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Barham DW. The role of cortisol in erectile function. Transl Androl Urol 2023; 12:1213-1214. [PMID: 37680226 PMCID: PMC10481202 DOI: 10.21037/tau-23-289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/05/2023] [Indexed: 09/09/2023] Open
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2
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Rahardjo HE, Becker AJ, Märker V, Kuczyk MA, Ückert S. Is cortisol an endogenous mediator of erectile dysfunction in the adult male? Transl Androl Urol 2023; 12:684-689. [PMID: 37305638 PMCID: PMC10251093 DOI: 10.21037/tau-22-566] [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: 08/22/2022] [Accepted: 02/12/2023] [Indexed: 06/13/2023] Open
Abstract
Background It has been speculated for decades whether there is a significance of the adrenal corticosteroid cortisol in the process of male sexual function, including the control of sexual arousal and penile erection. In order to investigate further the role of the adrenocorticotropic axis in the physiological process of penile erection, we aimed to determine the course of cortisol in the cavernous and systemic blood through different stages of sexual arousal in patients suffering from erectile dysfunction (ED) in comparison to a cohort of healthy males. Methods Fifty-four healthy adult males and 45 patients with ED were presented sexually explicit visual material in order to elicit tumescence and (in the healthy males) rigid erection. Blood was collected from the cavernous space (corpus cavernosum penis, CC) and a cubital vein (CV) at different stages of the sexual arousal cycle as indicated by the penile stages flaccidity, tumescence, rigidity (attained only by the healthy males) and detumescence. Cortisol (µg/dL serum) was measured using a radioimmunometric assay (RIA). Results In healthy males, cortisol decreased in both the cavernous and systemic blood with the beginning of sexual stimulation (CV: 15 to 13, CC: 16 to 13). At detumescence, in the systemic circulation, no alterations in cortisol levels were registered, whereas it decreased further in the CC (to 12). In the ED patients, no significant changes in cortisol were noticed in the systemic and cavernous blood. Conclusions The findings indicate that cortisol might act as an antagonist of the normal sexual response cycle of the adult male. A dysregulation of the secretion and/or degradation of the hormone might well play a role in the manifestation of ED.
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Affiliation(s)
- Harrina E. Rahardjo
- Department of Urology, University of Indonesia, School of Medicine, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Armin J. Becker
- Department of Urology, Ludwig Maximilians University, Academic Hospital Grosshadern, Munich, Germany
| | - Viktoria Märker
- Department of Forensic Psychiatry, University Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Markus A. Kuczyk
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany
| | - Stefan Ückert
- Division of Surgery, Department of Urology & Urological Oncology, Hannover Medical School, Hannover, Germany
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3
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Jiang Q, Linn T, Drlica K, Shi L. Diabetes as a potential compounding factor in COVID-19-mediated male subfertility. Cell Biosci 2022; 12:35. [PMID: 35307018 PMCID: PMC8934536 DOI: 10.1186/s13578-022-00766-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/21/2022] [Indexed: 01/09/2023] Open
Abstract
Recent work indicates that male fertility is compromised by SARS-CoV-2 infection. Direct effects derive from the presence of viral entry receptors (ACE2 and/or CD147) on the surface of testicular cells, such as spermatocytes, Sertoli cells, and Leydig cells. Indirect effects on testis and concentrations of male reproductive hormones derive from (1) virus-stimulated inflammation; (2) viral-induced diabetes, and (3) an interaction between diabetes and inflammation that exacerbates the deleterious effect of each perturbation. Reproductive hormones affected include testosterone, luteinizing hormone, and follicle-stimulating hormone. Reduction of male fertility is also observed with other viral infections, but the global pandemic of COVID-19 makes demographic and public health implications of reduced male fertility of major concern, especially if it occurs in the absence of serious symptoms that would otherwise encourage vaccination. Clinical documentation of COVID-19-associated male subfertility is now warranted to obtain quantitative relationships between infection severity and subfertility; mechanistic studies using animal models may reveal ways to mitigate the problem. In the meantime, the possibility of subfertility due to COVID-19 should enter considerations of vaccine hesitancy by reproductive-age males.
