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Lo JO, Hedges JC, Chou WH, Tager KR, Bachli ID, Hagen OL, Murphy SK, Hanna CB, Easley CA. Influence of substance use on male reproductive health and offspring outcomes. Nat Rev Urol 2024; 21:534-564. [PMID: 38664544 DOI: 10.1038/s41585-024-00868-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/30/2024]
Abstract
The prevalence of substance use globally is rising and is highest among men of reproductive age. In Africa, and South and Central America, cannabis use disorder is most prevalent and in Eastern and South-Eastern Europe, Central America, Canada and the USA, opioid use disorder predominates. Substance use might be contributing to the ongoing global decline in male fertility, and emerging evidence has linked paternal substance use with short-term and long-term adverse effects on offspring development and outcomes. This trend is concerning given that substance use is increasing, including during the COVID-19 pandemic. Preclinical studies have shown that male preconception substance use can influence offspring brain development and neurobehaviour through epigenetic mechanisms. Additionally, human studies investigating paternal health behaviours during the prenatal period suggest that paternal tobacco, opioid, cannabis and alcohol use is associated with reduced offspring mental health, in particular hyperactivity and attention-deficit hyperactivity disorder. The potential effects of paternal substance use are areas in which to focus public health efforts and health-care provider counselling of couples or individuals interested in conceiving.
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Affiliation(s)
- Jamie O Lo
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA.
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA.
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA.
| | - Jason C Hedges
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
| | - Wesley H Chou
- Department of Urology, Oregon Heath & Science University, Portland, OR, USA
| | - Kylie R Tager
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
| | - Ian D Bachli
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
| | - Olivia L Hagen
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Carol B Hanna
- Division of Reproductive & Developmental Sciences, Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR, USA
| | - Charles A Easley
- Department of Environmental Health Science, University of Georgia College of Public Health, Athens, GA, USA
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Asal AA, Ayoub DR, Mazen ME, El Makawi SM. Psychosexual dysfunction in male patients with cannabis dependence and synthetic cannabinoid dependence. Int J Psychiatry Med 2024:912174241230886. [PMID: 38282460 DOI: 10.1177/00912174241230886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE There are contradicting reports regarding the relationship between cannabis use and male sexual functions with almost no data about synthetic cannabinoids (SC) and its effect on male sexual functions. This study investigates psychological concerns related to male sexual functions among cannabis and SC users. The research aims to assess different sexual functions and aspects of sexual psychopathology in cannabis and SCs dependent men compared to controls. METHOD Thirty male patients with cannabis dependence, thirty male patients with SCs dependence and thirty matched controls from the outpatient clinic of Kasr Al Ainy hospital, Egypt, were assessed using Structured Clinical Interview for DSM-IV TR Axis I Disorders (SCID-I), International Index of Erectile Function (IIEF), and Sexuality scale. RESULTS The means of IIEF questionnaire in the cannabis and SC group were significant lower than the means of the control group (P < .001) except the orgasmic function in cannabis group (P = .052). In the SCs group, sexual depression was higher and preoccupation lower than the cannabis (P < .020; P < .003, respectively) and control groups (P < .001; P < .001, respectively). The duration and dose of intake of cannabis and SCs correlated significant with sexual esteem, sexual preoccupation and all domains of IIEF. CONCLUSION Cannabis and SC dependence were associated with lower erectile function, sexual desire, intercourse satisfaction and overall satisfaction, and lower orgasmic functions in the SC group than controls. Both groups showed higher sexual depression, lower sexual esteem and sexual preoccupation than controls. SC has a higher negative impact on male sexual functions and psychopathology than cannabis.
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Affiliation(s)
- Abdelrahman A Asal
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa R Ayoub
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed E Mazen
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shirin M El Makawi
- Department of Psychiatry, Faculty of Medicine, Cairo University, Cairo, Egypt
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3
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Barbonetti A, Rastrelli G, Sparano C, Castellini C, Vignozzi L, Maggi M, Corona G. Is marijuana a foe of male sexuality? Data from a large cohort of men with sexual dysfunction. Andrology 2024; 12:9-19. [PMID: 36617843 DOI: 10.1111/andr.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although it has been assumed that chronic cannabis use may have an unfavorable impact on male sexual function and its metabolic correlates, evidence from clinical studies remains inconclusive. OBJECTIVE To investigate the relationship between cannabis use and sexual behavior, anthropometrics and metabolic/vascular profiles in a large series of men evaluated for sexual dysfunction. METHODS A total of 4800 men (mean age 50.8 years) attending an andrology outpatient clinic for sexual dysfunction were studied. Sexual symptoms, hormonal, metabolic, and instrumental (penile color Doppler ultrasound, PCDU) parameters were evaluated according to the reported habitual use of recreational substances (no use, 1-2 joints/week, >2 joints/week, and use of illicit drugs other than cannabis). RESULTS When compared with non-users, cannabis users were younger and exhibited a lower prevalence of comorbidities as well as better PCDU parameters, despite reporting higher alcohol and tobacco consumption. After adjustment for confounders, cannabis use was associated with a greater instability in the couple's relationship and a higher frequency of masturbation. In addition, the group smoking >2 joints/week showed a significantly lower body mass index than both controls and users of substances other than cannabis. Men who reported using recreational drugs (either cannabis or other) exhibited significantly lower levels of both total and low-density lipoprotein cholesterol than non-users. At the PCDU, smoking 1-2 joints/week was associated with significantly higher dynamic peak systolic velocity than both non-drug use and use of >2 joints/week. Prolactin levels were significantly higher in individuals smoking 1-2 joints/week and in those who used substances other than cannabis when compared with controls, whereas no difference in total testosterone levels was observed. DISCUSSION In men with sexual dysfunction, mild cannabis consumption may be associated with a more favorable anthropometric and lipid profile and with a better penile arterial vascular response to intracavernous prostaglandin injection.
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Affiliation(s)
- Arcangelo Barbonetti
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Clotilde Sparano
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Chiara Castellini
- Andrology Unit, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila, Coppito, L'Aquila, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
| | - Mario Maggi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, - Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
- Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
- Endocrinology Unit, Careggi Teaching Hospital, Mario Serio Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Mostafa T, Alghobary M. Substance abuse and male sexual dysfunction: what lies beneath? Sex Med Rev 2023; 11:395-411. [PMID: 37085960 DOI: 10.1093/sxmrev/qead011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences. OBJECTIVES We sought to assess the relationship between substance abuse and male sexual health. METHODS A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance. RESULTS The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels. CONCLUSION Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non-substance-use disorders on male sexual health.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology, Sexology, & STIs, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Moheiddin Alghobary
- Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Clinical Science, Fakeeh College of Medical Sciences, Jeddah, KSA
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Ren Y, Yuan J, Xue Y, Zhang Y, Li S, Liu C, Liu Y. Advanced hydrogels: New expectation for the repair of organic erectile dysfunction. Mater Today Bio 2023; 19:100588. [PMID: 36896414 PMCID: PMC9988670 DOI: 10.1016/j.mtbio.2023.100588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Organic erectile dysfunction (ED) is a type of sexual disorder in men that is usually associated with illness, surgical injury, normal aging and has a high incidence across the globe. And the essence of penile erection is a neurovascular event regulated by a combination of factors. Nerve and vascular injury are the main causes of erectile dysfunction. Currently, the main treatment options for ED include phosphodiesterase type 5 inhibitors (PDE5Is), intracorporeal injections and vacuum erection devices (VEDs), which are ineffective. Therefore, it is essential to find an emerging, non-invasive and effective treatment for ED. The histopathological damage causing ED can be improved or even reversed with hydrogels, in contrast to current therapies. Hydrogels have many advantages, they can be synthesized from various raw materials with different properties, possess a definite composition, and have good biocompatibility and biodegradability. These advantages make hydrogels an effective drug carrier. In this review, we began with an overview of the underlying mechanisms of organic erectile dysfunction, discussed the dilemmas of existing treatments for ED, and described the unique advantages of hydrogel over other approaches. Then emphasizing the progress of research on hydrogels in the treatment of ED.
