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Biernikiewicz M, Sobieszczańska M, Szuster E, Pawlikowska-Gorzelańczyk A, Janocha A, Rożek-Piechura K, Rusiecka A, Gebala J, Okrzymowska P, Kałka D. Erectile Dysfunction as an Obesity-Related Condition in Elderly Men with Coronary Artery Disease. J Clin Med 2024; 13:2087. [PMID: 38610852 PMCID: PMC11012732 DOI: 10.3390/jcm13072087] [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: 02/29/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: This cross-sectional study aimed to investigate the prevalence of erectile dysfunction (ED) in elderly men with overweight or obesity and coronary artery disease. Methods: Patients recruited in cardiac rehabilitation centers post-myocardial infarction provided demographic and anthropomorphic data. ED was assessed using the abbreviated International Index of Erectile Function 5 (IIEF-5) Questionnaire. Results: The study included 661 men with a mean age of 67.3 ± 5.57 years, a mean BMI of 27.9 ± 3.6 m/kg2, and a mean waist circumference of 98.9 ± 10.23 cm. Over 90% of men experienced ED, with similar proportions across BMI categories. The development of ED in men with a waist circumference of ≥100 cm had 3.74 times higher odds (OR 3.74; 95% CI: 1.0-13.7; p = 0.04) than in men with a waist circumference of <100 cm. Men with obesity and moderate-to-severe and severe ED were older compared to those without these disorders (67.1 ± 5.29 vs. 65.3 ± 4.35; p = 0.23). Conclusions: The prevalence of ED in men with coronary artery disease surpasses 90%. An increased body weight raises the risk of ED, with waist circumference proving to be a more reliable predictor of this risk compared to BMI. Physicians are encouraged to screen elderly patients with cardiovascular disease for ED and address obesity to enhance overall health.
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Affiliation(s)
| | | | - Ewa Szuster
- Obstetrics and Gynecology Department, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | | | - Anna Janocha
- Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland
| | - Krystyna Rożek-Piechura
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Agnieszka Rusiecka
- Statistical Analysis Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Jana Gebala
- Men’s Health Centre in Wroclaw, 53-151 Wroclaw, Poland
| | - Paulina Okrzymowska
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Dariusz Kałka
- Men’s Health Centre in Wroclaw, 53-151 Wroclaw, Poland
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
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2
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Rezali MS, Mohamad Anuar MF, Abd Razak MA, Chong ZL, Shaharudin AB, Kassim MSA, Mohamed Daud MA, Ismail SB, Said ZM. Prevalence and associated factors of moderate to severe erectile dysfunction among adult men in Malaysia. Sci Rep 2023; 13:21483. [PMID: 38057375 PMCID: PMC10700487 DOI: 10.1038/s41598-023-48778-y] [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: 08/11/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
Erectile dysfunction (ED) is a pervasive problem among men, often shrouded in silence and stigma. This manuscript analysed the National Health and Morbidity Survey 2019 data to identify the prevalence of moderate to severe ED among men aged 18 and above in Malaysia and describe its associated factors. Self-administered questionnaire on ED utilised a locally validated International Index of Erectile Function. Variables on sociodemographics, risky lifestyles and comorbidities were obtained via an interviewer-administered questionnaire. The prevalence was determined using complex sampling analysis, and logistic regression was used to determine the associated factors of ED. A sample of 2403 men aged ≥ 18 participated, with a moderate to severe ED prevalence was 31.6% (95% CI 28.8, 34.6). The mean (± SD) of the total score of IIEF-5 for overall respondents was 18.16 (± 4.13). Multiple logistic regression analysis revealed a significant association between moderate to severe ED among men aged 60 years and above, single or divorcee, men without formal, primary, and secondary education, non-government employees, unemployed, and retiree, as well as physically inactive men. Focused public health interventions are necessary to improve education in sexual health, increase health promotion programs, and promote healthy ageing across the population.
