal diet. T. occidentalis seeds-incorporated diet may be useful in inhibiting the induction of experimental andropause.
Collapse
Affiliation(s)
- Cecc Ejike
- Department of Biochemistry, University of Nigeria, Nsukka, Enugu State, Nigeria ; Department of Biochemistry, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria
| | | |
Collapse
|
41
|
Yao F, Huang Y, Zhang Y, Dong Y, Ma H, Deng C, Lin H, Liu D, Lu K. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. ACTA ACUST UNITED AC 2012; 35:653-9. [PMID: 22519624 DOI: 10.1111/j.1365-2605.2012.01273.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction(ED) in young men with low risk of coronary heart disease and no well-known aetiology. To conduct this study, 122 patients with ED under the age of 40 were enrolled, along with 33 age-matched normal control subjects. The patients with ED had significantly higher levels of systolic blood pressure (SBP), total cholesterol and triglyceride, high sensitivity C-reactive protein (hs-CRP), greater carotid intima-media thickness (CIMT) and Framingham risk score (FRS) than the control group, though all of these values were within the respective normal range. Further, the brachial artery flow- mediated vasodilation (FMD) values were significantly lower in ED patients and correlated positively with the severity of ED (r = 0.714, p < 0.001). When these significant factors were studied in the multivariate logistic regression model, FMD, SBP, hs-CRP and FRS remained the statistical significance. The receiver-operating characteristic (ROC) analysis demonstrated that FMD had a high ability to predict ED in young male with low FRS [area under the curve (AUC) 0.921, p < 0.001]. The cutoff value of FMD <10.25% had sensitivity of 82.8% and specificity of 100% for diagnosis of ED. FRS and hs- CRP were also proven to be predictors of ED (AUC 0.812, p < 0.001; AUC 0.645, p = 0.011, respectively). The results of this study validated that subclinical endothelial dysfunction and low-grade inflammation may be the underlying pathogenesis of ED with no well-known aetiology. Young patients complaining of ED should be screened for cardiovascular risk factors and possible subclinical atherosclerosis. Measurement of FMD, hs-CRP and FRS can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early for young male.
Collapse
Affiliation(s)
- F Yao
- Division of Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Ryan JG, Gajraj J. Erectile dysfunction and its association with metabolic syndrome and endothelial function among patients with type 2 diabetes mellitus. J Diabetes Complications 2012; 26:141-7. [PMID: 22437118 DOI: 10.1016/j.jdiacomp.2011.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 12/14/2011] [Accepted: 12/15/2011] [Indexed: 12/16/2022]
Abstract
CONTEXT Evidence suggests that numerous comorbid conditions contribute to erectile dysfunction (ED) among patients with type 2 diabetes mellitus (T2DM). OBJECTIVE To review the relationship and mechanism between diabetes, metabolic syndrome, cardiovascular disease (CVD), and ED. METHODS A manual review of authoritative literature from peer-reviewed publications from January 2001 through July 2010 was performed. These publications were further mined to consider the impact of metabolic syndrome as a comorbid condition. Publications from key references were also consulted. RESULTS The associations between obesity, dyslipidemia, metabolic syndrome, T2DM, CVD, and depression with sexual dysfunction suggest that sexual dysfunction, particularly ED, is a precursor to CVD. Because these conditions share important risk factors with CVD, identifying them and their relationships with the pathogenesis of ED is likely to be critical to the manner in which primary care physicians screen for and manage this condition. CONCLUSIONS Primary care physicians ought to establish trusting relationships with their patients, providing opportunities for them to probe such sensitive issues as sexual activities, as a means of addressing the possibility of ED. When making the new diagnosis of sexual dysfunction in the absence of metabolic disease or CVD, physicians ought to consider the risk for T2DM and CVD. Associations between metabolic disease, heart disease, and sexual dysfunction further suggest that all patients who are obese and have dyslipidemia, T2DM, and/or depression should be further screened for ED.