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Affiliation(s)
- Yan Ren
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China.,CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, China
| | - Jing Yuan
- First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yueguang Xue
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, China
| | - Yiming Zhang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, China
| | - Shilin Li
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, China
| | - Cuiqing Liu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ying Liu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety & CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing, 100190, China.,GBA National Institute for Nanotechnology Innovation, Guangzhou, 510700, China
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6
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Moser A, Ballard SM, Jensen J, Averett P. The influence of cannabis on sexual functioning and satisfaction. J Cannabis Res 2023; 5:2. [PMID: 36658600 PMCID: PMC9854104 DOI: 10.1186/s42238-022-00169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/11/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine the perceived influence of cannabis on sexual functioning and satisfaction. This study used Kaplan's and Masters and Johnson's sexual response cycle (desire, excitement, orgasm, plateau, resolution) and included satisfaction to complete the sexual response cycle. Given increased attention in the research literature to the potential benefits of cannabis and the lack of research on the sexual benefits of cannabis use, the current study was completed. METHODS Data were collected using the online survey tool "Qualtrics" from a self-selected, convenience sample of adults over the age of 18 who reported previous cannabis use. The survey, developed by the researchers based on previous literature, included demographic questions followed by a scale to measure sexual functioning and satisfaction in relation to cannabis use (α = 0.897). RESULTS The final sample was 811 participants ranging in age from 18 to 85 years old (M = 32.11). The majority of participants were identified as female (n = 536, 64.9%), White/Caucasian (n = 640, 78.9%), and college educated (n = 650, 80.1%). Almost 25% of the participants were identified as LGBTQIA+ (n = 187, 23.1%). Most of the participants reported being in a monogamous sexual relationship (n = 598, 73.7%). Data were analyzed using descriptive statistics, t-tests, one-way ANOVA, and multiple regression. Age and gender were not found to have significant effects on cannabis use and sexual functioning and satisfaction. Over 70% of participants reported increased desire (M = 4.05, SD = 0.962) and orgasm intensity (M = 4.05, SD = 0.884). Participants who reported masturbating indicated that cannabis enhanced their pleasure while masturbating (n = 620, 62.5%). Participants also stated that cannabis enhanced their sense of taste (n = 583, 71.9%) and touch (n = 576, 71.0%). DISCUSSION The results of this study contrast and establish new evidence within the literature. Demographic results indicate that the people who use cannabis are of a wide range of ages, from a variety of occupations, and have differing cannabis use preferences. The inclusion of LGBTQIA + respondents is a strength of this study. Overall, results indicated that both men and women perceived that cannabis use increased their sexual functioning and satisfaction, particularly increased desire and orgasm intensity. CONCLUSION This study updates the current literature on cannabis and sexuality and provides implications for improving sexual quality. Medical implications of this study include the possible use of cannabis for treating sexual dysfunctions, especially within women.
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Affiliation(s)
- Amanda Moser
- grid.255364.30000 0001 2191 0423Human Development and Family Science, East Carolina University, Greenville, USA
| | - Sharon M. Ballard
- grid.255364.30000 0001 2191 0423Human Development and Family Science, East Carolina University, Greenville, USA
| | - Jake Jensen
- grid.255364.30000 0001 2191 0423Human Development and Family Science, East Carolina University, Greenville, USA
| | - Paige Averett
- grid.40803.3f0000 0001 2173 6074Social Work, North Carolina State University, Raleigh, USA
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Shahinyan GK, Hu MYY, Jiang T, Osadchiy V, Sigalos JT, Mills JN, Kachroo N, Eleswarapu SV. Cannabis and male sexual health: contemporary qualitative review and insight into perspectives of young men on the internet. Sex Med Rev 2023; 11:139-150. [PMID: 36763944 DOI: 10.1093/sxmrev/qeac010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Cannabis use is increasing across the United States, yet its short- and long-term effects on sexual function remain controversial. Currently, there is a paucity of studies exploring the relationship between cannabis and men's health. OBJECTIVES To summarize the available literature on cannabis and men's health and provide insight into lay perceptions of this topic. METHODS We performed a qualitative PubMed review of the existing literature on cannabis and men's health according to the PRISMA guidelines. Separately, we analyzed relevant themes in online men's health forums. We utilized a Google cloud-based platform (BigQuery) to extract relevant posts from 5 men's health Reddit forums from August 2018 to August 2019. We conducted a qualitative thematic analysis of the posts and quantitatively analyzed them using natural language processing and a meaning extraction method with principal component analysis. RESULTS Our literature review revealed a mix of animal and human studies demonstrating the negative effects of cannabis on semen parameters and varying effects on erectile function and hormone levels. In our analysis of 372 686 Reddit posts, 1190 (0.3%) included relevant discussion on cannabis and men's health. An overall 272 posts were manually analyzed, showing that online discussions revolve around seeking answers and sharing the effects of cannabis on various aspects of sexual health and quality of life, often with conflicting experiences. Quantitative analysis revealed 1 thematic cluster related to cannabis, insecurity, and mental/physical health. CONCLUSIONS There is a limited number of quality human studies investigating the effects of cannabis on men's health. Men online are uncertain about how cannabis affects their sexual health and seek more information. As the prevalence of cannabis use increases, so does the need for research in this area.
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Affiliation(s)
- Gary K Shahinyan
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Ming-Yeah Y Hu
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Tommy Jiang
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Vadim Osadchiy
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - John T Sigalos
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Jesse N Mills
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
| | - Naveen Kachroo
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44125, United States.,Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI 48202, United States
| | - Sriram V Eleswarapu
- Division of Andrology, Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
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Kumar B, Pandey M, Aggarwal R, Sahoo PK. A comprehensive review on invasomal carriers incorporating natural terpenes for augmented transdermal delivery. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00440-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Abstract
Background
Transdermal drug delivery is one of the most widely used drug administration routes, which offer several advantages over other routes of drug delivery. The apical layer of the skin called the stratum corneum is the most dominant obstacle in the transdermal drug delivery, which restricts the passage of drugs across the skin. Considerable strategies have been applied to enhance the rate of permeation across the epithelial cells; however, the most widely used strategy is the use of sorption boosters, also known as permeation enhancers.
Main body
Terpenes were considered as efficient skin permeation enhancers and are generally recognized as safe as per Food and Drug Administration. Terpenes improve the permeability of drugs either by destructing the stratum corneum’s tightly packed lipid framework, excessive diffusivity of drug in cell membrane or by rampant drug partitioning into epithelial cells. Various vesicular systems have been developed and utilized for the transdermal delivery of many drugs. Invasomes are one such novel vesicular system developed which are composed of phospholipids, ethanol and terpenes. The combined presence of ethanol and terpenes provides exceptional flexibility to the vesicles and improves the permeation across the barrier offered due to the stratum corneum as both ethanol and terpenes act as permeation enhancers. Therefore, utilization of invasomes as carriers to facilitate higher rate of drug permeation through the skin can be a very useful approach to improve transdermal drug delivery of a drug.
Conclusion
The paper focuses on a broad updated view of terpenes as effective permeation enhancers and invasomes along with their applications in the pharmaceutical formulations.