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Affiliation(s)
- Muhammad Solihin Rezali
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Mohamad Fuad Mohamad Anuar
- Biostatistic and Repository Data, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohamad Aznuddin Abd Razak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Zhuo Lin Chong
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Azli Baharudin Shaharudin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Mohd Shaiful Azlan Kassim
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, No.1, Jalan Setia Murni U13/52, Seksyen U13, Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | | | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Gelugor, Malaysia
| | - Zakiah Mohd Said
- Adult Health Sector, Family Health Development Division, Ministry of Health Malaysia, Shah Alam, Malaysia
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3
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Shigehara K, Kato Y, Iijima M, Kawaguchi S, Nohara T, Izumi K, Kadono Y, Namiki M, Mizokami A. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido. Sex Med 2021; 9:100426. [PMID: 34517208 PMCID: PMC8498958 DOI: 10.1016/j.esxm.2021.100426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Decreased libido in middle-aged and elderly men is often difficult to treat, and identifying the risk factors affecting decreased libido is important for the clinical management of decreased libido. However, limited information is available regarding specific risk factors in this population. Aim The present study investigated the risk factors for decreased libido among middle-aged and elderly men. Methods Patients who attended our male andropausal outpatient clinic between 2009 and 2015 were enrolled. All patients completed a self-administered questionnaire, which included the Aging Male Symptoms (AMS) scale, International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM). Information on waist size, body mass index, present illness, present use of any medication, and lifestyle habits were collected by each attending physician. Blood biochemical data such as free testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-Chol), and hemoglobin A1c values were assessed. Libido was assessed based on AMS scale question 17, and a score of 4 or higher was defined as severely decreased libido (severe group). Main Outcome Measure The clinical factors associated with severely decreased libido were analyzed based on multiple regression analysis. Results A total of 292 subjects were included in the analysis, 111 (38%) of which belonged to the severe group. The mean age of study subjects was 66.2 years, and the mean FT value was 7.1 ± 2.2. Comparisons of each variable among the severe and not severe groups showed significant differences in older age, current cigarette smoking, AMS scale, IPSS, frequency of nocturnal voiding, SHIM score, and HDL-Chol value. Multivariate regression analysis revealed that current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for severely decreased libido. Furthermore, the frequency of nocturnal voiding significantly increased with severity of decreased libido. Conclusion Current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for a severely low libido. K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido. Sex Med 2021;9:100426.
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Affiliation(s)
- Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
| | - Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Masashi Iijima
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Shohei Kawaguchi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Takahiro Nohara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
| | - Mikio Namiki
- Department of Urology, Hasegawa Hospital, Toyama, Toyama, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan
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Kałka D, Gebala J, Biernikiewicz M, Mrozek-Szetela A, Rożek-Piechura K, Sobieszczańska M, Szuster E, Majchrowska M, Miętka A, Rusiecka A. Erectile Dysfunction in Men Burdened with the Familial Occurrence of Coronary Artery Disease. J Clin Med 2021; 10:jcm10184046. [PMID: 34575155 PMCID: PMC8470252 DOI: 10.3390/jcm10184046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/12/2022] Open
Abstract
Erectile dysfunction (ED) and coronary artery disease (CAD) share common risk factors, some of which have genetic backgrounds, while others may be stimulated by family lifestyle. We investigated the impact of the familial occurrence of CAD on the presence of ED and the presence of classic risk factors for ED in men with CAD. This cross-sectional observational study involved 751 men with CAD who were subjected to cardiac rehabilitation. Overall, 75.63% of the men had ED. CAD was diagnosed in 39.28% of the studied men’s relatives. ED was less frequent in the men with familial CAD than in those without (71.53% vs. 78.29%). Similar relations were observed for the presence of CAD in parents (70.43% vs. 78.34%) and the father (69.95% vs. 77.46%). The International Index of Erectile Function 5 score was significantly higher in patients with familial CAD (median (interquartile range); 17 (12–22) vs. 16 (10–21); p = 0.0118), in parents (18 (12–22) vs. 16 (10–20); p = 0.021), and in the father (18 (12–22) vs. 16 (10–21); p = 0.0499). Age and education minimized the effect of familial CAD. Familial CAD increased the incidence of hypertension, dyslipidemia, and smoking but not sedentary lifestyle. Despite the higher prevalence of selected risk factors for ED in men with familial CAD, a higher incidence of ED was not observed.