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Affiliation(s)
- Qingkui Jiang
- grid.430387.b0000 0004 1936 8796Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers The State University of New Jersey, Newark, NJ USA
| | - Thomas Linn
- grid.8664.c0000 0001 2165 8627Clinical Research Unit, Centre of Internal Medicine, Justus-Liebig-University (JLU), Giessen, Germany
| | - Karl Drlica
- grid.430387.b0000 0004 1936 8796Public Health Research Institute and Department of Microbiology, Biochemistry, and Molecular Genetics, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers The State University of New Jersey, Newark, NJ USA
| | - Lanbo Shi
- grid.430387.b0000 0004 1936 8796Public Health Research Institute, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Rutgers The State University of New Jersey, Newark, NJ USA
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4
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Cedergren Weber G, Odin P. Diagnostic work up: Laboratory and biomarkers. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:53-96. [PMID: 35397789 DOI: 10.1016/bs.irn.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This chapter will focus on the diagnostic work around sexual dysfunction in Parkinson's disease, especially laboratory tests and biomarkers. A number of methods to analyze if sexual dysfunction is caused by neural pathology, vascular dysfunction or other mechanisms are now available. Other methods can be used to differentiate between psychogenic/functional reasons behind sexual dysfunction and organic ones. The role of biomarkers for diagnosis, but also for understanding the reason behind and for counteracting sexual dysfunction is becoming more evident. There is also a rich and increasing number of scales and other instruments available for detecting and quantifying sexual hypo- and hyperactivity. When investigating the reason behind sexual dysfunction in patients with Parkinson's disease comorbidities should also be considered. Finally, early and pronounced sexual dysfunction might in some cases be an indication that differential diagnosis, like Multisystem Atrophy, should be thought about. All these aspects of the diagnostic procedures around sexual dysfunction in Parkinson's disease will be covered in this chapter.
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Affiliation(s)
- Gustav Cedergren Weber
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Per Odin
- Division of Neurology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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5
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Zhang F, Xiong Y, Qin F, Yuan J. Short Sleep Duration and Erectile Dysfunction: A Review of the Literature. Nat Sci Sleep 2022; 14:1945-1961. [PMID: 36325277 PMCID: PMC9621223 DOI: 10.2147/nss.s375571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022] Open
Abstract
The meaning of sleep has puzzled people for millennia. In modern society, short sleep duration is becoming a global problem. It has been established that short sleep duration can increase the risk of several diseases, such as cardiovascular and metabolic diseases. Currently, a growing body of research has revealed a possible link between sleep disorders and erectile dysfunction (ED). However, the mechanisms linking short sleep duration and ED are largely unknown. Thus, we provide a review of clinical trials and animal studies. In this review, we propose putative pathways connecting short sleep duration and ED, including neuroendocrine pathways and molecular mechanisms, aiming to pave the way for future research. Meanwhile, the assessment and improvement of sleep quality should be recommended in the diagnosis and treatment of ED patients.
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Affiliation(s)
- Fuxun Zhang
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yang Xiong
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Feng Qin
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jiuhong Yuan
- Andrology Laboratory, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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6
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Romano L, Granata L, Fusco F, Napolitano L, Cerbone R, Priadko K, Sciorio C, Mirone V, Romano M. Sexual Dysfunction in Patients With Chronic Gastrointestinal and Liver Diseases: A neglected Issue. Sex Med Rev 2021; 10:620-631. [PMID: PMID: 37051954 DOI: 10.1016/j.sxmr.2021.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/20/2021] [Accepted: 02/25/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Normal sexual activity is an important determinant of quality of life. Unfortunately, several chronic health disorders are associated with an impaired sexual function. OBJECTIVE To provide coverage of the current literature on prevalence and pathophysiology of sexual dysfunction in patients with gastrointestinal and liver disorders METHODS: A Comprehensive review of the literature on the prevalence of sexual dysfunction in chronic gastrointestinal and liver disorders, assessing the underlying mechanism (s) was performed. RESULTS Many gastrointestinal disorders, either functional or organic, are associated with some degree of sexual dysfunction. The main pathogenic mechanisms are: (i) the disease itself causing fatigue, anxiety or depression with a potential alteration of self-esteem; (ii) worry of transmitting a potential infectious agent through sexual activity; (iii) alteration of the endocrine mechanisms which are necessary for normal sexual functioning; (iv) chronic pro- inflammatory conditions which may cause endothelial dysfunction and abnormal vascular responses; (v) iatrogenic. CONCLUSION Based on this review, a thorough evaluation of sexual function through validated questionnaires and/or psychological interviews with patients with chronic gastrointestinal disorders should be part of the clinical assessment in order to timely diagnose and possibly treat sexual dysfunction in this clinical setting. L Romano, L Granata, F Fusco, et al. Sexual Dysfunction in Patients With Chronic Gastrointestinal and Liver Diseases: A neglected Issue. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Lorenzo Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Lucia Granata
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Rosa Cerbone
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | - Kateryna Priadko
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
| | | | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Marco Romano
- Dipartimento di Medicina di Precisione, Hepato-Gastroenterology Unit, Università della Campania Luigi Vanvitelli, Napoli, Italy
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7
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Salvio G, Martino M, Giancola G, Arnaldi G, Balercia G. Hypothalamic-Pituitary Diseases and Erectile Dysfunction. J Clin Med 2021; 10:2551. [PMID: 34207687 PMCID: PMC8229897 DOI: 10.3390/jcm10122551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 12/11/2022] Open
Abstract
Several hormones contribute to ensure penile erection, a neurovascular phenomenon in which nitric oxide plays a major role. Erectile dysfunction (ED), which is defined as the persistent inability to obtain or maintain penile erection sufficient for a satisfactory sexual performance, may be due to arteriogenic, neurogenic, iatrogenic, but also endocrinological causes. The hypothalamus-pituitary axis plays a central role in the endocrine system and represents a fundamental link between the brain and peripheral glands, including gonads. Therefore, the hormonal production of the hypothalamic-pituitary axis can control various aspects of sexual function and its dysregulation can compromise erectile function. In addition, excess and deficiency of pituitary hormones or metabolic alterations that are associated with some pituitary diseases (e.g., Cushing's disease and acromegaly, hypopituitarism) can determine the development of ED with different mechanisms. Thus, the present review aimed to explore the relationship between hypothalamic and pituitary diseases based on the most recent clinical and experimental evidence.