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Meah F, Lundholm M, Emanuele N, Amjed H, Poku C, Agrawal L, Emanuele MA. The effects of cannabis and cannabinoids on the endocrine system. Rev Endocr Metab Disord 2022; 23:401-420. [PMID: 34460075 DOI: 10.1007/s11154-021-09682-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 01/24/2023]
Abstract
With the increase in cannabis use due to policy changes and areas of decriminalization, it is important to recognize the potential impact of these substances on endocrine processes. Cannabinoids have many effects by activating the endocannabinoid system. This system plays a role in the normal functioning of nearly every organ and consists of the body's natural endocannabinoids, the cannabinoid receptors, and the enzymes and processes that regulate endocannabinoids. Exogenous cannabinoids such as Δ9-tetrahydrocannabinol (THC) are known to act through cannabinoid type 1 and 2 receptors, and have been shown to mimic endocannabinoid signaling and affect receptor expression. This review summarizes the known impacts of cannabis on thyroid, adrenal, and gonadal function in addition to glucose control, lipids, and bone metabolism, including: reduced female fertility, increased risk of adverse pregnancy outcomes, reduced sperm counts and function, lower thyroid hormone levels with acute use, blunting of stress response with chronic use, increased risk of prediabetes but lower risk of diabetes, suggested improvement of high density lipoproteins and triglycerides, and modest increase in fracture risk. The known properties of endocannabinoids, animal data, population data, and the possible benefits and concerns of cannabinoid use on hormonal function are discussed. The interconnectivity of the endocrine and endocannabinoid systems suggests opportunities for future therapeutic modalities which are an area of active investigation.
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Affiliation(s)
- Farah Meah
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Michelle Lundholm
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Nicholas Emanuele
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Hafsa Amjed
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Caroline Poku
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA
| | - Lily Agrawal
- Endocrinology Section, Medical Service, VA Hospital, Hines, Illinois, USA
| | - Mary Ann Emanuele
- Department of Medicine, Division of Endocrinology, Loyola University Health Care System, Maywood, Illinois, USA.
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Srinivasan M, Hamouda RK, Ambedkar B, Arzoun HI, Sahib I, Fondeur J, Escudero Mendez L, Mohammed L. The Effect of Marijuana on the Incidence and Evolution of Male Infertility: A Systematic Review. Cureus 2021; 13:e20119. [PMID: 34984155 PMCID: PMC8720305 DOI: 10.7759/cureus.20119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/02/2021] [Indexed: 11/05/2022] Open
Abstract
Over the past decade, the consumption of marijuana or any other form of cannabis, whether medically, recreationally, or illegally, has been escalating worldwide. The additive effect of marijuana and the easy availability could make this increasing trend possible for imperceptible outcomes affecting one's physiology on multiple levels. The rationale of this review is to study and enumerate several effects marijuana may have on male reproductive organs, especially in men who are dealing with subfertility or infertility issues. A literature search was done from September 1, 2021, to September 14, 2021, using the following databases: PubMed, Google Scholar, Bielefeld Academic Search Engine (BASE), University of California, Santa Barbara Library, and PubMed Central. The studies included in this review comprised systematic reviews, cross-sectional, case-control, cohort, and longitudinal studies published during 2010-2021 in the English language. After an extensive review of all studies, the quality was assessed using appropriate quality appraisal tools, and 15 eligible reports were identified and included. In-depth research on the final studies concluded that marijuana seems to have specific adverse effects on the sperm parameters, namely, sperm count, concentration, motility, morphology, capacitation, and viability, thus affecting fertility in men. Certain hormone levels, including testosterone, luteinizing hormone, and follicle-stimulating hormone, also drew attention, potentially impacting men's fertility; however, a finite inference could not be substantiated by the studies. Although the studies show significant effects in sperm parameters and organic sexual dysfunction, it is also to be noted that these studies are observational only and are conducted in small groups in multicenter geographical locations where other lifestyle patterns could be confounding. Given this restriction, it is suggested that further human trials on a larger scale be conducted to provide an even more concrete conclusion, especially after considering other factors that may affect the generalization of these trials.
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Affiliation(s)
- Mirra Srinivasan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ranim K Hamouda
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Baba Ambedkar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Hadia I Arzoun
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Isra Sahib
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jack Fondeur
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Lubna Mohammed
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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11
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Massarotti C, Sbragia E, Gazzo I, Stigliani S, Inglese M, Anserini P. Effect of Multiple Sclerosis and Its Treatments on Male Fertility: Cues for Future Research. J Clin Med 2021; 10:jcm10225401. [PMID: 34830684 PMCID: PMC8623707 DOI: 10.3390/jcm10225401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
Abstract
Multiple sclerosis is a chronic disease that may lead to different types of symptoms and disabilities. with the better quality of life and decreased disability due to early diagnosis and the availability of disease-modifying therapies (DMTs), the treating physician is increasingly asked to counsel patients on its effects on fertility and reproduction. In particular, reproductive issues are still scarcely studied and discussed in men. Among the still open questions are the following: (a) Does multiple sclerosis cause infertility per sè? (b) Is multiple sclerosis correlated with conditions that increase the risk of infertility? (c) Do DMTs or other therapies for multiple sclerosis impact gonadal function in men? The aim of this review is to provide an overview on the available literature data about the reproductive issues unique to men with multiple sclerosis, underlining the numerous areas where evidence is lacking and, therefore, the priorities for future research.
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Affiliation(s)
- Claudia Massarotti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16128 Genova, Italy; (C.M.); (I.G.)
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Elvira Sbragia
- Center of Excellence for Biomedical Research and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16128 Genova, Italy; (E.S.); (M.I.)
| | - Irene Gazzo
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16128 Genova, Italy; (C.M.); (I.G.)
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Sara Stigliani
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Matilde Inglese
- Center of Excellence for Biomedical Research and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, 16128 Genova, Italy; (E.S.); (M.I.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Paola Anserini
- Physiopathology of Human Reproduction Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Correspondence:
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Nguyen S, Mangubat M, Eleswarapu S, Wilson JB, Molina J, Abraham A, Artaza JN, Friedman TC, Ferrini MG. The Combination of High-Fat Diet and Oral Marijuana Promotes the Development of Fibrosis in the Mouse Corpora Cavernosa. Sex Med 2021; 9:100312. [PMID: 33540365 PMCID: PMC8072182 DOI: 10.1016/j.esxm.2020.100312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The link between cannabis use and erectile dysfunction remains unclear. Moreover, the effect of cannabis in tandem with current Western dietary habits is an area in male sexual health that has yet to be explored. This study seeks to investigate the impact of diet and cannabis on penile health in an animal model. AIM To determine the effects of diet and oral cannabis extract on fibrosis and oxidative stress within the corpora cavernosa of mice. METHODS This is a pilot animal study in which groups of 2-month old C57BL/6J male mice were fed a normal chow diet (NCD) or high-fat diet (HFD) daily and treated with or without either MJ or THC extract for 2 months. After euthanization, mouse penises were isolated and processed for immunohistochemical studies to determine: (i) smooth muscle cell to collagen content, (ii) myofibroblast proliferation, and (iii) anti-oxidative activity. MAIN OUTCOME MEASURES Quantitative assessment of immunohistochemical markers of fibrosis and oxidative stress within the corpora cavernosa of mice fed a high-fat diet in combination with either oral marijuana (MJ) or Δ-9-tetrahydrocannabinol extract (THC). RESULTS The combination of HFD with MJ resulted in: (i) a decrease in the smooth/collagen ratio in the corpora cavernosa, (ii) an increase in alpha-smooth muscle actin expression in the tunica albuginea compatible with myofibroblast proliferation, and (iii) a decrease in heme oxygenase 1 expression indicating an increase in oxidative stress. Significant histological changes were not observed in the HFD + THC group. CONCLUSIONS HFD combined with oral MJ extract led to structural alterations in erectile tissue that are associated with accelerated corporal fibrosis. However, the addition of THC to the diet did not exacerbate histological changes within the corpora. Further studies are warranted to elucidate the discrepant effects between MJ and THC in order to optimize the therapeutic potential of cannabis and minimize its adverse effects on penile health. S Nguyen, M Mangubat, S Eleswarapu, et al. The Combination of High-Fat Diet and Oral Marijuana Promotes the Development of Fibrosis in the Mouse Corpora Cavernosa. Sex Med 2021;9:100312.