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Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Physiology & Pathophysiology, Wrocław Medical University, 50-368 Wrocław, Poland; (M.M.); (A.M.); (A.R.)
- Centre for Men’s Health, 53-151 Wrocław, Poland
- Correspondence:
| | - Jana Gebala
- Cardiosexology Students’ Scientific Club, Wrocław Medical University, 50-368 Wrocław, Poland; (J.G.); (E.S.)
| | | | - Aneta Mrozek-Szetela
- Doctoral School at Wrocław of Environmental and Life Sciences, 50-375 Wrocław, Poland;
| | - Krystyna Rożek-Piechura
- Faculty of Physiotherapy, Wrocław University of Health and Sport Sciences, 51-612 Wrocław, Poland;
| | | | - Ewa Szuster
- Cardiosexology Students’ Scientific Club, Wrocław Medical University, 50-368 Wrocław, Poland; (J.G.); (E.S.)
| | - Marzena Majchrowska
- Cardiosexology Unit, Department of Physiology & Pathophysiology, Wrocław Medical University, 50-368 Wrocław, Poland; (M.M.); (A.M.); (A.R.)
| | - Anna Miętka
- Cardiosexology Unit, Department of Physiology & Pathophysiology, Wrocław Medical University, 50-368 Wrocław, Poland; (M.M.); (A.M.); (A.R.)
| | - Agnieszka Rusiecka
- Cardiosexology Unit, Department of Physiology & Pathophysiology, Wrocław Medical University, 50-368 Wrocław, Poland; (M.M.); (A.M.); (A.R.)
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5
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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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6
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Sivaratnam L, Selimin DS, Abd Ghani SR, Nawi HM, Nawi AM. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2020; 18:121-143. [PMID: 33223424 DOI: 10.1016/j.jsxm.2020.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Erectile dysfunction (ED) is a common problem among men across the world. It is usually multifactorial in origin. Behavioral factors can be related to the development of ED and related to many other chronic diseases. It impacts not only the sexual function but also the psychology and their overall quality of life. AIM To determine the association of the behavior factors in relation to ED and to identify the risk and protective factors. METHOD A systematic review search based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis was conducted. The primary databases PubMed, PlosOne, Oxford Academic, SCOPUS, and Ovid were accessed using specific keyword searches. Quality of articles was assessed by using Newcastle-Ottawa Assessment Scale according to the study design. OUTCOME Evaluation of the relationship between behavioral factors and ED. RESULTS 24 studies were identified from the 5 databases which met the predetermined criteria. Overall, the study population include adult male age between 18 and 80 years. The sample size of the studies ranges from 101 to the largest sample size of 51,329. Smoking, alcohol, and drugs usage are found to be risk factors for ED. Meanwhile, dietary intake, physical activity, and intimacy are the protective factors for ED. CLINICAL IMPLICATION The findings from this review may aid clinicians to aim for early detection of ED by screening their risk factors and providing early treatment. This can also be used to promote awareness to the community on the sexual health and factors that can affect their sexual function. STRENGTH & LIMITATION This study looks at all types of behavioral factors that may affect ED; however, there was a substantial heterogeneity detected across the selected study factors. Furthermore, the lack of PROSPERO registration is also a limitation in this study. CONCLUSION Overall, smoking, dietary intake, alcohol consumption, drugs, and physical activities are modifiable risk factors for ED in men. Therefore, it is crucial to promote healthy lifestyle and empower men to prevent ED and early detection of ED for early treatment. Sivaratnam L, Selimin DS, Abd Ghani SR, et al. Behavior-Related Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2021;18:121-143.
