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Gao D, Chen C, Wu Z, Li H, Xie C, Tang B. The association between serum 25-hydroxyvitamin D levels and erectile dysfunction: a two-sample Mendelian randomization analysis. Int J Impot Res 2024:10.1038/s41443-024-00862-1. [PMID: 38429499 DOI: 10.1038/s41443-024-00862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
Considering that vascular endothelial cell dysfunction is the pathological basis of erectile dysfunction (ED), and recognizing the beneficial effects of 25-hydroxyvitamin D (25(OH)D) on vascular endothelial cell protection, the researchers diligently investigated the causal relationship between serum 25(OH)D levels and ED. However, inconsistent clinical evidence has left the association between serum 25(OH)D levels and ED unclear. The objective of this work was to employ Mendelian randomization (MR) analysis to ascertain the potential causal relationship between serum 25(OH)D levels and ED. We conducted a two-sample MR analysis utilizing data from publicly available genome-wide association studies (GWASs). The primary analysis method for the MR analysis was the inverse-variance weighted (IVW) method, supplemented by the MR-Egger and weighted median methods. In addition, we evaluated heterogeneity with Cochran's Q test, assessed pleiotropy using the MR-Egger intercept test, and performed a leave-one-out analysis to identify single-nucleotide polymorphisms (SNPs) with potential effects. Outliers were detected using MR-pleiotropy residual sum and outlier (MR-PRESSO). Genetically predicted serum 25(OH)D levels were not found to be causally associated with ED in IVW method (OR = 1.028, 95% CI = 0.845-1.250, P = 0.785), MR-Egger method (OR = 1.057, 95% CI = 0.782-1.430, P = 0.720), and weighted median method (OR = 1.225, 95% CI = 0.920-1.633, P = 0.165). The results of sensitivity analyses reinforced our conclusion, indicating no evidence of heterogeneity or directional pleiotropy. In summary, our findings do not substantiate a genetic-level causal link between serum 25(OH)D levels and the prevalence of ED. Nonetheless, future research, including larger MR studies, clinical trials, and additional observational studies, is essential to validate and reinforce the outcomes of our present study.
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Affiliation(s)
- Dawei Gao
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Cheng Chen
- Traditional Chinese Medicine Department, Chongqing General Hospital, Chongqing, 401121, China
| | - Ziliang Wu
- Health Management Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Huakang Li
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Cheng Xie
- Department of Medical Research, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Bo Tang
- Department of Urology, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, 611730, China.
- Department of Urology, No.3 Affiliated Hospital of Chengdu University of Traditional Chinese Medicine (West District), Chengdu, 611730, China.
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Babalola OO, Iwaloye O, Ottu PO, Aturamu PO, Olawale F. Biological activities of African medicinal plants in the treatment of erectile dysfunction: a mechanistic perspective. Horm Mol Biol Clin Investig 2023; 44:357-370. [PMID: 38221710 DOI: 10.1515/hmbci-2022-0090] [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: 09/26/2022] [Accepted: 09/24/2023] [Indexed: 01/16/2024]
Abstract
The global incidence of erectile dysfunction is increasingly becoming a significant health concern, as its frequency demonstrates a consistent upward trajectory each year. In recent years, FDA-approved drugs like sildenafil among others has been approved to treat this disorder however the drug is not without its own side effects. In a bid to develop alternative therapeutic option, scientists have now turned to traditional medicine in search of a treatment regimen. Africa is blessed with numerous medicinal plants used in the treatment and management of several diseases including erectile dysfunction. Due to limited access to modern medicine and high-quality medical facilities, a significant number of individuals in Africa continue to depend on traditional medicine as a means of addressing critical health issues. Perhaps one of the grossly explored medicinal properties of plants in Africa is for erectile function. Through years of extensive research in medicinal plants, several plants indigenous to Africa have been identified to show profound ability to mitigate erectile dysfunction. While previous reports have indeed corroborated the ability of this plant to abate erectile dysfunction, there is still a dearth of information regarding the mechanistic aspect of these plants. Hence, the current review aims to provide a comprehensive mechanistic perspective to the major African medicinal plant which have been reported to be effective in the treatment of erectile dysfunction.