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Affiliation(s)
- Sabine Nguyen
- Department of Health and Life Sciences, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA
| | - Michael Mangubat
- Department of Health and Life Sciences, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA
| | - Sriram Eleswarapu
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Julian B Wilson
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA
| | - Jocelyn Molina
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA
| | - Andrea Abraham
- Department of Health and Life Sciences, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA
| | - Jorge N Artaza
- Department of Health and Life Sciences, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Theodore C Friedman
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Monica G Ferrini
- Department of Health and Life Sciences, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA; Department of Internal Medicine, Charles R. Drew University of Medicine and Science Los Angeles, CA, USA.
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13
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Maccarrone M, Rapino C, Francavilla F, Barbonetti A. Cannabinoid signalling and effects of cannabis on the male reproductive system. Nat Rev Urol 2020; 18:19-32. [PMID: 33214706 DOI: 10.1038/s41585-020-00391-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 12/17/2022]
Abstract
Marijuana is the most widely consumed recreational drug worldwide, which raises concerns for its potential effects on fertility. Many aspects of human male reproduction can be modulated by cannabis-derived extracts (cannabinoids) and their endogenous counterparts, known as endocannabinoids (eCBs). These latter molecules act as critical signals in a variety of physiological processes through receptors, enzymes and transporters collectively termed the endocannabinoid system (ECS). Increasing evidence suggests a role for eCBs, as well as cannabinoids, in various aspects of male sexual and reproductive health. Although preclinical studies have clearly shown that ECS is involved in negative modulation of testosterone secretion by acting both at central and testicular levels in animal models, the effect of in vivo exposure to cannabinoids on spermatogenesis remains a matter of debate. Furthermore, inconclusive clinical evidence does not seem to support the notion that plant-derived cannabinoids have harmful effects on human sexual and reproductive health. An improved understanding of the complex crosstalk between cannabinoids and eCBs is required before targeting of ECS for modulation of human fertility becomes a reality.
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Affiliation(s)
- Mauro Maccarrone
- Department of Applied Clinical and Biotechnological Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Cinzia Rapino
- School of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - Felice Francavilla
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Arcangelo Barbonetti
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Pizzol D, Demurtas J, Stubbs B, Soysal P, Mason C, Isik AT, Solmi M, Smith L, Veronese N. Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis. Am J Mens Health 2020; 13:1557988319892464. [PMID: 31795801 PMCID: PMC6893937 DOI: 10.1177/1557988319892464] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Globally, there is increasing usage and legalization of cannabis. In addition to its reported therapeutic effects, cannabis has several health risks which are not clearly defined. Erectile dysfunction (ED) is the most common male sexual disorder and there are plausible mechanisms linking cannabis use to ED. No attempt has been made to collate the literature on this topic. The aim of this review was to summarize the prevalence and risk of ED in cannabis users compared to controls. A systematic review of major databases from inception to January 1, 2019, without language restriction, was undertaken to identify studies investigating cannabis use and presence of ED. The analysis compared the prevalence of ED in cannabis users versus controls. Consequently, the odds ratio (OR) with 95% confidence intervals (CI) was calculated, applying a random-effect model. Five case–control studies were included with data from 3,395 healthy men, 1,035 using cannabis (smoking) and 2,360 nonusers. The overall prevalence of ED in cannabis users was 69.1% (95% CI: 38.0–89.1), whilst the correspondent figure in controls was 34.7% (95% CI: 20.3–52.7). The OR of ED in cannabis users was almost four times that of controls (OR = 3.83; 95% CI: 1.30–11.28; p = .02), even if characterized by high heterogeneity (I2 = 90%) and the prediction intervals overlapped 1.00 (95% CI: 0.35–7.26). Data suggest that ED is twice as high in cannabis users compared to controls. Future longitudinal research is needed to confirm/refute this and explore if a dose–response relationship between cannabis and ED may be evident.
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Affiliation(s)
- Damiano Pizzol
- Italian Agency for Development Cooperation, Jerusalem, Israel
| | - Jacopo Demurtas
- Primary Care Department Azienda USL Toscana Sud Est, Grosseto, Italy
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,Positive Ageing Research Institute, Anglia Ruskin University, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Corina Mason
- Department of Health Psychology, University of Aberdeen, UK
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Italy
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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15
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Pham MN, Hudnall MT, Nadler RB. Marijuana, Lower Urinary Tract Symptoms, and Pain in the Urologic Patient. Urology 2020; 139:8-13. [PMID: 32027882 DOI: 10.1016/j.urology.2020.01.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/19/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To describe marijuana's clinical role for urologic symptoms. METHODS Studies related to marijuana, voiding dysfunction, lower urinary tract symptoms (LUTS), and pain through January 2019 from PubMed were evaluated for relevance and quality. RESULTS Forty-eight studies were reviewed. Cannabinoids have mixed efficacy for neurogenic LUTS and little evidence for non-neurogenic LUTS, chronic non-cancer-related and perioperative pain. For cancer-related pain, high-level studies demonstrate cannabinoids are well-tolerated with unclear benefit. CONCLUSION Cannabinoids appear well-tolerated in the short-term, but their efficacy and long-term impact is unproven and unknown in urologic discomfort. Cannabinoids for urologic symptoms should be further explored with well-designed randomized controlled trials.
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Affiliation(s)
- Minh N Pham
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew T Hudnall
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robert B Nadler
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
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16
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Role of Serum High-Sensitivity C-Reactive Protein as a Predictor of Therapeutic Response to Tadalafil in Patients With Erectile Dysfunction: A Prospective Observational Study. J Sex Med 2019; 16:1912-1921. [DOI: 10.1016/j.jsxm.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/09/2019] [Accepted: 09/15/2019] [Indexed: 02/06/2023]
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17
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The Risky Health Behaviours of Male Adolescents in the Southern Italian Region: Implications for Sexual and Reproductive Disease. J Clin Med 2019; 8:jcm8091414. [PMID: 31500383 PMCID: PMC6781188 DOI: 10.3390/jcm8091414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 12/14/2022] Open
Abstract
Recent epidemiological studies suggest an increase of sexual and reproductive chronic diseases caused by problematic behaviours acquired during peri-pubertal age. The aims of our study were: (i) to investigate awareness of sexual transmitted infections (STIs) among adolescents; (ii) to describe the close relationship between possibly incorrect lifestyles during adolescence and reproductive and sexual disturbances during adulthood. The “Amico-Andrologo” survey is a permanent nationwide surveillance program supported by the Italian Ministry of Health. We administered a validated structured interview to investigate the lifestyle of adolescents and their knowledge of STIs. We selected a cohort of 360 male high-school students aged ≥18 years old. In this cohort, 150 (41.5%) were smokers while 59 (19.7%) smoked more than 10 cigarettes/day; 25 (9.3%) declared a consumption ≥6 drinks/weekend; and 65 (19.7%) were habitual cannabis consumers (at least twice/week). Among the sample of students selected, the main sources of sexual disease information were the internet and friends. The perceived level of knowledge on STIs was the same between students that used contraceptive methods and students that did not. The present results demonstrate that adolescents in Calabria do not receive appropriate information about risky health behaviours. Therefore, there is a necessity for specific educational programs to increase awareness of dangerous behaviours during the transitional age that is relevant for a safe sexual and reproductive adult life.
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Abstract
PURPOSE With cannabis consumption on the rise and use prominent among males of reproductive age it is essential to understand the potential impact of cannabis on male fertility. We reviewed the literature regarding the effects of cannabis on male fertility. MATERIALS AND METHODS We performed a literature search using PubMed®/MEDLINE® to identify relevant studies of the effects of cannabis on male fertility. Relevant studies were identified and reviewed. RESULTS The strongest evidence of cannabis induced alterations in male fertility is in the category of semen parameters. Research supports a role for cannabis in reducing sperm count and concentration, inducing abnormalities in sperm morphology, reducing sperm motility and viability, and inhibiting capacitation and fertilizing capacity. Animal models demonstrate a role for cannabis in testicular atrophy, and reduced libido and sexual function but to our knowledge these results have not yet been replicated in human studies. Studies of hormonal changes suggest inconclusive effects on testosterone levels, lowered luteinizing hormone levels and unchanged follicle-stimulating hormone levels. CONCLUSIONS Current research suggests that cannabis may negatively impact male fertility. Further studies are needed to validate that robust findings in animal models will carry over into human experience. Clinicians should be aware of these potential effects when prescribing medical marijuana therapies to men of reproductive age, and they should consider the degree of cannabis use as a possible component of a complete male infertility workup.