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Affiliation(s)
- Gianmaria Salvio
- Division of Endocrinology, Department of Clinical and Molecular Sciences (DISCLIMO), Polytechnic University of Marche, Umberto I Hospital, 60126 Ancona, Italy; (M.M.); (G.G.); (G.A.); (G.B.)
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8
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Fiala L, Lenz J, Sajdlova R. Effect of increased prolactin and psychosocial stress on erectile function. Andrologia 2021; 53:e14009. [PMID: 33595132 DOI: 10.1111/and.14009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/11/2020] [Accepted: 01/27/2021] [Indexed: 02/02/2023] Open
Abstract
Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = .50) and results of the trauma checklist score (R = .55) and significant Spearman correlations between TSC-40 and prolactin (R = .52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.
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Affiliation(s)
- Ludek Fiala
- Psychiatric Clinic, Department of Sexology, Faculty of Medicine, Charles University, Pilsen, Czech Republic.,First Faculty of Medicine, Institute of Sexology, Charles University, Prague, Czech Republic
| | - Jiri Lenz
- Department of Pathology, Znojmo Hospital, Znojmo, Czech Republic.,Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Rachel Sajdlova
- Psychiatric Clinic, Department of Sexology, Faculty of Medicine, Charles University, Pilsen, Czech Republic
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9
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Leydig cell aging: Molecular mechanisms and treatments. VITAMINS AND HORMONES 2021; 115:585-609. [PMID: 33706963 DOI: 10.1016/bs.vh.2020.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Late-onset hypogonadism, resulting from deficiency in serum testosterone (T), affects the health and quality of life of millions of aging men. T is synthesized by Leydig cells (LCs) in response to luteinizing hormone (LH). LH binds LC plasma membrane receptors, inducing the formation of a supramolecular complex of cytosolic and mitochondrial proteins, the Steroidogenic InteracTomE (SITE). SITE proteins are involved in targeting cholesterol to CYP11A1 in the mitochondria, the first enzyme of the steroidogenic cascade. Cholesterol translocation is the rate-determining step in T formation. With aging, LC defects occur that include changes in SITE, an increasingly oxidative intracellular environment, and reduced androgen formation and serum T levels. T replacement therapy (TRT) will restore T levels, but reported side effects make it desirable to develop additional strategies for increasing T. One approach is to target LC protein-protein interactions and thus increase T production by the hypofunctional Leydig cells themselves.
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10
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Fiala L, Lenz J. Psychosocial stress, somatoform dissociative symptoms and free testosterone in premature ejaculation. Andrologia 2020; 52:e13828. [DOI: 10.1111/and.13828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/09/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Ludek Fiala
- Institute of Sexology First Faculty of Medicine Charles University Prague Czech Republic
- Department of Psychiatry Faculty of Medicine Charles University Pilsen Czech Republic
| | - Jiri Lenz
- Department of Pathology Znojmo Hospital Znojmo Czech Republic
- Department of Anatomy, Histology and Embryology Faculty of Veterinary Medicine University of Veterinary and Pharmaceutical Sciences Brno Brno Czech Republic
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11
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The Role of Hormones in Male Sexual Function. CURRENT SEXUAL HEALTH REPORTS 2020. [DOI: 10.1007/s11930-020-00271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
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Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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13
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Physical activity as an adjunct treatment for erectile dysfunction. Nat Rev Urol 2019; 16:553-562. [PMID: 31239541 DOI: 10.1038/s41585-019-0210-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 01/04/2023]
Abstract
Increasing data are available to suggest that physical activity and lifestyle modification in general can benefit erectile function, with effect sizes comparable with established treatment options such as testosterone therapy and phosphodiesterase type 5 inhibitors. Despite this evidence, primary-care physicians are rarely afforded critical information on the underlying mechanisms through which physical activity works as a treatment, severely hampering treatment credibility for both physician and patient. Physical activity is associated with psychological and metabolic adaptations that are compatible with the adaptations required for the treatment of erectile dysfunction (ED). These adaptations include increased expression and activity of nitric oxide synthase, strengthened endothelial function, acute rises in testosterone, decreased stress and anxiety, and improved body image. Use of physical activity as a first-line treatment option for ED is limited, and explicit physical activity guidelines for the treatment of ED are required. Such guidelines should include not only a suggested exercise programme but also guidelines for physician-patient communication that might enhance patient receptivity and therapy continuation. An understanding of how physical activity affects erectile function, as well as its effectiveness in treating ED compared with other established treatments, can benefit urologists and primary-care physicians searching for noninvasive treatment options for men presenting with poor erectile function.