Collapse
Affiliation(s)
- John G Ryan
- Division of Primary Care/Health Services Research and Development, Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, FL, USA.
| | | |
Collapse
|
43
|
Abstract
The endocrine effects of opioids used for the management of persistent pain are poorly understood by clinicians and patients, and hormone levels are rarely measured. It is recognized that opioids exert this effect via the hypothalamic-pituitary-gonadal axis. Additional effects on adrenal hormones, weight, blood pressure and bone density may also occur. Symptoms and signs of sex hormone deficiency occur in both men and women but are under-reported and are often clinically unrecognized. The potential effects of long term opioid therapy on the endocrine system should be explained to patients before opioid therapy is commenced. Monitoring of sex hormones is recommended; if there are deficiencies opioids should be tapered and withdrawn, if this is clinically acceptable. If opioid therapy has to continue, hormone replacement therapy should be initiated and monitored by an endocrinologist.
Collapse
|
44
|
White A, Richardson N. Gendered epidemiology: making men's health visible in epidemiological research. Public Health 2011; 125:407-10. [PMID: 21764410 DOI: 10.1016/j.puhe.2011.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 02/17/2011] [Indexed: 10/17/2022]
Abstract
This paper will argue that it should no longer be seen as acceptable to present data that is limited to just a population wide or age standardised sex analysis. Such blunt approaches miss the opportunity to develop our understanding of the pivotal role that sex and gender play in health, wellbeing and illness. Taking what we have referred to as a gendered epidemiological approach, would: (i) ensure the routine inclusion of sex differences, (ii) explore how sex differences can be analysed in conjunction with other factors influenced by gender (age, social class, education, marital status etc), (iii) highlight differences within each sex and not just between the sexes, and (iv) apply a gendered lens to the interpretation of the findings. This more nuanced stance is required to ensure that the complexity of men and women can be reflected in the field of public health.
Collapse
Affiliation(s)
- A White
- Centre for Men's Health, Faculty of Health & Social Sciences, Leeds Metropolitan University, Room 231c, Queen Square House, 80 Woodhouse Lane, Leeds LS2 8NU, UK.
| | | |
Collapse
|
45
|
Cao J, Li J, Hao W, Li X, Wang H, Liu L, Zhu B, Guo Z. Correlation of sex hormone and androgen receptor with diabetes mellitus in elderly men. Aging Male 2011; 14:162-7. [PMID: 21574908 DOI: 10.3109/13685538.2011.575479] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM To investigate sex hormone and androgen receptor (AR) levels and to evaluate their relationship with diabetes mellitus (DM) in senile men. METHODS The cross-sectional study included 492 elderly men comprising 104 healthy subjects (mean age 71.4 ± 5.2 years), 259 subjects without DM (71.5 ± 5.0 years) and 129 DM patients (73.0 ± 6.3 years). Plasma concentrations of total testosterone (TT), free testosterone (FT), dehydroepiandrosterone sulphate, sex hormone-binding globulin (SHBG), estradiol (E(2)), luteinising hormone) and follicle-stimulating hormone (FSH) were determined. AR-positive cells were measured by flow cytometry. RESULTS TT concentrations were significantly lower in the DM group (13.8 ± 4.7 nmol/l) than in the healthy (17.1 ± 6.1 nmol/l) and non-diabetes groups (15.8 ± 6.0 nmol/l; all P < 0.01). FT, SHBG, AR-positive proportion (AR%) and AR fluorescence intensity showed a decreasing trend among the healthy, non-DM and DM groups, but the differences were not significant. TT, E(2), E(2)/testosterone and SHBG were negatively correlated with blood glucose. SHBG was positively correlated and TT and AR% were negatively correlated with the course of DM. Logistic multiple regression analysis revealed that age, waist/hip ratio, FSH, SHBG and AR% are potential risk factors for DM. CONCLUSIONS Low levels of TT, SHBG and AR may be potential risk factors for DM in elderly men.
