The effect of alcohol drinking on erectile dysfunction in Chinese men

Association between air pollution and male sexual function: A nationwide observational study in China

This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The average air pollution exposure (PM2.5, PM10, SO2, CO, NO2, and O3) for the preceding 1, 3, 6, and 12 months before the participants' response was assessed. Male sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT). Generalized linear models were utilized to explore the associations between air pollution and male sexual function. K-prototype algorithm was conducted to identify the association among specific populations. Significant adverse effects on the IIEF-5 score were observed with NO2 exposure during the preceding 1, 3, and 6 months (1 m: β = -5.26E-05; 3 m: β = -4.83E-05; 6 m: β = -4.23E-05, P < 0.05). PM2.5 exposure during the preceding 12 months was found to significantly negatively affect the PEDT after adjusting for confounding variables. Our research indicated negative correlations between air pollutant exposures and male sexual function for the first time. Furthermore, these associations were more pronounced among specific participants who maintain a normal BMI, exhibit extroverted traits, and currently engage in smoking and alcohol consumption.

Erectile Dysfunction in Alcohol Use Disorder and the change in erectile function after one month of abstinence

OBJECTIVE

The association between alcohol use and erectile dysfunction (ED) has not been explored adequately. The aim of this study is (i) to determine the prevalence of ED in patients with Alcohol use disorder (AUD), (ii) the association of ED with sociodemographic and clinical variables, (iii) the association between severity of drinking and sociodemographic and clinical variables, and (iv) the assess the change in ED after one month of abstinence from alcohol.

METHODS

203 consecutive patients were recruited into the study after taking written informed consent. Sociodemographic data was collected using a proforma and ED was assessed using International Index of Erectile Function-5 (IIEF-5). The patients were also followed up after 1 month of abstinence to assess the change in erectile function.

RESULTS

The prevalence of ED was 68.5%. Out of the 203 subjects, 28.1% had mild ED, 24.1% had mild to moderate ED, 9.9% had moderate ED and 6.4% had severe ED. Significant association were seen between ED and age, marital status, diabetes mellitus, hypertension, total duration, and severity of drinking. A significant association was seen between severity of drinking and age, diabetes mellitus, hypertension, alcoholic liver disease, tobacco use and duration of drinking. The improvement in ED after 1 month abstinence was found to be significant.

CONCLUSIONS

ED is a common problem in patients with AUD. Routine assessment of sexual functioning is warranted in patients with AUD and the information that ED improves with abstinence can provide an impetus to change.

Prevalence and Pattern of Sexual Dysfunction in Male Patients with Alcohol Dependence

Background

Alcohol is a potent substance that causes both acute and chronic changes in almost all neurochemical systems, with the result that heavy drinking can produce serious psychological symptoms including depression, anxiety, and psychoses. It also affects sexual health adversely and causes sexual dysfunction.

Methods

This study aimed to find the prevalence and pattern of sexual dysfunction in male patients with alcohol dependence. This cross-sectional study included 100 patients attending psychiatry out patient department (OPD) at a tertiary care center in west India. Informed written consent was taken for collecting socio-demographic and clinical data in a uniform and standard manner. Sexual dysfunction was assessed using a sexual dysfunction checklist, constructed by Arackal and Benegal at the national institute of mental health and neuroscience, Bangalore containing 12 items from the diagnostic criteria for research and ICD-10 classification of mental and behavioral disorders. The Leeds dependence questionnaire was used to assess the severity of alcohol dependence.

Findings

Sexual dysfunction was present in 62% of the patients. Among the patients, 36% had difficulty achieving an erection, 34% had difficulty maintaining an erection, 37% reported premature ejaculation, 7% had delayed ejaculation, 14% reported anorgasmia, 1% had ejaculation with a flaccid penis, 2% had pain during intercourse, 6% were dissatisfied with the frequency of intercourse, 4% were dissatisfied with their sexual partner, and 7% were dissatisfied with their performance.

Conclusion

Sexual dysfunction is significantly and positively associated with duration, amount of alcohol consumed per day, and severity of alcohol dependence.