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14
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Trends in Analysis of Cortisol and Its Derivatives. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1140:649-664. [DOI: 10.1007/978-3-030-15950-4_39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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15
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Sexual Enhancing Effect of Anacardium occidentale in Stress-Exposed Rats by Improving Dopaminergic and Testicular Functions. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6452965. [PMID: 30498760 PMCID: PMC6222230 DOI: 10.1155/2018/6452965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 08/12/2018] [Accepted: 09/12/2018] [Indexed: 12/25/2022]
Abstract
In this study, we aimed to assess the effect and possible underlying mechanism of Anacardium occidentale leaves extract on male sexual behaviors in stress-exposed rats. Male Wistar rats were orally given A. occidentale extract at doses of 25, 100, and 200 mg/kg BW before 12-hour-immobilization exposure for 14 days. Sexual behaviors, serum testosterone and corticosterone levels, TH-positive cells density in nucleus accumbens (NAc) and ventral tegmental area (VTA), MAO-B activity in NAc and medial preoptic area (MPOA), testis histology together with phosphodiesterase type-5 ( PDE-5) activity, and endothelial nitric oxide synthase (eNOS) expression in penis were evaluated after treatment. All doses of extract improved male sexual behaviors, suppressed MAO-B in NAc, enhanced TH-positive cells density in NAc, suppressed PDE-5 in penis, and enhanced interstitial cell of Leydig. The increase of serum testosterone, TH-positive cells density in VTA, eNOS expression in penis, and the decreased serum corticosterone were observed at some doses. Therefore, the sexual enhancing effect of extract occurred mainly via the improved dopaminergic and testicular functions. PDE-5 suppression in penis also played the role especially in the increased intromission behavior. Therefore, A. occidentale leaves extract is the potential protective agent against sexual dysfunction. However, further researches are necessary.
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16
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Hoyt MA, Gaffey AE, Wang AW, Litwin MS, Lawsin CJ. Sexual well-being and diurnal cortisol after prostate cancer treatment. J Health Psychol 2018; 25:1796-1801. [PMID: 29696999 DOI: 10.1177/1359105318772655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sexual dysfunction and psychological distress are common after prostate cancer. Research has not examined the role of neuroendocrine markers of stress (e.g. cortisol). This study examines whether sexual functioning or sexual bother is associated with diurnal cortisol. Men treated for prostate cancer completed the University of California-Los Angeles Prostate Cancer Index and provided saliva samples four times daily for cortisol assessment. Higher sexual bother, but not sexual functioning, was associated with steeper cortisol slope. Better sexual functioning, and not sexual bother, was significantly associated with the cortisol awakening response. Assessment of stress and stress-reducing interventions might be warranted in sexual rehabilitation after prostate cancer.
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17
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Androvicova R, Horacek J, Tintera J, Hlinka J, Rydlo J, Jezova D, Balikova M, Hlozek T, Miksatkova P, Kuchar M, Roman M, Tomicek P, Tyls F, Viktorinova M, Palenicek T. Individual prolactin reactivity modulates response of nucleus accumbens to erotic stimuli during acute cannabis intoxication: an fMRI pilot study. Psychopharmacology (Berl) 2017; 234:1933-1943. [PMID: 28401285 DOI: 10.1007/s00213-017-4601-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/13/2017] [Indexed: 01/13/2023]
Abstract
RATIONALE Self-report studies indicate that cannabis could increase sexual desire in some users. We hypothesized that intoxication increases activation of brain areas responsive to visual erotica, which could be useful in the treatment of hypoactive sexual desire disorder, a condition marked by a lack of sexual desire. OBJECTIVES The aim of this study is to assess the aphrodisiacal properties of cannabis. METHODS We conducted an open-randomized study with 21 heterosexual casual cannabis users. A 3T MRI was used to measure brain activation in response to erotic pictures. Blood samples were collected to determine the serum levels of cannabinoids, cortisol and prolactin. Participants were grouped according to whether they had ever experienced any aphrodisiacal effects during intoxication (Group A) or not (Group non-A). RESULTS Intoxication was found to significantly increase activation in the right nucleus accumbens in the Group A while significantly decreasing activation in the Group non-A. There was also a significant interaction between the group and intoxication, with elevated prolactin in the Group non-A during intoxication. No intoxication-related differences in subjective picture evaluations were found. CONCLUSION Cannabis intoxication increases activation of the right nucleus accumbens to erotic stimuli. This effect is limited to users whose prolactin is not elevated in response to intoxication. This effect may be useful in the treatment of low sexual desire.