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Affiliation(s)
- Lavanyah Sivaratnam
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Diana Safraa Selimin
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Siti Rasidah Abd Ghani
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Haniff Mohd Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
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7
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Huynh LM, Liang K, Osman MM, El-Khatib FM, Dianatnejad S, Towe M, Roberts NH, Yafi FA. Organic Diet and Intermittent Fasting are Associated With Improved Erectile Function. Urology 2020; 144:147-151. [PMID: 32717247 DOI: 10.1016/j.urology.2020.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/04/2020] [Accepted: 07/09/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To explore associations between dietary habits and erectile dysfunction (ED) in a cohort of patients presenting to a high-volume men's health clinic. MATERIALS AND METHODS All patients presenting to a high-volume men's health clinic between July 2018 and May 2019 were evaluated for their dietary habits and screened with the International Index of Erectile Function-5 (IIEF-5) and Androgen Deficiency in Aging Males (ADAM). The primary outcome measure was the impact of dietary habits on ED, defined as IIEF-5 <22. Stepwise logistic regressions were used to control for patient characteristics and relevant comorbidities. RESULTS Two hundred seventy-one patients were included. Primary reasons for visit were ED (110, 40.6%), hypogonadism (39, 14.4%), benign prostatic hyperplasia/lower urinary tract symptoms (80, 29.5%), and Peyronie's Disease (30, 11.1%). 176 (64.9%) followed no diet, while 11 (4.1%), 11 (4.1%), 8 (2.9%), and 11 (4.1%) were whole food only, low-carb/keto, vegetarian/pescatarian, and low-fat, respectively. Additionally, 105 (38.7%) reported organic foods consumption, while 51 (18.8%) had no processed food consumption, and 77 (28.4%) performed intermittent fasting. Patients reporting ED were more likely to be over the age of 65, had higher body mass index, more comorbidities, and less likely to report an organic diet or intermittent fasting. There were no correlations between diet and ADAM score. In adjusted analysis, patients reporting organic diet or intermittent fasting were significantly less likely to have ED. CONCLUSION This is the first study suggesting organic diet and intermittent fasting to be protective against ED. These results are hypothesis-generating and warrant further exploration.
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Affiliation(s)
- Linda M Huynh
- Department of Urology, University of California, Irvine Health, Orange, CA
| | - Karren Liang
- Department of Urology, University of California, Irvine Health, Orange, CA
| | - Mohamad M Osman
- Department of Urology, University of California, Irvine Health, Orange, CA
| | - Farouk M El-Khatib
- Department of Urology, University of California, Irvine Health, Orange, CA
| | | | - Maxwell Towe
- Department of Urology, University of California, Irvine Health, Orange, CA
| | | | - Faysal A Yafi
- Department of Urology, University of California, Irvine Health, Orange, CA.
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8
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Rusiecki L, Zdrojowy R, Gebala J, Rabijewski M, Sobieszczańska M, Smoliński R, Pilecki W, Dziubek W, Janocha A, Womperski M, Kałka D. Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality. Asian J Androl 2020; 22:526-531. [PMID: 31929194 PMCID: PMC7523618 DOI: 10.4103/aja.aja_131_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.
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Affiliation(s)
- Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Romuald Zdrojowy
- Department and Clinic of Urology, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Jana Gebala
- Cardiosexology Students' Scientific Club, Wrocław Medical University, Wrocław 50-368, Poland
| | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw 01-004, Poland
| | | | - Ryszard Smoliński
- Consultant Sexologist, Clinical Hospital Wrocław Medical University, Wrocław 50-556, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Wioletta Dziubek
- Department of Physiotherapy, University School of Physical Education, Wroclaw 51-612, Poland
| | - Anna Janocha
- Department of Physiology, Wroclaw Medical University, Wroclaw 50-368, Poland
| | | | - Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland.,Centre for Men's Health, Wroclaw 53-151, Poland
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9
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Kałka D, Zdrojowy R, Womperski K, Gebala J, Smoliński R, Dulanowska A, Stolarczyk K, Dulanowski J, Pilecki W, Rusiecki L. Should information about sexual health be included in education directed toward men with cardiovascular diseases? Aging Male 2018; 21:243-250. [PMID: 29463161 DOI: 10.1080/13685538.2018.1439911] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Modifiable risk factors contribute to the pathogenesis of cardiovascular disease (CVD) and erectile dysfunction (ED). We aimed to compare the knowledge about the contribution of modifiable risk factors to the pathogenesis of CVD and ED. The impact of patients' having modifiable risk factors on the awareness of their negative influence on the development of CVD and ED was examined. METHODS To this multicenter cohort study, we included 417 patients with CHD who had been hospitalized in the cardiology or cardiac surgery department during the previous six weeks and underwent cardiac rehabilitation in one of the five centers. Knowledge about modifiable risk factors was collected. ED was assessed by an abridged IIEF-5 questionnaire. Comparisons between groups were conducted using the Student's t-test, Mann-Whitney U test, and Kruskal-Wallis test. Relationships were analyzed with Spearman's rank correlation coefficient. RESULTS The mean number of correctly identified risk factors for CVD was significantly higher than those for ED (3.71 ± 1.87 vs. 2.00 ± 1.94; p < .0001). Smoking was the most recognized risk factor both for CVD and ED. Dyslipidemia was least frequently identified as a risk factor for CVD. Sedentary lifestyle was the only risk factor whose incidence did not affect the level of patient knowledge. CONCLUSIONS Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.