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19
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Evaluation of Sexual Function in Turkish Male Individuals Who are Substance Abusers: A Descriptive Study. ADDICTIVE DISORDERS & THEIR TREATMENT 2019. [DOI: 10.1097/adt.0000000000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Rajanahally S, Raheem O, Rogers M, Brisbane W, Ostrowski K, Lendvay T, Walsh T. The relationship between cannabis and male infertility, sexual health, and neoplasm: a systematic review. Andrology 2019; 7:139-147. [DOI: 10.1111/andr.12585] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/15/2018] [Accepted: 12/20/2018] [Indexed: 12/13/2022]
Affiliation(s)
- S. Rajanahally
- Department of Urology University of Washington Medical Center Seattle WA USA
| | - O. Raheem
- Department of Urology Tulane University New Orleans LA USA
| | - M. Rogers
- Department of Urology Medical University of South Carolina Charleston SC USA
| | - W. Brisbane
- Department of Urology University of Washington Medical Center Seattle WA USA
| | - K. Ostrowski
- Department of Urology University of Washington Medical Center Seattle WA USA
| | - T. Lendvay
- Department of Urology Seattle Children's Hospital Seattle WA USA
| | - T. Walsh
- Department of Urology University of Washington Medical Center Seattle WA USA
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21
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Elsaied MA, Masallat D, Abdel-Hamid IA. Correlation of Adiponectin With Testosterone in Patients With and Without Type 2 Diabetes and Erectile Dysfunction. Am J Mens Health 2019; 13:1557988318807049. [PMID: 30339037 PMCID: PMC6771219 DOI: 10.1177/1557988318807049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the levels of adiponectin in diabetic patients with and without erectile dysfunction (ED). In addition, the correlations of adiponectin with the scores of international index of erectile function (IIEF) and total testosterone levels were explored in diabetic and nondiabetic patients with ED. The study included three groups: Type 2 Diabetic patients (T2DM) with and without ED and a third nondiabetics with ED group, each of 29 patients. Fasting blood glucose (FBG), fasting insulin (FI), homeostasis model assessments of insulin resistance (HOMA-IR index), testosterone and adiponectin levels were evaluated. IIEF was applied to diabetic and nondiabetic patients with ED. The results showed that adiponectin was lower in diabetic patients with ED than in both nondiabetics with ED and diabetics without ED groups (5.23 ± 1.05 vs. 11.38 ± 10.08 and 6.5 ± 2.13; p = .003 and .006 respectively). Testosterone was lower in diabetic patients with ED than in diabetics without ED group (2.52 ± 1.15 vs. 4.1 ± 1.46; p = .024). Testosterone had a direct correlation with adiponectin ( r = .371; p = .001). Both adiponectin and testosterone levels did not correlate with IIEF. In conclusion, the decreased adiponectin and testosterone are associated with ED in T2DM. Testosterone has a direct correlation with circulating adiponectin while both have no correlation with IIEF.
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Affiliation(s)
- Moustafa A. Elsaied
- Division of Andrology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Doaa Masallat
- Department of Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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22
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The 2018 Revision to the Process of Care Model for Evaluation of Erectile Dysfunction. J Sex Med 2018; 15:1280-1292. [DOI: 10.1016/j.jsxm.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
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Aldemir E, Akyel B, Keskin Gokcelli D, Celikay H, Altintoprak AE, Coskunol H. A controlled study of sexual function in men with cannabis use disorder: A brief report. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.1080/14659891.2016.1245794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ebru Aldemir
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
| | - Betul Akyel
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
| | | | - Hande Celikay
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
| | | | - Hakan Coskunol
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
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Diehl A, Pillon SC, dos Santos MA, Rassool GH, Laranjeira R. Sexual Dysfunction and Sexual Behaviors in a Sample of Brazilian Male Substance Misusers. Am J Mens Health 2016; 10:418-27. [DOI: 10.1177/1557988315569298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior, and severity of dependence were evaluated.The prevalence of sexual dysfunction was 37.2% and premature ejaculation was 63.8%. Men with sexual dysfunction presented from moderate to severe level of alcohol, tobacco, and other drugs of dependence. The findings from this study are particularly relevant identifying those sociodemographic factors, severity of drug use, and sexual behavior are related to men who experience sexual dysfunction. Health promotion and motivational interventions on sexual health targeted to male drug users can contribute in reducing these at-risk behaviors. More interdisciplinary research is desirable in future in considering men’s sexual health.
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Microvascular endothelial dysfunction predicts the development of erectile dysfunction in men with coronary atherosclerosis without critical stenoses. Coron Artery Dis 2016; 25:552-7. [PMID: 25028978 DOI: 10.1097/mca.0000000000000145] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is associated with an increased risk for cardiovascular disease, stroke, and all-cause mortality, independent of conventional cardiovascular risk factors. Coronary endothelial dysfunction is independently associated with ED in men with early coronary atherosclerosis. We aimed to investigate whether coronary microvascular dysfunction predicts development of ED in patients presenting with coronary atherosclerosis without critical stenoses. PATIENTS AND METHODS Coronary microvascular function was evaluated in 130 men with coronary atherosclerosis without critical stenoses by administration of intracoronary acetylcholine at the time of diagnostic study. After a mean follow-up of 8.4 years, patients were assessed for the development of ED by administration of a questionnaire. RESULTS In all, 68 (50%) men had microvascular endothelial dysfunction at baseline; 35 (51%) men with microvascular endothelial dysfunction developed ED on follow-up compared with 19 (31%) men without microvascular endothelial dysfunction. Men who developed ED had a lower coronary blood flow response (% [INCREMENT]CBF) compared with men who did not develop ED, with mean±SD of 25.4±71.3 versus 81.7±120 (P=0.003). In univariate analysis, microvascular endothelial dysfunction was a predictor for the development of ED, with relative risk of 2.4 (1.2-4.9) (P=0.016). In multivariate logistic regression adjusting for traditional cardiovascular risk factors (age, hypertension, hyperlipidemia, diabetes, vascular disease, and family history of coronary artery disease), only microvascular endothelial dysfunction (P=0.027) and age (P=0.044) remained significant predictors of development of ED. CONCLUSION Coronary microvascular dysfunction is a predictor of the development of ED in men with coronary atherosclerosis without critical stenoses. This study underscores the systemic involvement of the endothelial function in vascular disease.
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Peixoto C, Botelho F, Tomada I, Tomada N. Comportamento sexual de estudantes de medicina portugueses e seus fatores preditivos. Rev Int Androl 2016. [DOI: 10.1016/j.androl.2015.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Kumsar NA, Kumsar Ş, Dilbaz N. Sexual dysfunction in men diagnosed as substance use disorder. Andrologia 2016; 48:1229-1235. [PMID: 26940022 DOI: 10.1111/and.12566] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2016] [Indexed: 01/23/2023] Open
Abstract
Illicit drugs are often used as aphrodisiacs to enhance sexual performance and/or pleasure; however, the available data suggest that most illicit drugs have adverse effects on erection, sexual desire and ejaculation latency in males and that these effects are not fully understood. This study aimed to determine the effect of illicit drug abuse on male sexual function, based on the International Index of Erectile Function (IIEF) score. This descriptive study was conducted at the Alcohol and Substance Research Treatment and Education Center, Ankara, Turkey. Males diagnosed as substance use disorder according to DSM-IV (n = 101) were included as the patient group, and age-matched healthy male volunteers (n = 43) were included as the control group. A 30-item sociodemographic interview form developed by researchers and the 15-item IIEF were administered to all the participants. Data were compared between the patient and control groups. Mean IIEF score was 46.7 ± 3.3 in the patients that used alcohol, 23.7 ± 3.3 in the opioid users, 34.1 ± 5.3 in the ecstasy users, 43.5 ± 4.2 in the cannabis users and 55.3 ± 1.6 in the control group. There was not a significant difference between the alcohol and cannabis users' mean IIEF scores and that in the control group (P > 0.05 and >0.05 respectively), whereas there was a significant difference between the opioid and ecstasy users' mean IIEF scores and that in the control group (P < 0.001 and <0.001 respectively). All IIEF subscale scores in the opioid users were significantly lower than in the control group (P < 0.001). IIEF erectile function, sexual desire and general satisfaction subscale scores were significantly lower in the ecstasy users than in the control group (P < 0.001, <0.005 and <0.001 respectively). In the alcohol users only, the IIEF general satisfaction subscale score was lower than in the control group (P < 0.005).