The Impact of Abstinence From Alcohol on Erectile Dysfunction: A Prospective Follow up in Patients With Alcohol Use Disorder

BACKGROUND

There is a compelling evidence for the relation between alcohol use and erectile dysfunction (ED), however the impact of alcohol abstinence on improvement of ED is explored sparsely.

AIM

This study aimed to determine the impact of alcohol abstinence on ED. The association between total duration of drinking, the quantity of alcohol consumed, sociodemographic, clinical variables and ED were also studied.

METHODS

One hundred and four subjects with alcohol use disorder and complaints of ED meeting the inclusion and exclusion criteria were recruited into the study after taking written informed consent. The subjects were assessed at baseline and after 3 months of abstinence from alcohol with IIEF-5 and a specially designed pro forma. Wilcoxon signed rank test was used to assess the change in ED after 3 months of abstinence. Chi square test was done to assess the associations and binary logistic regression was done to determine the significance of variables after 3 months of abstinence.

OUTCOMES

Improvement in ED after 3 months of abstinence from alcohol and its association between socio demographic and clinical variables were assessed.

RESULTS

Of the 104 subjects studied, 88.5% (92) showed improvement in ED after 3 months of abstinence from alcohol. Wilcoxon signed rank test showed that the improvement in ED after 3 months of abstinence was significant. (Z = 8.708, P < .001). Significant association was found between age, alcoholic liver disease, total duration of drinking, and number of standard drinks per day with ED after 3 months of abstinence.

CLINICAL IMPLICATIONS

Information that ED will improve with abstinence from alcohol can be used in deaddiction treatment to provide a motivation for change.

STRENGTH AND LIMITATIONS

This study aims to fill the gap in literature as only a few studies have examined the impact of abstinence from alcohol on ED. The main limitations of this study are short follow up period and since this study was conducted in a tertiary care hospital it could have given rise to Berksonian bias.

CONCLUSION

Results indicate that ED shows improvement with abstinence from alcohol. Absence of alcoholic liver disease, younger age, shorter duration of drinking, lesser number of standard drinks per day had a significant influence in the improvement of ED with alcohol abstinence and this information can be beneficial in treatment to provide an impetus for change. Karunakaran A., Michael J. P. The Impact of Abstinence From Alcohol on Erectile Dysfunction: A Prospective Follow up in Patients With Alcohol Use Disorder. J Sex Med 2022;19:581-589.

A Meta-Analysis of Erectile Dysfunction and Alcohol Consumption

PURPOSE

The purpose of the study was to evaluate the association between alcohol consumption and risk of erectile dysfunction (ED).

METHODS

PubMed was searched for reports published before June 2019. Data were extracted and combined odds ratios (ORs) calculated with random-effects models.

RESULTS

Finally, 46 studies were included (216,461 participants). The results of our meta-analysis indicated that there was a significant association between regular alcohol consumption and ED (OR 0.89, 95% confidence interval [CI]: 0.81-0.97). There was no indication of publication bias (Egger's test, p = 0.37). In the stratified analysis, the pooled OR of ED for light to moderate and high alcohol consumption was 0.82 (95% CI: 0.72-0.94) and 0.82 (95% CI: 0.67-1.00), respectively. No variable related to the source of heterogeneity was found in univariate and multivariate meta-regression analyses. A dose-response meta-analysis suggested that a nonlinear relationship between alcohol consumption and risk of ED was observed (p for nonlinearity <0.001).

CONCLUSION

A J-shaped relationship between alcohol consumption and risk of ED was observed. Alcohol should be taken in moderate quantities in order to obtain the dual effect of disinhibition and relaxation. If taken chronically, it could provoke vascular damages.

Prevalence of erectile dysfunction and associated factors among males visiting family medicine clinics in a Tertiary Care Hospital in Karachi, Pakistan

Background

The burden of erectile dysfunction (ED) among the developed countries is found to be quite high. However, there is a paucity of data among developing countries to know its actual burden and factors associated with it.