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Affiliation(s)
- R Androvicova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic. .,Third Medical Faculty, Charles University, Prague, Czech Republic.
| | - J Horacek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Third Medical Faculty, Charles University, Prague, Czech Republic
| | - J Tintera
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Institute of clinical and experimental medicine, Prague, Czech Republic
| | - J Hlinka
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic
| | - J Rydlo
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Institute of clinical and experimental medicine, Prague, Czech Republic
| | - D Jezova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - M Balikova
- Institute of Forensic Medicine and Toxicology, First Medical Faculty, Charles University, Prague, Czech Republic
| | - T Hlozek
- Institute of Forensic Medicine and Toxicology, First Medical Faculty, Charles University, Prague, Czech Republic
| | - P Miksatkova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Department of Chemistry of Natural Compounds, Forensic Laboratory of Biologically Active Substances, University of Chemistry and Technology, Prague, Czech Republic
| | - M Kuchar
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Department of Chemistry of Natural Compounds, Forensic Laboratory of Biologically Active Substances, University of Chemistry and Technology, Prague, Czech Republic
| | - M Roman
- Police of the Czech Republic, Institute of criminalistics Prague, Prague, Czech Republic
| | - P Tomicek
- Police of the Czech Republic, Institute of criminalistics Prague, Prague, Czech Republic
| | - F Tyls
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Third Medical Faculty, Charles University, Prague, Czech Republic
| | - M Viktorinova
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Third Medical Faculty, Charles University, Prague, Czech Republic
| | - T Palenicek
- National Institute of Mental Health, Topolova 748, 250 67, Klecany, Czech Republic.,Third Medical Faculty, Charles University, Prague, Czech Republic
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Balkarli A, Erol MK, Yalcinkaya S, Erol RS. Frequency of Erectile Dysfunction in Males with Central Serous Chorioretinopathy. Semin Ophthalmol 2017; 33:482-487. [PMID: 28328282 DOI: 10.1080/08820538.2017.1301968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To evaluate the frequency of sexual dysfunction and associated factors in patients with central serous chorioretinopathy (CSCR). MATERIAL AND METHODS Fifty-eight CSCR patients who met the inclusion criteria and 99 age- and sex-matched healthy controls were prospectively investigated for sexual dysfunction and associated factors. All participants were investigated using the Beck Depression Inventory (BDI), Beck Anxiety Scale (BAS), and the15-question Index of Erectile Function-15 (IIEF-15) and by extensive examination of CSCR, associated factors, and confounding factors. RESULTS The mean ages of the patient and control groups were 46.95±11.27 and 45.3±10.93 years, respectively (p=0.370). The erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall sexual satisfaction scores of the patient group were significantly lower than those of the control group (p<0.001). Severe erectile dysfunction (ED) was diagnosed in 3 (5.2%), moderate ED in 10 (17.2%), mild-to-moderate ED in 7 (12.1%), and mild ED in 15 (25.9%) patients in the patient group, whereas no severe or moderate ED was diagnosed in the control group. The erectile function score was found to be negatively correlated with age and BMI. No sexual parameters were found to be correlated with choroidal thickness (CT) in either the patient or control group. CONCLUSION CSCR patients experience a higher incidence of sexual dysfunction compared to healthy individuals without CSCR. The exclusion of confounding factors suggests that factors involved in CSCR pathogenesis may also play a role in ED.
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Affiliation(s)
- Ayse Balkarli
- a Department of Internal Medicine, Division of Rheumatology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Muhammet Kazim Erol
- b Department of Ophthalmology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Soner Yalcinkaya
- c Department of Urology , Antalya Education and Research Hospital , Antalya , Turkey
| | - Rumeysa Selvinaz Erol
- d Department of Internal Medicine, Division of Endocrinology , Ordu State Hospital , Ordu , Turkey
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Ajo R, Segura A, Mira L, Inda MDM, Alfayate R, Sánchez-Barbie A, Margarit C, Peiró AM. The relationship of salivary testosterone and male sexual dysfunction in opioid-associated androgen deficiency (OPIAD). Aging Male 2017; 20:1-8. [PMID: 27750480 DOI: 10.1080/13685538.2016.1185408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T). OBJECTIVES To evaluate OPIAD in long-term opioid use in CNP patients. METHODS A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured. Correlations were calculated by Spearman's rho (SPSS 20). RESULTS From 2012 to 2014, 134 from 249 (54%) consecutive male outpatients reported erectile dysfunction (ED), 37% of them related to opioids and 19% evidenced OPIAD. A total of 120 subjects (94 cases and 26 matched-controls) were included. A significantly lower luteinizing hormone, Total-T and Free-T were found, as well as, a significant correlation between Sal-T and Total-T (r = 0.234, p = 0.039), Bio-T (r = 0.241, p = 0.039), IIEF (r = 0.363, p = 0.003) and HAD-anxiety (r = -0.414, p = 0.012) in OPIAD patients. Sal-T levels were significantly lower in patients with severe-moderate ED versus mild ED (p = 0.045) and in patients with severe ED versus moderate-mild ED (p = 0.036). CONCLUSIONS These data demonstrate the high prevalence of ED in long-term use of opioids, part of this is associated to OPIAD, which can be tested by Sal-T as a non-invasive approach.