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Affiliation(s)
- Dariusz Kałka
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
- b Centre for Men's Health in Wroclaw , Wroclaw , Poland
| | - Romuald Zdrojowy
- c Department and Clinic of Urology , Wroclaw Medical University , Wroclaw , Poland
| | - Krzysztof Womperski
- d Department of Cardiac Rehabilitation , Hospital of the Ministry of Interior , Głucholazy , Poland
| | - Jana Gebala
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | | | - Alicja Dulanowska
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Karolina Stolarczyk
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Jakub Dulanowski
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Witold Pilecki
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
| | - Lesław Rusiecki
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
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Dougherty P. Erectile Dysfunction. PHYSICIAN ASSISTANT CLINICS 2018. [DOI: 10.1016/j.cpha.2017.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Kałka D, Gebala J, Smoliński R, Rusiecki L, Pilecki W, Zdrojowy R. Low-energy Shock Wave Therapy—A Novel Treatment Option for Erectile Dysfunction in Men With Cardiovascular Disease. Urology 2017; 109:19-26. [DOI: 10.1016/j.urology.2017.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 05/08/2017] [Accepted: 05/19/2017] [Indexed: 10/19/2022]
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Gao J, Peng D, Zhang X, Hao Z, Zhou J, Fan S, Zhang Y, Mao J, Dou X, Liang C. Prevalence and Associated Factors of Premature Ejaculation in the Anhui Male Population in China: Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation. Sex Med 2016; 5:e37-e43. [PMID: 28041923 PMCID: PMC5302376 DOI: 10.1016/j.esxm.2016.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/27/2016] [Accepted: 11/04/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction In 2014, new evidence-based definitions of lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE) were proposed by the International Society for Sexual Medicine. Based on the new PE definitions, the prevalence of and factors associated with LPE and APE have not been investigated in China. Aim To evaluate the prevalence of and factors associated with LPE and APE in men with the complaint of PE in China. Methods From December 2011 to December 2015, a cross-sectional field survey was conducted in five cities in the Anhui province of China. Questionnaire data of 3,579 men were collected in our database. The questionnaire included subjects' demographic information and medical and sexual histories. Men who were not satisfied with their time to ejaculate were accepted as having the complaint of PE. Men with the complaint of PE who met the new definition of PE were diagnosed as having LPE or APE. Main Outcome Measures New definition of LPE and APE. Results Of 3,579 men who completed the questionnaire, 34.62% complained of PE. Mean age, body mass index, and self-estimated intravaginal ejaculatory latency time for all subjects were 34.97 ± 9.02 years, 23.33 ± 3.56 kg/m2, and 3.09 ± 1.36 minutes, respectively. The prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. LPE and APE were associated with age, body mass index, and smoking and exercise rates (P < .001 for all comparisons). Men with APE reported more comorbidities than men with LPE, especially in the presence of hypertension, diabetes mellitus, and heart disease (P < .001 for all comparisons). Conclusion In this study, the prevalences of LPE and APE in men with the complaint of PE were 10.98% and 21.39%, respectively. Patients with APE were older and more likely to smoke, had more comorbidities, and had a higher body mass index than patients with LPE.