Methods

The current study is cross-sectional and was conducted in Family Medicine clinics of Liaquat National Hospital during May 2017-January 2018. A total of 450 males participated in this study with the age range of 24-77 years. More than half of the participants were graduates or above.

Results

On multivariable analysis, age (aOR = 5.47, 95% CI: 2.74-10.89), alcohol use (aOR = 5.23, 95% CI: 1.45-18.84), diabetes (aOR = 6.61, 95% CI: 3.27-13.36), and current smoking (OR = 2.41, 95% CI: 1.35-4.31) were significantly associated with ED. ED risk was significantly lower in those who either attended secondary school (aOR = 0.33, 95% CI: 0.13-0.88) or were at least graduates (aOR = 0.40, 95% CI: 0.17-0.96) than illiterate when model was adjusted for other covariates.

Conclusion

Erectile dysfunction in a Pakistani male population highlights the need for routine screening at the primary care level. There is a possibility that the actual burden is underreported due to cultural stigmatization; hence, further research is warranted to validate the findings.

Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: A cross-sectional study

BACKGROUND

Contrary to the popular belief concerning the aphrodisiac effects of alcohol, there exists scientific evidence which conclude on sexual dysfunction caused by chronic alcohol use. There is a dearth of studies from India.

AIM

The aim is to estimate the prevalence and correlates of sexual dysfunction in alcohol-dependent patients and to explore the association between sexual dysfunction and various alcohol-related variables.

MATERIALS AND METHODS

The study employed a cross-sectional descriptive design and recruited 84 male patients admitted for de-addiction in a tertiary care center. The evaluation was conducted using a specially designed intake proforma and tools such as Severity of Alcohol Dependence Questionnaire, Arizona Sexual Experience Scale, and International Classification of Disease, 10^th revision, diagnostic criteria for research.

RESULTS

Thirty-seven percent of the patients had sexual dysfunction - the most common type being erectile dysfunction (25%), followed by dysfunction in satisfying orgasm (20%) and premature ejaculation (15.5%). Sexual dysfunction was significantly associated with the duration of alcohol dependence, amount of alcohol consumed per day, and severity of alcohol dependence.

CONCLUSIONS

Sexual dysfunction is common in male patients with alcohol dependence. The study highlights the detrimental effects of alcohol on sexual function and this information can be utilized in motivational interviewing of patients with alcohol dependence syndrome.

Alcohol consumption and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: Baseline data from the Dogo Study

Diabetes mellitus and heavy alcohol consumption are both associated with vascular disease, a category that includes erectile dysfunction (ED). However, the association between alcohol consumption and ED among patients with type 2 diabetes mellitus remains unclear. The aim of the present multicenter cross-sectional study was to investigate the relationship between drinking frequency, weekly alcohol consumption, daily alcohol consumption, and ED among Japanese patients with type 2 diabetes mellitus. Study subjects were 340 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. ED was defined as present when a subject had a Sexual Health Inventory for Men score <8. Adjustment was made for age, body mass index, duration of type 2 diabetes mellitus, current smoking, hypertension, dyslipidemia, glycated hemoglobin, stroke, coronary artery disease, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. The prevalence of ED was 43.2% (147/340). The frequency of alcohol consumption and weekly alcohol consumption were independently inversely associated with ED (p for trend p = 0.001 and 0.004, respectively). The relationship between daily alcohol consumption and ED was an inverted J-shaped curve: alcohol consumption of less than 60 g, but not 60 g or more, per day was independently related to a lower prevalence of ED (p for quadratic trend = 0.003). In Japanese men with type 2 diabetes mellitus, an inverted J-shaped relationship between daily alcohol consumption and ED was observed, while frequency of alcohol consumption and weekly alcohol consumption were significantly inversely associated with ED.

The Circle of Lifestyle and Erectile Dysfunction

INTRODUCTION

Erectile dysfunction (ED) has been significantly associated with many chronic conditions including obesity, the metabolic syndrome, hypogonadism, diabetes mellitus, cardiovascular disease (CVD), lower urinary tract symptoms, and psychiatric/psychological disorders. ED is also a well-established predictor of CVD.