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Affiliation(s)
- Olorunfemi Oyewole Babalola
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Opeyemi Iwaloye
- Department of Biochemistry, Federal University of Technology Akure, Akure, Nigeria
| | - Paul Olamide Ottu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Precious Olayinka Aturamu
- Department of Chemical Sciences, Biochemistry Unit, Olusegun Agagu University of Science and Technology Okitipupa, Okitipupa, Nigeria
| | - Femi Olawale
- Nanogene and Drug Delivery Group, University of KwaZulu-Natal, Durban, South Africa
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Vance G, Zeigler-Hill V, Meehan MM, Young G, Shackelford TK. Erectile Dysfunction, Suspicious Jealousy, and Partner-Directed Behaviors in Heterosexual Romantic Couples. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3139-3153. [PMID: 37537426 DOI: 10.1007/s10508-023-02672-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Erectile dysfunction (ED) can have negative consequences for men and their intimate partners. The purpose of the present research was to replicate and extend the results of previous studies concerning the connections that ED has with partner-directed behaviors using a sample of heterosexual romantic couples. Specifically, we used an actor-partner interdependence mediation model to examine whether the associations that ED had with men's mate retention behaviors, partner-directed insults, partner-directed violence, and partner-inflicted injuries were mediated by suspicious jealousy, but not reactive jealousy. These associations were examined in 113 romantic couples, using men's self-reports, and partner-reports provided by their female partners. Results indicated that suspicious jealousy (but not reactive jealousy) mediated the associations that ED had with men's use of partner-directed behaviors, such that higher levels of ED were associated with men experiencing more suspicious jealousy, which, in turn, was associated with more cost-inflicting mate retention behaviors, benefit-provisioning mate retention behaviors, partner-directed insults, partner-directed violence, and partner-inflicted injury. However, there were some discrepancies between the reports provided by men and women such that these associations emerged more consistently in the partner-reports provided by women than in the self-reports provided by men. Discussion addresses evolutionary implications of these findings, as well as limitations of this research and directions for research concerning ED.
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Affiliation(s)
- Gavin Vance
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA.
| | - Virgil Zeigler-Hill
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Madeleine M Meehan
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Gracynn Young
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
| | - Todd K Shackelford
- Center for Evolutionary Psychological Science, Department of Psychology, Oakland University, Rochester, MI, 48309, USA
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Lin JH, Ho DR, Shi CS, Chen CS, Li JM, Huang YC. The influence of smoking exposure and cessation on penile hemodynamics and corporal tissue in a rat model. Transl Androl Urol 2020; 9:637-645. [PMID: 32420170 PMCID: PMC7215033 DOI: 10.21037/tau.2019.12.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background While epidemiological studies have clearly documented that smoking cessation significantly enhances sexual health, the underlying mechanism remains largely unknown. Thus, we wished to explore possible mechanisms by using a rat model of smoking-associated erectile dysfunction (ED). Methods Forty 8-week old male Sprague-Dawley rats were divided into 4 groups. Ten rats were exposed only to room air (N group). The remaining 30 rats were passively exposed to cigarette smoke over a 12-week period. At the end of 12 weeks, the smoking (S, n=10) group underwent immediate erectile function testing and were sacrificed. The remaining 20 rats were exposed to room air only for 4 (Q4W, n=10) or 8 (Q8W, n=10) weeks and then underwent erectile function testing and sacrifice. Erectile function was evaluated by measuring intracavernous pressure (ICP) and mean arterial pressure (MAP). After blood collection for serum testosterone determination, rats were sacrificed to obtain corporal tissue for immunohistochemistry. Results Mean ICP/MAP ratio was significantly lower in the S group compared to the N and Q8W groups (0.52±0.11, 0.94±0.05, and 0.94±0.12, respectively, P=0.0189). Smooth muscle/collagen ratio was also significantly lower in the S group compared to the N and Q8W groups (11.8±0.94, 17.5±1.82, and 16.4±0.60, respectively, P=0.0008). Oxidative stress and apoptotic indices were significantly higher in the S group compared to the N and Q8W groups. Neuronal and endothelial nitric oxide synthases were significantly less expressed in the S group compared to the N and Q8W groups. Conclusions Smoking cessation is associated with partial recovery of penile hemodynamics in a rat model of smoking associated ED.
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Affiliation(s)
- Jian-Hui Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi
| | - Dong-Ru Ho
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi
| | - Chung-Sheng Shi
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan
| | - Chih-Shou Chen
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi
| | - Jhy-Ming Li
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan.,Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi
| | - Yun-Ching Huang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chiayi.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan
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Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU Int 2019; 124:587-599. [PMID: 31267639 DOI: 10.1111/bju.14813] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterise discrepancies caused by the use of different ED screening tools. METHODS The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population-based studies investigating the prevalence of ED and the association between ED and CVD, BPH, and dementia in the general population. RESULTS The global prevalence of ED was 3-76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)-derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all-cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01-1.57), as well as CVD mortality OR 1.43 (95% CI 1.00-2.05). Men with ED are 1.33-6.24-times more likely to have BPH then men without ED, and 1.68-times more likely to develop dementia than men without ED. CONCLUSION ED screening tools in population-based studies are a major source of discrepancy. Non-validated questionnaires may be less sensitive than the IIEF and MMAS-derived questionnaire. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia, and all-cause mortality.