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Affiliation(s)
- Jingjing Gao
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dangwei Peng
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiansheng Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Zongyao Hao
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jun Zhou
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Song Fan
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yao Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jun Mao
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xianming Dou
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chaozhao Liang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Chronic periodontitis and the risk of erectile dysfunction: a systematic review and meta-analysis. Int J Impot Res 2016; 29:43-48. [DOI: 10.1038/ijir.2016.43] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 08/11/2016] [Accepted: 10/02/2016] [Indexed: 01/11/2023]
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DeLay KJ, Haney N, Hellstrom WJ. Modifying Risk Factors in the Management of Erectile Dysfunction: A Review. World J Mens Health 2016; 34:89-100. [PMID: 27574592 PMCID: PMC4999494 DOI: 10.5534/wjmh.2016.34.2.89] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 12/16/2022] Open
Abstract
Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process.
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Affiliation(s)
- Kenneth J DeLay
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nora Haney
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne Jg Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Marchal-Escalona C, Herrera-Imbroda B, Clemente-Postigo M, Alcaide-Torres J, Quiñonero A, Marchal M, Queipo-Ortuño MI, Aragón IM, Martín-Morales A, Lara MF, Cardona F. PDE5A Polymorphisms Influence on Sildenafil Treatment Success. J Sex Med 2016; 13:1104-10. [DOI: 10.1016/j.jsxm.2016.04.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/22/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
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Abstract
Erectile dysfunction (ED) is a common condition affecting millions of men worldwide. The pathophysiology and epidemiologic links between ED and risk factors for cardiovascular disease (CVD) are well-established. Lifestyle modifications such as smoking cessation, weight reduction, dietary modification, physical activity, and psychological stress reduction have been increasingly recognized as foundational to the prevention and treatment of ED. The aim of this review is to outline behavioral choices which may increase ones risk of developing ED, to present relevant studies addressing lifestyle factors correlated with ED, and to highlight proposed mechanisms for intervention aimed at improving erectile function in men with ED. These recommendations can provide a framework for counseling patients with ED about lifestyle modification.
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Affiliation(s)
- Marah C Hehemann
- 1 Department of Urology, Loyola University Health Systems, Maywood, IL, USA ; 2 Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - James A Kashanian
- 1 Department of Urology, Loyola University Health Systems, Maywood, IL, USA ; 2 Department of Urology, Weill Cornell Medicine, New York, NY, USA
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Kellesarian SV, Kellesarian TV, Ros Malignaggi V, Al-Askar M, Ghanem A, Malmstrom H, Javed F. Association Between Periodontal Disease and Erectile Dysfunction: A Systematic Review. Am J Mens Health 2016; 12:338-346. [PMID: 27030114 DOI: 10.1177/1557988316639050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A limited number of studies have reported an association between erectile dysfunction (ED) and chronic periodontitis (CP). The aim of the present study is to assess the association between CP and ED through a systematic review of published literature. To address the focused question, "Is there a relationship between ED and CP?" indexed databases were searched till December 2015 using various key words "erectile dysfunction," "periodontal disease," "periodontitis," "dental infection," and "impotence." Letters to the editor, commentaries, historic reviews, and experimental studies were excluded. The pattern of the present systematic review was customized to primarily summarize the pertinent data. Nine studies were included. Seven studies had a cross-sectional design and two studies were randomized control trials. The number of study participants ranged between 53 and 513,258 individuals with age ranging between 20 years and 85 years (median age ranging between 34.9 ± 4.9 years and 50.9 ± 16.6 years). In all studies, a positive relationship between CP and ED was reported. In four studies, odds ratio were reported, ranging between 1.53 and 3.35. From the literature reviewed, there seems to be a positive association between ED and CP; however, further well-designed controlled clinical trials are needed in this regard. It is emphasized that physicians should refer patients with ED to oral health care providers for a comprehensive oral evaluation and treatment.
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Affiliation(s)
| | | | | | | | | | | | - Fawad Javed
- 1 University of Rochester, Rochester, NY, USA
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