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Affiliation(s)
- Raquel Ajo
- a Research Unit, Foundation for the Promotion of Health Research and Biomedicine of Valencia (FISABIO) , Alicante , Spain
| | - Ana Segura
- b Andrology Unit, University General Hospital of Alicante (HGUA) , Alicante , Spain
| | - Laura Mira
- c Occupational Observatory, University Miguel Hernández of Elche (UMH) , Alicante , Spain
| | - María-Del-Mar Inda
- a Research Unit, Foundation for the Promotion of Health Research and Biomedicine of Valencia (FISABIO) , Alicante , Spain
| | | | | | | | - Ana M Peiró
- a Research Unit, Foundation for the Promotion of Health Research and Biomedicine of Valencia (FISABIO) , Alicante , Spain
- g Clinical Pharmacology, HGUA , Alicante , Spain
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Walther A, Mahler F, Debelak R, Ehlert U. Psychobiological Protective Factors Modifying the Association Between Age and Sexual Health in Men: Findings From the Men's Health 40+ Study. Am J Mens Health 2017; 11:737-747. [PMID: 28413941 PMCID: PMC5675228 DOI: 10.1177/1557988316689238] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Sexual health severely decreases with age. For males older than 40 years, erectile dysfunction (ED) is the most common sexual disorder. Although physical and psychological risk factors for ED have been identified, protective factors are yet to be determined. To date, no study has examined endocrine and psychosocial factors in parallel with regard to their modifying effect on the age-related increase in ED. Two hundred and seventy-one self-reporting healthy men aged between 40 and 75 years provided both psychometric data on sexual function and a set of potential psychosocial protective factors, and saliva samples for the analysis of steroid hormones and proinflammatory cytokines. Around 35% of the participants reported at least a mild form of ED. Direct associations with ED were identified for perceived general health, emotional support, relationship quality, intimacy motivation but not for steroid hormones or proinflammatory markers. Moderation analyses for the association between age and ED revealed positive effects for testosterone (T), dehydroepiandrosterone (DHEA), perceived general health, emotional support, intimacy motivation, and a negative effect for interleukin-6 (all p < .05; f2 > .17). Group differences between older men with and without ED emerged for T, DHEA, and psychometric measures such as perceived general health, emotional support, satisfaction with life, and intimacy motivation (all p < .05; d > .3). Both psychosocial and endocrine parameters moderated the association between age and sexual health. Perceived general health, emotional support, intimacy motivation, and relationship quality emerged as psychosocial protective factors against ED. Higher T and DHEA and lower interleukin-6 levels also buffered against an age-related increase in ED.
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Hsu CY, Lin CL, Kao CH. Gout is associated with organic and psychogenic erectile dysfunction. Eur J Intern Med 2015; 26:691-5. [PMID: 26089189 DOI: 10.1016/j.ejim.2015.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 05/21/2015] [Accepted: 06/01/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Gout is a deposition disease with an inflammatory response that can increase the risk of cardiovascular disease. Gout is stressful for affected individuals, and can cause erectile dysfunction (ED). The objective of this study was to identify the association between gout and psychogenic ED (PED) and organic ED (OED). METHOD We analyzed 35,265 patients from the National Health Insurance Research Database who had been diagnosed with gout between 2000 and 2011. A total of 70,529 matched controls were included in the study as a comparison. Patients with a history of PED and OED occurring before the index date, aged less than 20 years, or with incomplete demographic information were excluded. Control patients were selected from the population of people without a history of gout, PED, or OED. The following risk factors for PED and OED were included as covariates in the multivariable models: age, comorbidities of coronary artery disease (CAD), peripheral arterial disease, chronic kidney disease (CKD), hypertension, diabetes, hyperlipidemia, depression and anxiety. RESULT Men with gout were more likely to have an increased risk (1.21 times) of ED than were those without gout. Patients with gout were 1.52 times more likely to develop OED and 1.18 times more likely to develop PED than patients in the control group. The risk of developing ED was greater for patients with comorbidities of CKD, diabetes, hyperlipidemia, depression and anxiety. CONCLUSION Gout is associated with organic and psychogenic ED. Clinical physicians should consider this association when treating patients with gout.