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Affiliation(s)
- N A Kumsar
- Sakarya University Training and Research Hospital Psychiatry Clinic, Sakarya, Turkey
| | - Ş Kumsar
- Sakarya University Training and Research Hospital Urology Clinic, Sakarya, Turkey
| | - N Dilbaz
- Üsküdar University NP Hospital, Istanbul, Turkey
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Defeudis G, Gianfrilli D, Di Emidio C, Pofi R, Tuccinardi D, Palermo A, Lenzi A, Pozzilli P. Erectile dysfunction and its management in patients with diabetes mellitus. Rev Endocr Metab Disord 2015; 16:10.1007/s11154-015-9321-4. [PMID: 26497842 DOI: 10.1007/s11154-015-9321-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Diabetes can be described as a syndrome of multiple closely related conditions induced by a chronic state of hyperglycaemia resulting from defective insulin secretion, insulin action or both. Chronic complications associated with diabetes (including neuropathy, vascular disease, nephropathy and retinopathy) are common, and of these, erectile dysfunction (ED) deserves special attention. ED and its correlation with cardiovascular disease require careful evaluation and appropriate treatment. PDE5 inhibitors (PDE5is) are an important tool for the treatment of ED, with new drugs coming onto the market since the late 90s. This review offers an overview of PDE5is and their use in treating ED in diabetes. We underline the differences between different types of PDE5i, focusing on available doses, duration of action, T ½, side effects and selectivity profiles in relation to patients with diabetes. We also discuss the link between diabetes and ED in presence of various associated cofactors (obesity, hypertension and its pharmacological treatments, atherosclerosis, hyperhomocysteinaemia, neuropathy, nephropathy, hypogonadism and depression). Finally a number of past and ongoing clinical trials on the use of PDE5is in patients with diabetes are presented to offer an overview of the appropriate treatment of ED in this condition.
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Affiliation(s)
- Giuseppe Defeudis
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Chiara Di Emidio
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Riccardo Pofi
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Dario Tuccinardi
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Andrea Palermo
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Viale del Policlinico 155, Rome, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Via Alvaro del Portillo 21, Rome, Italy.
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Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility. J Assist Reprod Genet 2015; 32:1575-88. [PMID: 26277482 DOI: 10.1007/s10815-015-0553-8] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 07/27/2015] [Indexed: 02/06/2023] Open
Abstract
Marijuana has the highest consumption rate among all of the illicit drugs used in the USA, and its popularity as both a recreational and medicinal drug is increasing especially among men of reproductive age. Male factor infertility is on the increase, and the exposure to the cannabinoid compounds released by marijuana could be a contributing cause. The endocannabinoid system (ECS) is deeply involved in the complex regulation of male reproduction through the endogenous release of endocannabinoids and binding to cannabinoid receptors. Disturbing the delicate balance of the ECS due to marijuana use can negatively impact reproductive potential. Various in vivo and in vitro studies have reported on the empirical role that marijuana plays in disrupting the hypothalamus-pituitary-gonadal axis, spermatogenesis, and sperm function such as motility, capacitation, and the acrosome reaction. In this review, we highlight the latest evidence regarding the effect of marijuana use on male fertility and also provide a detailed insight into the ECS and its significance in the male reproductive system.
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Juan CK, Chen HJ, Shen JL, Kao CH. Lichen Simplex Chronicus Associated With Erectile Dysfunction: A Population-Based Retrospective Cohort Study. PLoS One 2015; 10:e0128869. [PMID: 26076496 PMCID: PMC4468076 DOI: 10.1371/journal.pone.0128869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/01/2015] [Indexed: 12/24/2022] Open
Abstract
Background An association between lichen simplex chronicus (LSC) and sexual dysfunction was explored. However, no data are available from investigations into the relationship between erectile dysfunction (ED) and LSC. Objectives This retrospective population-based cohort study aimed to clarify the risk of ED associated with LSC. Methods By using the Taiwan National Health Insurance Research dataset, we identified 5611 male patients who had been newly diagnosed with LSC from 2000 to 2004. The date of diagnosis was identified as the index date. LSC patients with incomplete demographic information or with a history of ED before the index date were excluded. In total, 22444 age-matched patients without LSC were randomly selected as the non-LSC group based on a 1:4 ratio. Subsequence occurrence of ED was measured until 2011. The association between LSC and the risk of developing ED was estimated using Cox proportional hazard regression model. Results After adjusting for age and comorbidities, patients with LSC had a 1.74-fold greater risk of developing ED compared with those without LSC (95% confidence interval=1.44–2.10). LSC patients with comorbidities including diabetes, hyperlipidemia, hypertension, cardiovascular disease, peripheral arterial disease, chronic obstructive pulmonary disease, chronic kidney disease, depression, and anxiety were at a higher risk of ED compared with the non-LSC patients without comorbidities. Conclusions LSC confers a greater risk in the development of ED. Physicians should be aware of the potential of ED occurrence in LSC patients.
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Affiliation(s)
- Chao-Kuei Juan
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Jui-Lung Shen
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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Abstract
Illicit drug use is prevalent worldwide; over 24 million people are estimated to have used recreational drugs during the past month in the UK and USA alone. Illicit drug use can result in a wide spectrum of potential medical complications that include many urological manifestations. To ensure optimal care and treatment, urologists need to be cognizant of these complications in their patients, particularly among youths. Ketamine uropathy is thought to affect over one-quarter of ketamine users and can lead to severe lower urinary tract symptoms, as well as upper tract obstruction. Cannabis use has been associated with an increased risk of bladder cancer, prostate cancer and nonseminomatous germ cell tumours in case-control studies. Fournier's gangrene has been reported following injection of heroin and cocaine into the penis. Excessive use of cough medicines can lead to the development of radiolucent stones composed of ephedrine, pseudoephedrine and guaifenesin. As the current evidence is mostly limited to case reports and case series, future epidemiological studies are needed to fully address this issue.
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Affiliation(s)
- Sean C Skeldon
- Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - S Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Level 6, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
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Increased risk of erectile dysfunction in patients with sudden sensorineural hearing loss: a nationwide, population-based cohort study. Otol Neurotol 2013; 34:862-7. [PMID: 23739556 DOI: 10.1097/mao.0b013e3182923fd5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Previous studies have proposed that impaired cochlear blood perfusion and microvascular damage are important etiopathogenetic events in the development of sudden sensorineural hearing loss (SSHL). The purpose of this study was to test the hypothesis that SSHL is a risk factor for the development of erectile dysfunction (ED). STUDY DESIGN A retrospective cohort study. SETTING Population-based study of Taiwan National Health Insurance Research Database. METHODS We compared male patients newly diagnosed with SSHL between January 1, 2001, and December 31, 2006 (N = 23,212), with age-matched controls (1:2) (N = 46,424). MAIN OUTCOME MEASURES The incidence of ED at the end of 2009 was determined. RESULTS After adjusting for potential confounding factors, we found an adjusted hazard ratio (HR) of 1.942 (95% confidence interval, 1.688-2.233, p < 0.05), showing that patients with SSHL were more likely to experience ED than the control population. When stratified by patients' age, the incidence of ED was 1.90-, 2.25-, and 1.84-fold higher for SSHL-diagnosed patients 16 to 34 years old (p = 0.0408), 35 to 49 years old (p < 0.0001), and 50 to 64 years old (p < 0.0001), respectively, than in the non-SSHL group. Hypertension and chronic renal disease comorbidities in patients with SSHL seemed to be associated with an increased risk of developing ED. CONCLUSION SSHL may confer an independent risk of ED. This observation supports the assumption of the underlying vascular mechanism regarding the development of SSHL. Thus, clinicians managing SSHL patients should be aware of the potential of the development of ED. EVIDENCE LEVEL 2B.