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Affiliation(s)
- Anna Kessler
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Sam Sollie
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Ben Challacombe
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Karen Briggs
- Urology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Sciences, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
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Chan MY, Chok KSH, Fung JYY, Ng SL, Yiu MK, Lo CM. Prospective Study on Sexual Dysfunction in Male Chinese Liver Transplant Recipients. Am J Mens Health 2019; 13:1557988319835139. [PMID: 30836839 PMCID: PMC6440053 DOI: 10.1177/1557988319835139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In patients with end-stage liver disease, hypogonadism and erectile dysfunction are often seen. This study was to determine the incidence of erectile dysfunction before and after liver transplantation (LT) with correlation to change in sex hormone levels from a Chinese cohort. This prospective longitudinal study was registered with The University of Hong Kong Clinical Trials Centre (HKUCTR-1563). The Institutional Review Board approval number is UW-12-273. The study period was from January 2012 to December 2016. Adult male patients with end-stage liver disease enlisted for LT were recruited on informed written consent. All recruited patients were to complete a cross-sectional cohort questionnaire—International Index of Erectile Function, version 5 (IIEF5)—and to receive serum sex hormone checks before and after LT. Twenty-eight patients who underwent LT were included in the analysis. The included patients had significantly reduced prolactin (p < .001) and 17-beta-estradiol (p = .024) after LT. There was also a significant drop of IIEF5 score at 1 month after LT, but the score returned to pre-LT level at 6 months. This study demonstrated that there was improvement in sex hormone levels after LT, namely, normalization of estradiol level and lowering of prolactin and progesterone levels. However, improvement in sex hormone levels did not translate into improvement of erectile dysfunction.
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Affiliation(s)
- Miu Yee Chan
- 1 Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - Kenneth Siu Ho Chok
- 2 Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.,3 State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong SAR, China
| | - James Yan Yue Fung
- 3 State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong SAR, China.,4 Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
| | - Sau Loi Ng
- 1 Department of Surgery, Queen Mary Hospital, Hong Kong SAR, China
| | - Ming Kwong Yiu
- 2 Department of Surgery, The University of Hong Kong, Hong Kong SAR, China
| | - Chung Mau Lo
- 2 Department of Surgery, The University of Hong Kong, Hong Kong SAR, China.,3 State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong SAR, China
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Berry MD, Berry PD. Contemporary Treatment of Sexual Dysfunction: Reexamining the Biopsychosocial Model. J Sex Med 2013; 10:2627-43. [DOI: 10.1111/jsm.12273] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Liong CCM. Factors Influencing Distress Toward Erectile Dysfunction and Attitude Toward Erectile Dysfunction Drugs Among Middle‐Aged and Elderly Chinese Women and Men in Hong Kong. J Sex Med 2013; 10:782-90. [DOI: 10.1111/j.1743-6109.2012.02975.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Li D, Jiang X, Zhang X, Yi L, Zhu X, Zeng X, Guo X, Tang Y. Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China. Urology 2012; 79:601-6. [PMID: 22386407 DOI: 10.1016/j.urology.2011.11.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 11/21/2011] [Accepted: 11/21/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the pathophysiologic composition and age structure of erectile dysfunction (ED) in men visiting outpatient clinics in China. METHODS We studied 3327 consecutive ED outpatients (median age 39 years) from 2006 to 2010 in the 5 training hospitals in China. Every patient was independently evaluated by an experienced urologist/andrologist using comprehensive diagnostic procedures. The simplified International Index of Erectile Function was used to assess the severity of ED. RESULTS Most patients (95.0%) were <60 years old, and none were >70 years old. The psychogenic patients were younger and had greater percentage than any other patients. Vasculogenic factors were a major etiology of organic ED. A significant difference was found in the age distribution between the patients with psychogenic ED and those with organic ED (P = .000). Diabetes, hypertension, coronary artery disease, and hyperlipidemia played significant roles in affecting the severity of ED in a statistical model, including age. The International Index of Erectile Function scores decreased with age (rs = -0.199, P = .000). Moreover, the percentage of severe and moderate cases increased with age (P = .003 and P = .002, respectively). However, the constituent ratio of patients sharply declined from 30.3% to 4.5% with age. CONCLUSION The number of men visiting outpatient clinics with psychological ED is greater than the number with organic causes in China. The age of the Chinese patients with ED who seek medical help is young and this is mainly because of inadequate sex education to young men and because most older patients are reluctant to visit the hospital just for the loss of erectile function.