AIM

This review will focus on the association of ED with cardiovascular, metabolic, and cognitive conditions and discuss the effects of managing lifestyle factors in order to reduce the burden of ED and consequently outcomes in patients with chronic conditions.

METHODS

A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), and abstracts from scientific meetings was performed from 1990.

MAIN OUTCOME MEASURES

Main outcome measures were improvements in sexual function.

RESULTS

A total of 59 reviews on the topic were evaluated.

CONCLUSIONS

Targeting several lifestyle factors associated with CVD/metabolic/cognitive disorders, e.g., smoking, alcohol consumption, obesity, and physical activity, can have significant benefits, leading to an improvement in ED as well as testosterone levels and consequently CVD. Kirby M. The circle of lifestyle and erectile dysfunction. Sex Med Rev 2015;3:169-182.

Sexual dysfunction in patients with peripheral nervous system lesions

Peripheral nervous system (PNS) disorders may cause sexual dysfunction (SD) in patients of both genders. These disorders include mainly polyneuropathies (particularly those affecting the autonomic nervous system (ANS)) and localized lesions affecting the innervation of genital organs. Impaired neural control may produce a malfunction of the genital response consisting of loss of genital sensitivity, erectile dysfunction, loss of vaginal lubrication, ejaculation disorder, and orgasmic disorder. In addition, there is often a loss of desire which actually has a complex pathogenesis, which goes beyond the mere loss of relevant nerve function. In patients who have no manifest health problems - particularly men with erectile dysfunction - one should always consider the possibility of an underlying polyneuropathy; in patients with SD after suspected denervation lesions of the innervation of genital organs within the lumbosacral spinal canal and in the pelvis, clinical neurophysiologic testing may clarify the PNS involvement. SD can alter self-esteem and lower patients' quality of life; opening up a discussion on sexual issues should be a part of the management of patients with PNS disorders. They may greatly benefit from counseling, education on coping strategies, and specific treatments.

Sexual dysfunction in patients with alcohol and opioid dependence

There are limited numbers of studies which have evaluated the sexual dysfunction (SD) in patients with alcohol and opioids dependence. This article reviews the existing literature. Electronic searches were carried out using the PubMed, Google Scholar, and ScienceDirect to locate the relevant literature. Subjects addicted to heroin or on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT) show higher rates of SD in comparison to the general population. SD rates have ranged 34-85% for heroin addicts, 14-81% for MMT, 36-83% for BMT, and 90% for naltrexone maintenance. The rates of SD in alcohol-dependent population have ranged 40-95.2%, with rates being consistently much higher in alcohol-dependent population than in the healthy controls or social drinkers. The common SDs reported have been erectile dysfunction followed by premature ejaculation, retarded ejaculation and decreased sexual desire among men, and dyspareunia and vaginal dryness among women. This review suggests that long-term use of alcohol and opioids are associated with SD in almost all domains of sexual functioning. There is a need to increase the awareness of clinicians about this association as many times SD in patients with substance abuse lead to poor treatment compliance and relapse. Further, there is a need to carry out more number of studies to understand the relationship in a better way.

What do most erectile dysfunction guidelines have in common? No evidence-based discussion or recommendation of heart-healthy lifestyle changes and/or Panax ginseng

Sexual health or erectile dysfunction (ED) state of the art guidelines provide a thorough overview of conventional prescription or other notable extrinsic treatment options. Yet, over the past 10-15 years, a plethora of international researchers have established that individual and comprehensive lifestyle changes can prevent and potentially improve ED. We review the lifestyle evidence that should equate to grade A or level 1 evidence recommendations for ED. We also review the evidence for Panax ginseng, an over-the-counter (OTC) dietary supplement with a 35-year history of laboratory investigations, multiple positive randomized trials over approximately 15 years and several independent meta-analyses and systematic reviews. Perhaps it is time to at least discuss and even emphasize lifestyle and other non-conventional interventions in ED guidelines so that patients can explore a diversity of potentially synergistic choices with their physicians and can improve their quality and quantity of life. Ignoring the consistent, positive data on lifestyle modifications in ED guidelines, for example, is tantamount to ignoring diet and lifestyle changes to reduce the risk of or ameliorate cardiovascular diseases.