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Wang Y, Liu T, Rossi PJ, Watkins-Bruner D, Hsiao W, Cooper S, Yang X, Jani AB. Influence of vascular comorbidities and race on erectile dysfunction after prostate cancer radiotherapy. J Sex Med 2013; 10:2108-14. [PMID: 23742221 DOI: 10.1111/jsm.12215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vascular comorbidities (VC) (hypertension, diabetes, and hyperlipidemia) are known factors related to erectile dysfunction (ED) in men. However, no data are yet available for the effects of VC on ED incidence after prostate cancer radiotherapy (XRT). AIM To investigate the influence of VC on post-XRT ED incidence and to further characterize ED incidence by racial groups. MAIN OUTCOME MEASURES ED incidence. METHODS We reviewed 732 charts of patients (267 Caucasian and 465 African American [AA]) who received prostate XRT (external beam radiotherapy and/or brachytherapy) with or without hormone therapy between 1999 and 2010. The number of pre-XRT VC (0, 1, 2, or 3) was determined by medical history and medication list. ED (defined by use of erectile aids or by documentation of moderate or high sexual dysfunction on patient history) was determined pre-XRT as well as 1, 2, and 4 years post-XRT. RESULTS ED incidence progressively increased from 22% pre-XRT to 58% 4 years post-XRT (P < 0.01). Additionally, ED incidence significantly increased with number of VC-4-year incidence between patients with 1 vs. 0 (P = 0.02), 2 vs. 0 (P < 0.01), 3 vs. 0 (P < 0.01), 3 vs. 1 (P < 0.01), and 3 vs. 2 (P = 0.04) VC (2 vs. 1 VC was nonsignificant). Compared with the Caucasian patients, ED incidences were slightly higher for the AA group with 0, 1, 2, and 3 comorbidities at 4 years follow-up (but statistically nonsignificant). CONCLUSIONS The number of VCs have a significant effect on development of post-XRT ED. Pre- and post-XRT ED appear to be independent of race when number of VCs are considered. Our results can be used to guide physicians in counseling patients on the incidence of ED by number of VC and as preliminary data for prospective efforts aimed at reducing post-XRT ED.
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Affiliation(s)
- Yuefeng Wang
- Department of Radiation Oncology, Emory University, Atlanta, GA 30322, USA
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Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, Castiglione F, Briganti A, Cantiello F, Damiano R, Montorsi F, Salonia A. One patient out of four with newly diagnosed erectile dysfunction is a young man--worrisome picture from the everyday clinical practice. J Sex Med 2013; 10:1833-41. [PMID: 23651423 DOI: 10.1111/jsm.12179] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common complaint in men over 40 years of age, and prevalence rates increase throughout the aging period. Prevalence and risk factors of ED among young men have been scantly analyzed. AIM Assessing sociodemographic and clinical characteristics of young men (defined as ≤ 40 years) seeking first medical help for new onset ED as their primary sexual disorder. METHODS Complete sociodemographic and clinical data from 439 consecutive patients were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the International Index of Erectile Function (IIEF). MAIN OUTCOME MEASURE Descriptive statistics tested sociodemographic and clinical differences between ED patients ≤ 40 years and >40 years. RESULTS New onset ED as the primary disorder was found in 114 (26%) men ≤ 40 years (mean [standard deviation [SD]] age: 32.4 [6.0]; range: 17-40 years). Patients ≤ 40 years had a lower rate of comorbid conditions (CCI = 0 in 90.4% vs. 58.3%; χ(2) , 39.12; P < 0.001), a lower mean body mass index value (P = 0.005), and a higher mean circulating total testosterone level (P = 0.005) as compared with those >40 years. Younger ED patients more frequently showed habit of cigarette smoking and use of illicit drug, as compared with older men (all P ≤ 0.02). Premature ejaculation was more comorbid in younger men, whereas Peyronie's disease was prevalent in the older group (all P = 0.03). At IIEF, severe ED rates were found in 48.8% younger men and 40% older men, respectively (P > 0.05). Similarly, rates of mild, mild-to-moderate, and moderate ED were not significantly different between the two groups. CONCLUSIONS This exploratory analysis showed that one in four patients seeking first medical help for new onset ED was younger than 40 years. Almost half of the young men suffered from severe ED, with comparable rates in older patients. Overall, younger men differed from older individuals in terms of both clinical and sociodemographic parameters.
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Affiliation(s)
- Paolo Capogrosso
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
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Abstract
Erectile dysfunction is a common clinical entity that affects mainly men older than 40 years. In addition to the classical causes of erectile dysfunction, such as diabetes mellitus and hypertension, several common lifestyle factors, such as obesity, limited or an absence of physical exercise, and lower urinary tract symptoms, have been linked to the development of erectile dysfunction. Substantial steps have been taken in the study of the association between erectile dysfunction and cardiovascular disease. Erectile dysfunction is a strong predictor for coronary artery disease, and cardiovascular assessment of a non-cardiac patient presenting with erectile dysfunction is now recommended. Substantial advances have occurred in the understanding of the pathophysiology of erectile dysfunction that ultimately led to the development of successful oral therapies, namely the phosphodiesterase type 5 inhibitors. However, oral phosphodiesterase type 5 inhibitors have limitations, and present research is thus investigating cutting-edge therapeutic strategies including gene and cell-based technologies with the aim of discovering a cure for erectile dysfunction.
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Affiliation(s)
- Rany Shamloul
- Department of Urology, University of Ottawa, Ottawa, ON, Canada.
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Diehl A, Silva RLD, Laranjeira R. Female sexual dysfunction in patients with substance-related disorders. Clinics (Sao Paulo) 2013; 68:205-12. [PMID: 23525317 PMCID: PMC3584261 DOI: 10.6061/clinics/2013(02)oa14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 10/26/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit. METHODS This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerstrom Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered. RESULTS The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerstrom Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence. CONCLUSIONS Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use.
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Affiliation(s)
- Alessandra Diehl
- National Institute of Alcohol and Drugs Policy, Alcohol and Drug Research Unit, Psychiatry Department, Federal University of São Paulo, Sao Paulo, SP, Brazil.
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Mialon A, Berchtold A, Michaud PA, Gmel G, Suris JC. Sexual dysfunctions among young men: prevalence and associated factors. J Adolesc Health 2012; 51:25-31. [PMID: 22727073 DOI: 10.1016/j.jadohealth.2012.01.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 01/09/2012] [Accepted: 01/09/2012] [Indexed: 01/23/2023]
Abstract
PURPOSE The purposes of this study are to measure the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) among a population of Swiss young men and to assess which factors are associated with these sexual dysfunctions in this age-group. METHODS For each condition (PE and ED), we performed separate analyses comparing young men suffering from the condition with those who were not. Groups were compared for substance use (tobacco, alcohol, cannabis, other illegal drugs, and medication without a prescription), self-reported body mass index, sexual orientation, physical activity, professional activity, sexual experience (sexual life length and age at first intercourse), depression status, mental health, and physical health in a bivariate analysis. We then used a log-linear analysis to consider all significant variables simultaneously. RESULTS Prevalence rates for PE and ED were 11% and 30%, respectively. Poor mental health was the only variable to have a direct association with both conditions after controlling for potential confounders. In addition, PE was directly associated with tobacco, illegal drugs, professional activity, and physical activity, whereas ED was directly linked with medication without a prescription, length of sexual life, and physical health. CONCLUSIONS In Switzerland, one-third of young men suffer from at least one sexual dysfunction. Multiple health-compromising factors are associated with these dysfunctions. These should act as red flags for health professionals to encourage them to take any opportunity to talk about sexuality with their young male patients.