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Affiliation(s)
- Dongjie Li
- Department of Urology, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
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Chen X, Zhang Q, Tan X. Prevalence of sexual activity and associated factors in hypertensive males and females in China: a cross-sectional study. BMC Public Health 2012; 12:364. [PMID: 22607275 PMCID: PMC3395557 DOI: 10.1186/1471-2458-12-364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 05/18/2012] [Indexed: 11/17/2022] Open
Abstract
Background Hypertension is an important factor contributing to sexual dysfunction. The number of people with hypertension is increasing in China, but research into sexual life, which has implications for quality of life, is limited. We aimed to compare sexual activity and the influence of daily behaviors and sexual domain of hypertensive males and females in south China. Methods A cross-sectional study was conducted at the health care center of a university-affiliated hospital from 2007 to 2008. We enrolled 502 subjects with hypertension (225 males, 48.79 ± 7.39 years old; 277 females, 48.26 ± 6.93 years old) and 173 with normotension (82 males, 45.69 ± 6.58 years old; 91 females, 46.14 ± 7.03 years old), all sexually active. All subjects completed a self-administered questionnaire on sexual activity before a routine physical check-up. Data were collected on sociodemographic and clinical characteristics, use of cigarettes and intake of beverages (including alcohol). Results Hypertensive and normotensive subjects differed in frequency of orgasms and of sexual satisfaction, as well as duration of sexual activity. For hypertensive men, low frequency of sexual activity, orgasms and satisfaction were associated with unemployed or retired status than physical labor work (odds ratio [OR] 0.28 [95% confidence interval (95% CI) 0.12–0.69], 0.32 [0.12–0.86], 0.33 [0.19–0.88], respectively; p < 0.05), and long sexual duration was associated with never drinking alcohol than heavy drinking (OR 4.49 [1.28–6.41]). For hypertensive women, low frequency and duration of sexual activity and low satisfaction were associated with never drinking tea than heavy tea drinking (OR 0.42 [0.18–0.96], 0.49 [0.24–0.98], 0.29 [0.14–0.64], respectively; p < 0.05). Medication use and electrocardiography results were not associated with sexual activity for hypertensive patients. Conclusions For hypertensive people in China, lifestyle factors are associated with sexual dysfunction, which differs by the sex of the person. Further research needs to examine serum hormone levels to validate the result.
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Prevalence and medical management of erectile dysfunction in Asia. Asian J Androl 2011; 13:543-9. [PMID: 21460862 DOI: 10.1038/aja.2010.131] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Erectile dysfunction (ED) is an important worldwide health issue that has a significant negative impact on the quality of life and life satisfaction of both the affected individual and his partner. Here we review the prevalence of ED in Asia, associated factors that may influence sexual attitudes and sexual behaviours, and randomized clinical trials (RCTs) of phosphodiesterase-5 (PDE-5) inhibitors to evaluate the clinical efficacy and safety of PDE-5 inhibitors in Asian men. We searched for English-language articles in MEDLINE and PubMed from January 2000 to September 2010. Our results showed that the overall reported prevalence rate of ED in Asia ranged widely, from 2% to 88%. This finding indicates that ED is a common and major health problem in this region. However, sociocultural and economic factors in Asia prevent people from seeking and obtaining appropriate medical care. We found reports on five kinds of PDE-5 inhibitors for the management of ED: sildenafil, vardenafil, tadalafil, udenafil and mirodenafil. The results of RCTs showed that these five PDE-5 inhibitors are more effective than placebo in improving erectile function in Asian men with ED and that these drugs have similar efficacy and safety profiles.