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Affiliation(s)
- Chao-Yu Hsu
- Department of Medical Education and Research, Puli Christian Hospital, Puli, Taiwan; Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan; Center for General Education, National Chi Nan University, Puli, Taiwan; Center for General Education, National Taichung University of Science and Technology, Taichung, Taiwan; The General Education Center, Chaoyang University of Technology, Taichung, Taiwan; Department of General Education, National Chin-Yi University of Technology, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, 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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22
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Irritable bowel syndrome is associated not only with organic but also psychogenic erectile dysfunction. Int J Impot Res 2015; 27:233-8. [DOI: 10.1038/ijir.2015.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 08/25/2015] [Accepted: 09/07/2015] [Indexed: 02/06/2023]
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Sansone A, Romanelli F, Jannini EA, Lenzi A. Hormonal correlations of premature ejaculation. Endocrine 2015; 49:333-8. [PMID: 25552341 DOI: 10.1007/s12020-014-0520-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/21/2014] [Indexed: 12/20/2022]
Abstract
Premature ejaculation is the most frequent male sexual dysfunction, significantly impairing quality of life of both the patient and the partner and affecting up to one-third of men of every age. In the last years, our knowledge about this topic has greatly increased, and studies on the causes and treatments related to ejaculatory disorders have shed a light on previously uncharted territory. Public interest on sexual dysfunctions has likewise increased in the general population: the time lapse between the first symptoms of sexual dysfunction and the seeking of medical advice has been significantly reduced, whereas demand for a treatment has markedly increased. A role of endocrine regulation has been established in all the aspects of male reproduction; however, the endocrine control of ejaculation is not fully understood. Sex steroid, pituitary, and thyroid hormones have all been advocated as potential candidates in the regulation of the ejaculatory process, but exact mechanisms are not clear yet and further studies are required in order to identify potential targets for treatment.
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Affiliation(s)
- Andrea Sansone
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy,
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Hart TA, Mustanski B, Ryan DT, Gorbach PM, Stall RD, Surkan PJ, Plankey M. Depression and sexual dysfunction among HIV-positive and HIV-negative men who have sex with men: mediation by use of antidepressants and recreational stimulants. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:399-409. [PMID: 24671728 PMCID: PMC4177518 DOI: 10.1007/s10508-014-0279-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 10/12/2013] [Accepted: 01/02/2014] [Indexed: 06/02/2023]
Abstract
Erectile dysfunction and other forms of sexual dysfunction are highly prevalent among HIV+ men who have sex with men (MSM). Research has not previously identified the mechanisms by which depression may be associated with sexual dysfunction among HIV-positive and HIV-seronegative (HIV-negative) MSM. The present study examined the role of antidepressant use, stimulant use, and smoking as mediators of the relation between depression and sexual dysfunction among HIV-positive and HIV-negative MSM. Participants enrolled in the Multicenter AIDS Cohort Study, an ongoing prospective study of the natural and treated histories of HIV infection among MSM in the United States, completed a modified version of the International Index of Erectile Function for MSM. The study sample included 1,363 participants, with 619 HIV-positive men and 744 HIV-negative men. A structural equation model examined depression as a predictor of subsequent sexual dysfunction, mediated by antidepressant use, stimulant use, and smoking. Depression predicted subsequent sexual function among both HIV-negative and HIV-positive MSM. This effect appeared to be both a direct effect and an indirect effect via antidepressant use. Findings suggest that antidepressant medication use may partially explain sexual dysfunction among MSM.
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Affiliation(s)
- Trevor A Hart
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada,
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Sansone A, Romanelli F, Gianfrilli D, Lenzi A. Endocrine evaluation of erectile dysfunction. Endocrine 2014; 46:423-30. [PMID: 24705931 DOI: 10.1007/s12020-014-0254-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
Abstract
Erectile dysfunction is highly prevalent, affecting up to half of men in their 50-70s, and has been variably associated to a variety of causes including unhealthy lifestyles, such as smoking or overweight, or comorbidities such as hypertension, diabetes mellitus, and neurological disorders. General interest toward ED has exploded since the introduction of phosphodiesterase type 5 inhibitors-oral drugs that are widely accepted as the first line treatment in patients suffering from this conditions. In the last decade, the time lapse between first symptoms of sexual disorders and seeking of medical advice has greatly reduced. Unfortunately, none of the PDE5i has been proven curative, but rather acts as a symptomatic treatment. The availability of very active and safe drugs, however, diminished the space for diagnosis and search of etiological treatments. This is particularly true for the several endocrinopathies associated with ED. A number of epidemiological data support an inverse relationship between sexual health and testosterone levels, and it is well accepted that testosterone deficiency is a good marker of sexual and physical frailty. However, several other hormones, including LH, prolactin, TSH, and FT4 are involved in sexual functioning and should be investigated in a proper work-out of ED. Existing guidelines provide information almost entirely focusing on late-onset hypogonadism and therapeutic strategies; this mini-review aims to provide a wider spectrum of the diagnostic endocrine work-out of ED patients unrevealing the complexity of conditions, overt or subclinical, which can affect ED.