Testosterone is associated with erectile dysfunction: a cross-sectional study in Chinese men

BACKGROUND

Testosterone is essential for the regulation of erectile physiology, but the relationship between low testosterone and erectile dysfunction (ED) has not been firmly established.

PURPOSE

To examine the association between serum total, free and bio-available testosterone and ED in a population-based sample.

METHODS

A consecutive series of 1776 men aged 20-77 participated in the routine physical examination from September 2009 to December 2009 in Guangxi, China. ED was assessed using the five-item International Index of Erectile Function (IIEF-5) questionnaire. Total testosterone (TT), sex hormone binding globulin (SHBG) and other biochemical profiles were measured. Free testosterone (FT) and bio-available testosterone (BT) were calculated based on Vermeulen's formula. Data were collected with regard to smoking, alcoholic drinking, physical activity and metabolic syndrome.

RESULTS

The prevalence of ED (IIEF-5<22) was 47.6%. Men with ED were significantly older, and more prone to smoke cigarettes (≥20 cigarettes/day) or drink alcohol (≥3 drinks/week), and more likely to have elevated blood pressure (P = 0.036) or hyperglycemia (P<0.001) compared with those without ED. The significant increase in SHBG with age was parallel to its increase with increasing severity of ED (P<0.001). The obscure increase in TT across the ED status was detected without significance (P = 0.418), but TT was positively associated with ED after adjustment for age [odds ratio (OR)  = 1.02, 95% CI (confidence internal): 1.00-1.04]. FT and BT were inversely associated with ED (OR = 0.14, 95%CI: 0.06-0.33; OR = 0.92 (95%CI: 0.89-0.96, respectively) in the univariate analysis, and this inverse association appeared to be independent of smoking status, alcoholic drinking, physical activity, hyper-triglyceridemia and hyperglycemia.

CONCLUSIONS

FT and BT are inversely related to worsening ED, whereas the positive association between TT and ED is most likely due to the increase in SHBG.

Prevalence of sexual activity and associated factors in hypertensive males and females in China: a cross-sectional study

Background

Hypertension is an important factor contributing to sexual dysfunction. The number of people with hypertension is increasing in China, but research into sexual life, which has implications for quality of life, is limited. We aimed to compare sexual activity and the influence of daily behaviors and sexual domain of hypertensive males and females in south China.

Methods

A cross-sectional study was conducted at the health care center of a university-affiliated hospital from 2007 to 2008. We enrolled 502 subjects with hypertension (225 males, 48.79 ± 7.39 years old; 277 females, 48.26 ± 6.93 years old) and 173 with normotension (82 males, 45.69 ± 6.58 years old; 91 females, 46.14 ± 7.03 years old), all sexually active. All subjects completed a self-administered questionnaire on sexual activity before a routine physical check-up. Data were collected on sociodemographic and clinical characteristics, use of cigarettes and intake of beverages (including alcohol).

Results

Hypertensive and normotensive subjects differed in frequency of orgasms and of sexual satisfaction, as well as duration of sexual activity. For hypertensive men, low frequency of sexual activity, orgasms and satisfaction were associated with unemployed or retired status than physical labor work (odds ratio [OR] 0.28 [95% confidence interval (95% CI) 0.12–0.69], 0.32 [0.12–0.86], 0.33 [0.19–0.88], respectively; p < 0.05), and long sexual duration was associated with never drinking alcohol than heavy drinking (OR 4.49 [1.28–6.41]). For hypertensive women, low frequency and duration of sexual activity and low satisfaction were associated with never drinking tea than heavy tea drinking (OR 0.42 [0.18–0.96], 0.49 [0.24–0.98], 0.29 [0.14–0.64], respectively; p < 0.05). Medication use and electrocardiography results were not associated with sexual activity for hypertensive patients.

Conclusions

For hypertensive people in China, lifestyle factors are associated with sexual dysfunction, which differs by the sex of the person. Further research needs to examine serum hormone levels to validate the result.