Collapse
Affiliation(s)
- Jian Cao
- First Geriatric Cardiology Division, Chinese PLA General Hospital, Beijing 100853, P.R. China.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Travison TG, Sand MS, Rosen RC, Shabsigh R, Eardley I, McKinlay JB. The Natural Progression and Regression of Erectile Dysfunction: Follow‐Up Results from the MMAS and MALES Studies. J Sex Med 2011; 8:1917-24. [DOI: 10.1111/j.1743-6109.2011.02294.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
47
|
Goh VHH, Tong TYY. The moderating impact of lifestyle factors on sex steroids, sexual activities and aging in Asian men. Asian J Androl 2011; 13:596-604. [PMID: 21532602 DOI: 10.1038/aja.2010.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The present study sought to evaluate the relative associations of exercise, sleep and other lifestyle habits with aging, sex hormones, percent body fat (%BF) and sexual activities in men living in the community. A better understanding of this complex interrelationship is important in helping the formulation of modalities for a holistic approach to the management of aging men. The results showed that age is a major determinant for many physiological parameters, including sleep, hormonal and metabolic parameters, some lifestyle factors and sexual activities. Testosterone (T), bioavailable testosterone (BioT) and dehydroepiandrosterone sulphate (DHEAS) concentrations decreased with age, while estradiol (E2), sex hormone-binding globulin (SHBG) and %BF increased with age. In addition, there exist intricate associations among hormonal and lifestyle factors, %BF and age. High-intensity exercise and longer duration of sleep were associated with higher concentrations of T and BioT. T was shown to be associated positively with men who were engaged in masturbation. DHEAS was associated with men wanting more sex and with good morning penile rigidity. Older Singaporean men tended to sleep for shorter duration, but exercised more intensely than younger men. Coital and masturbation frequencies decreased with age, and a significantly greater number of younger men were engaged in masturbation. Relationship between the partners is a key determinant of sexuality in men. It appears that T may have a limited, while dehydroepiandrosterone (DHEA) have a greater role than previously suggest, as a motivational signal for sexual function in men. Both biological and psychosocial factors interact with each other to influence sexual functions in men. Hence, a biopsychosocial approach may be more appropriate for a more lasting resolution to sexual dysfunctions in men.
Collapse
Affiliation(s)
- Victor H H Goh
- Division of Endocrinology, Department of Medicine at David Geffen School of Medicine, University of California, Los Angeles at Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
| | | |
Collapse
|
48
|
BAR-CHAMA N, SNYDER S, ALEDORT L. Sexual evaluation and treatment of ageing males with haemophilia. Haemophilia 2011; 17:875-83. [DOI: 10.1111/j.1365-2516.2011.02507.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
49
|
|
50
|
Travison TG, Shackelton R, Araujo AB, Morley JE, Williams RE, Clark RV, McKinlay JB. Frailty, serum androgens, and the CAG repeat polymorphism: results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab 2010; 95:2746-54. [PMID: 20410235 PMCID: PMC2902073 DOI: 10.1210/jc.2009-0919] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The CAG repeat polymorphism in the androgen receptor, denoted (CAG)n, is thought to (inversely) index androgen sensitivity. We hypothesized that (CAG)n would exhibit a modifying influence on the association between circulating total and calculated free testosterone (TT and FT) and physical frailty in aging men. OBJECTIVE The objective of the study was to establish the influence of (CAG)n on the relation between circulating TT, FT, LH, SHBG, and frailty. DESIGN This was a prospective cohort study of health and endocrine functioning in randomly selected men, with a baseline (T1: 1987-89) and two follow-up (T2: 1995-1997; T3: 2002-2004) visits. SETTING This was an observational study of men residing in greater Boston, MA. PARTICIPANTS A total of 624 subjects aged 50-86 yr were retained. MAIN OUTCOME MEASURES The frailty phenotype was measured at T3. Components included weight loss, exhaustion, low physical activity, weakness, and slowness. Subjects exhibiting two of these five components were considered to be in an intermediate state, and those exhibiting three or more were considered frail. RESULTS (CAG)n was positively associated with TT and FT. Multivariable regression analyses revealed no influence of CAG on longitudinal within-subject changes in hormone levels or cross-sectional (T3) associations between hormone concentrations and the prevalence of intermediate frailty or frailty. Models incorporating subjects' history of hormone decline produced similar negative results. CONCLUSIONS This population-based study does not support the hypothesis that interindividual differences in (CAG)n can account for a lack of association between circulating androgens and the frailty phenotype. Longitudinal analyses are needed to confirm these conclusions.
Collapse
Affiliation(s)
- Thomas G Travison
- Department of Epidemiology, New England Research Institutes, 9 Galen Street, Watertown, Massachusetts 02472, USA.
| | | | | | | | | | | | | |
Collapse
|