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Affiliation(s)
- Andrea Sansone
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, "Sapienza" University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy,
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Tsai DC, Huang CC, Chen SJ, Chou P, Chung CM, Chan WL, Huang PH, Lin SJ, Chen JW, Leu HB. Increased risk of erectile dysfunction among males with central serous chorioretinopathy -- a retrospective cohort study. Acta Ophthalmol 2013; 91:666-71. [PMID: 22998678 DOI: 10.1111/j.1755-3768.2012.02528.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Central serous chorioretinopathy (CSCR) mostly affects middle-aged men and has been associated with stress and hypercortisolism. We hypothesized that some factors prone to inducing CSCR could also have a harmful effect on erectile function. This study aimed to investigate the risk of subsequent erectile dysfunction after CSCR using Taiwan National Health Insurance Research Database. METHODS The study cohort (n = 1220) consisted of newly diagnosed CSCR men aged 19-64 years between 1999 and 2007, and men matched for age, monthly income and time of enrolment were randomly selected as the control group (n = 10870). Cox proportional hazard regressions were performed to calculate the hazard ratios (HR) of clinically diagnosed erectile dysfunction (including organic origin and/or psychogenic origin) for the two groups. Erectile dysfunction-free survival analysis was assessed using a Kaplan-Meier method. RESULTS Twenty-five patients (2.0%) from the CSCR cohort and 103 (0.9%) from the control group were diagnosed erectile dysfunction clinically during a mean observation period of 4.3 years. Patients with CSCR had a significantly higher incidence of erectile dysfunction diagnosis than those without CSCR (p < 0.001). After adjusting for age, geographic location, chronic comorbidities and medication habits, patients with CSCR were found to have a 2.22-fold [95% confidence interval (CI), 1.42-3.46] higher hazard ratio of a subsequent erectile dysfunction diagnosis than the matched controls. The adjusted HR for organic and psychogenic erectile dysfunction were 2.14 (95% CI: 1.34-3.44) and 3.83 (95% CI: 1.47-10.01), respectively. CONCLUSIONS Central serous chorioretinopathy was independently associated with an increased risk of being diagnosed with erectile dysfunction.
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Affiliation(s)
- Der-Chong Tsai
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, TaiwanDepartment of Ophthalmology, National Yang-Ming University Hospital, Taipei, TaiwanInstitute of Pharmacology, National Yang-Ming University, Taipei, TaiwanCardiovascular Research Center, School of Medicine, National Yang-Ming University, Taipei, TaiwanDivision of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Medical Research and Education, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Ophthalmology, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Biomedical Sciences, Academia Sinica, Taipei, TaiwanHealthcare and Management Center, Taipei Veterans General Hospital, Taipei, TaiwanInstitute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Byun JS, Lyu SW, Seok HH, Kim WJ, Shim SH, Bak CW. Sexual dysfunctions induced by stress of timed intercourse and medical treatment. BJU Int 2012; 111:E227-34. [DOI: 10.1111/j.1464-410x.2012.11577.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Granata A, Tirabassi G, Pugni V, Arnaldi G, Boscaro M, Carani C, Balercia G. Sexual dysfunctions in men affected by autoimmune Addison's disease before and after short-term gluco- and mineralocorticoid replacement therapy. J Sex Med 2012; 10:2036-43. [PMID: 22429298 DOI: 10.1111/j.1743-6109.2012.02673.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is evidence suggesting that autoimmune Addison's disease (AD) could be associated with sexual dysfunctions probably caused by gluco- and mineralocorticoid deficiency; however, no study has yet treated this subject in males. AIM To evaluate male sexuality and psychological correlates in autoimmune AD before and after gluco- and mineralocorticoid replacement therapy. METHODS Twelve subjects with a first diagnosis of autoimmune AD were studied before (baseline) and 2 months after (recovery phase) initiating hormone replacement therapy. MAIN OUTCOME MEASURES Erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), overall satisfaction (OS), depression, and anxiety were studied using a number of questionnaires (International Index of Erectile Function, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory); clinical, biochemical, and hormone data were included in the analysis. RESULTS At baseline, low values were found for EF, OF, SD, IS, and OS and high values for depression and anxiety; all of these parameters improved significantly in the recovery phase compared with baseline. EF variation between the two phases correlated significantly and positively with the variation of serum cortisol, urinary free cortisol, systolic blood pressure, and diastolic blood pressure and inversely with that of upright plasma renin activity. Multiple linear regression analysis using EF variation as dependent variable confirmed the relationship of the latter with variation of serum cortisol, urinary free cortisol, and upright plasma renin activity but not with variation of systolic and diastolic blood pressure. CONCLUSIONS Our study showed that onset of autoimmune AD in males is associated with a number of sexual dysfunctions, all reversible after initiating replacement hormone therapy; cortisol and aldosterone deficiency seems to play an important role in the genesis of erectile dysfunction although the mechanism of their activity is not clear.
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Affiliation(s)
- Antonio Granata
- Endocrinology and Metabolic Diseases, University of Modena, Modena, Italy
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