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Affiliation(s)
- Anaïs Mialon
- Research Group on Adolescent Health, Institute of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
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Aversa A, Bruzziches R, Francomano D, Natali M, Lenzi A. Testosterone and phosphodiesterase type-5 inhibitors: new strategy for preventing endothelial damage in internal and sexual medicine? Ther Adv Urol 2011; 1:179-97. [PMID: 21789066 DOI: 10.1177/1756287209344992] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Normal vascular endothelium is essential for the synthesis and release of substances affecting vascular tone (e.g. nitric oxide; NO), cell adhesion (e.g. endothelins, interleukins), and the homeostasis of clotting and fibrinolysis (e.g. plasminogen inhibitors, von Willebrand factor). The degeneration of endothelial integrity promotes adverse events (AEs) leading to increased atherogenesis and to the development of vascular systemic and penile end-organ disease. Testosterone (T) is an important player in the regulation of vascular tone through non-genomic actions exerted via blockade of extracellular-calcium entry or activation of potassium channels; also, adequate T concentrations are paramount for the regulation of phosphodiesterase type-5 (PDE5) expression and finally, for the actions exerted by hydrogen sulphide, a gas involved in the alternative pathway controlling vasodilator responses in penile tissue. It is known that an age-related decline of serum T is reported in approximately 20 to 30% of men whereas T deficiency is reported in up to 50% of men with metabolic syndrome or diabetes. A number of laboratory and human studies have shown the combination of T and other treatments for erectile dysfunction (ED), such as PDE5 inhibitors, to be more beneficial in patients with ED and hypogonadism, who fail monotherapy for sexual disturbances.The aim of this review is to show evidence on the role of T and PDE5 inhibitors, alone or in combination, as potential boosters of endothelial function in internal medicine diseases associated with reduced T or NO bioavailability, i.e. metabolic syndrome, obesity, diabetes, coronary artery disease, hyperhomocysteinemia, that share common risk factors with ED. Furthermore, the possibility of such a strategy to prevent endothelial dysfunction in men at increased cardiovascular risk is discussed.
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Affiliation(s)
- Antonio Aversa
- Dip.to Fisiopatologia Medica, Room 37, Viale Policlinico 155, 00161 Rome Italy
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Banerjee A, Singh A, Srivastava P, Turner H, Krishna A. Effects of chronic bhang (cannabis) administration on the reproductive system of male mice. ACTA ACUST UNITED AC 2011; 92:195-205. [PMID: 21678546 DOI: 10.1002/bdrb.20295] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 03/30/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the effect of chronic uptake of bhang, prepared from the Cannabis sativa, on male reproductive physiology in adult male Parkes strain (P) mice. An attempt was also made to investigate the presence of cannabinoid 1 (CB1) and cannabinoid 2 (CB2) receptors, and fatty acid amide hydrolase (FAAH) in the testis and to evaluate any changes in it resulting from chronic intake of bhang in mice. METHODS AND RESULTS Adult male mice were given bhang (3 or 6 mg/kg body weight/day) orally for 36 consecutive days. Chronic intake of bhang caused regressive changes in the testes and suppressed sperm count, viability and motility. Bhang intake also caused significant decline in circulating testosterone level due to decline in testicular 3β HSD enzyme activity. An immunohistochemical study demonstrated the presence of CB1, CB2 and FAAH in the testis of mice. The present study also showed significant variation in the CB1 and CB2 receptors and FAAH protein levels in testes of mice exposed to bhang. These suppressive effects may be due to inhibitory effect of bhang on pituitary expression of gonadotrophin releasing hormone (GnRH) I receptor protein. Treatment of testes with bhang in vitro significantly decreased testicular luteinizing hormone receptor (LHR) and FAAH expression suggesting direct action of bhang on testicular activity. CONCLUSIONS The findings of this study thus suggest that bhang may impair fertility in male mice through alteration in the testicular endocannabinoid system and that chronic bhang exposure in humans would be predicted to alter male fertility.
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Affiliation(s)
- Arnab Banerjee
- Department of Zoology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Gorzalka BB, Hill MN, Chang SCH. Male-female differences in the effects of cannabinoids on sexual behavior and gonadal hormone function. Horm Behav 2010; 58:91-9. [PMID: 19733173 DOI: 10.1016/j.yhbeh.2009.08.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2009] [Revised: 08/18/2009] [Accepted: 08/26/2009] [Indexed: 11/19/2022]
Abstract
The putative role of the endocannabinoid system and the effects of cannabis use in male and female sexual functioning are summarized. The influence of cannabis intake on sexual behavior and arousability appear to be dose-dependent in both men and women, although women are far more consistent in reporting facilitatory effects. Furthermore, evidence from nonhuman species indicate somewhat more beneficial than debilitating effects of cannabinoids on female sexual proceptivity and receptivity while suggesting predominantly detrimental effects on male sexual motivation and erectile functioning. Data from human and nonhuman species converge on the ephemeral nature of THC-induced testosterone decline. However, it is clear that cannabinoid-induced inhibition of male sexual behavior is independent of concurrent declines in testosterone levels. Investigations also reveal a suppression of gonadotropin release by cannabinoids across various species. Historical milestones and promising future directions in the area of cannabinoid and sexuality research are also outlined in this review.
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Affiliation(s)
- Boris B Gorzalka
- Department of Psychology, University of British Columbia, Vancouver, Canada, BC V6T 1Z4.
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Fattore L, Melis M, Fadda P, Pistis M, Fratta W. The endocannabinoid system and nondrug rewarding behaviours. Exp Neurol 2010; 224:23-36. [PMID: 20353776 DOI: 10.1016/j.expneurol.2010.03.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Rewarding behaviours such as sexual activity, eating, nursing, parenting, social interactions, and play activity are conserved strongly in evolution, and they are essential for development and survival. All of these behaviours are enjoyable and represent pleasant experiences with a high reward value. Remarkably, rewarding behaviours activate the same brain circuits that mediate the positive reinforcing effects of drugs of abuse and of other forms of addiction, such as gambling and food addiction. Given the involvement of the endocannabinoid system in a variety of physiological functions of the nervous system, it is not surprising that it takes part in the complex machinery that regulates gratification and perception of pleasure. In this review, we focus first on the role of the endocannabinoid system in the modulation of neural activity and synaptic functions in brain regions that are involved in natural and nonnatural rewards (namely, the ventral tegmental area, striatum, amygdala, and prefrontal cortex). Then, we examine the role of the endocannabinoid system in modulating behaviours that directly or indirectly activate these brain reward pathways. More specifically, current knowledge of the effects of the pharmacological manipulation of the endocannabinoid system on natural (eating, sexual behaviour, parenting, and social play) and pathological (gambling) rewarding behaviours is summarised and discussed.
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Affiliation(s)
- Liana Fattore
- CNR Neuroscience Institute - Cagliari, Cittadella Universitaria di Monserrato, Italy
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Aversa A, Bruzziches R, Francomano D, Natali M, Gareri P, Spera G. Endothelial dysfunction and erectile dysfunction in the aging man. Int J Urol 2009; 17:38-47. [DOI: 10.1111/j.1442-2042.2009.02426.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Angelopoulou R, Goulis DG, Lavranos GM. The metabolic syndrome in andrology. JOURNAL OF MEN'S HEALTH 2009. [DOI: 10.1016/j.jomh.2009.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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