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Chan SSC, Leung DYP, Abdullah ASM, Lo SST, Yip AWC, Kok WM, Ho SY, Lam TH. Smoking-cessation and adherence intervention among Chinese patients with erectile dysfunction. Am J Prev Med 2010; 39:251-8. [PMID: 20709257 DOI: 10.1016/j.amepre.2010.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 03/12/2010] [Accepted: 05/07/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND Whether the association between smoking and erectile dysfunction is causal is uncertain. No RCTs have been previously conducted on cessation counseling and additional nicotine replacement therapy (NRT) adherence counseling among smokers with erectile dysfunction. PURPOSE The aim of the study was to determine if smoking-cessation counseling in conjunction with NRT increases quitting and NRT adherence compared to usual care, and if stopping smoking would improve erectile function among Chinese erectile dysfunction patients who smoke. DESIGN An RCT was conducted. Data were collected in 2004-2007 and analyzed in 2008. SETTING/PARTICIPANTS The sample included 719 Chinese adult erectile dysfunction patients who smoked at least 1 cigarette per day, intended to quit smoking within the next 7 days, and would use NRT. INTERVENTIONS Group A1 received 15-minute smoking-cessation and 3-minute NRT adherence counseling at baseline, 1 week, and 4 weeks with free NRT for 2 weeks. Group A2 received the same treatment, except for the adherence counseling. Group B received 10 minutes of quitting advice. All subjects received a self-help quitting booklet at first contact. MAIN OUTCOME MEASURES Self-reported 7-day tobacco abstinence at 6 months, 4-week NRT adherence at 1 month, and improvement in erectile dysfunction condition at 6 months. RESULTS The intervention groups (A1+A2) achieved higher rates of abstinence, both self-reported (23% vs 12.8%, RR=1.79, 95% CI=1.22, 2.62) and biochemically validated (11.4% vs 5.5%, RR=2.07, 95% CI=1.13, 3.77), than the control group. The NRT adherence rate did not differ between Groups A1 and A2 (13.7% vs 12.7%, RR=1.08, 95% CI=0.69, 1.69). An improvement in erectile dysfunction status from baseline to 6 months was associated with self-reported quitting at 6 months but not with intervention status. CONCLUSIONS Although quitting smoking was associated with improvement in erectile dysfunction, this study found significant outcome differences among the means used to achieve smoking cessation. TRIAL REGISTRATION ISRCTN13070778.
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Affiliation(s)
- Sophia S C Chan
- Department of Nursing Studies, The University of Hong Kong, Hong Kong
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Wong SYS, Leung JCS, Woo J. Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in Southern China. J Sex Med 2009; 6:74-80. [PMID: 19170839 DOI: 10.1111/j.1743-6109.2008.01034.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Few studies on sexuality and its correlates in adults have been conducted in Asia; most studies in Asia have focused instead on erectile dysfunction in men rather than sexuality or sexual activities. AIM This study was conducted to evaluate the prevalence and factors associated with sexual activity and erectile dysfunction in elderly Chinese men aged 65 years and above. MAIN OUTCOME MEASURES Sexual activity and sexual functions were assessed using the International Index of Erectile Function-5. Depressive symptoms were measured by the Chinese version of the Geriatric Depression Scale. Lower urinary tract symptoms (LUTS) were measured by the International Prostatic Symptom Score. METHODS Cross-sectional data from a large prospective cohort study of Chinese elderly men were used in this study. A questionnaire that included demographic, lifestyle, and medical risk factors and physical examination were administered to 1566 Chinese men aged between 65 to 92 years in Hong Kong. RESULTS Only 30.7% of men were sexually active in the previous 6 months in this sample and among those who were sexually active, 88% had some form of erectile dysfunction. Being sexually inactive in the previous 6 months was associated with being older (odds ratio [OR] = 1.80; confidence interval [CI]: 1.56-2.09), single (OR = 1.87; CI = 1.19-2.94) and the presence of peripheral arterial disease (OR = 2.43; CI: 1.25-4.71). In multiple multinomial logistic regression, having clinically relevant depressive symptoms (OR = 3.37; CI: 1.31-8.70) and having moderate to severe LUTS (OR = 1.63; CI: 1.01-2.64) were independently associated with increased risk of having erectile dysfunction. CONCLUSION We showed that a large proportion of elderly men were not sexually active in Hong Kong. For those who were sexually active, most suffered from some degree of erectile dysfunction. Having clinically relevant depressive symptoms and LUTS were independently associated with increased risk of erectile dysfunction.
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Affiliation(s)
- Samuel Yeung Shan Wong
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong.
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Gralla O, Knoll N, Fenske S, Spivak I, Hoffmann M, Rönnebeck C, Lenk S, Hoschke B, May M. Worry, Desire, and Sexual Satisfaction and Their Association with Severity of ED and Age. J Sex Med 2008; 5:2646-55. [DOI: 10.1111/j.1743-6109.2008.00842.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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