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Kazan Kizilkurt O, Kazan O, Efiloglu O, Erol B, Yildirim A. Effect of internet pornography use frequency on psychogenic erectile dysfunction severity in young Turkish men: the mediating role of dyadic adjustment. Int J Impot Res 2024; 36:621-626. [PMID: 38052977 DOI: 10.1038/s41443-023-00804-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/18/2023] [Accepted: 11/23/2023] [Indexed: 12/07/2023]
Abstract
This cross-sectional study aimed to investigate the effect of the frequency of using pornography on psychogenic erectile dysfunction severity after controlling for other psychological factors. It then evaluated the mediating role of dyadic adjustment regarding this. This study included 66 young married heterosexual male patients who were diagnosed with psychogenic erectile dysfunction after organic causes were excluded. The patients filled out the form about demographics, the age of onset of pornography use, and the frequency of pornography use. All participants were evaluated using a comprehensive data form, the International Index of Erectile Function, the Dyadic Adjustment Scale, the Patient Health Questionnaire-Somatic, Anxiety, and Depressive Symptoms, the Perceived Stress Scale, and the Rosenberg Self-Esteem Scale. A significant strong negative correlation was determined between the International Index of Erectile Function scores and pornography use frequency (r = -0.535 and p < 0.001). Pornography use frequency and Dyadic Adjustment Scale scores were found to have a significant predictive effect on erectile dysfunction scores in hierarchical regression analysis after controlling for somatization, depression, and perceived stress, which are typically correlated with erectile dysfunction scores (Beta = -0.28, and 0.34 respectively, p = 0.02, and 0.01 respectively). The Sobel test conducted to evaluate the mediating effect of dyadic adjustment revealed that dyadic adjustment played a mediating role in the correlation between pornography use frequency and erectile dysfunction scores (z = -1.988 and p = 0.047, respectively). The most significant observation of this study was the specific causative effect of pornography use frequency on erectile dysfunction severity through dyadic adjustment, especially considering that the frequency of using pornography is a modifiable factor.
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Affiliation(s)
- Ozlem Kazan Kizilkurt
- Department of Psychiatry, Uskudar University, School of Medicine, NPIstanbul Neuropsychiatry Hospital, Istanbul, Turkey
| | - Ozgur Kazan
- Department of Urology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.
| | - Ozgur Efiloglu
- Department of Urology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Bulent Erol
- Department of Urology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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Liu WY, Jiesisibieke ZL, Chien CW, Tung TH. Association between COVID-19 and sexual health: an umbrella review. Ann Med 2023; 55:2258902. [PMID: 37733015 PMCID: PMC10515670 DOI: 10.1080/07853890.2023.2258902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE We conducted this umbrella review to review the current evidence on the relationship between COVID-19 and sexual health in both men and women. METHODS We conducted searches in Pubmed, Embase, and the Cochrane dataset for meta-analyses that met our pre-set inclusion criteria. We included studies with detailed information investigating the link between COVID-19 and sexual health in men/women. We did not limit the language. RESULTS The results of the included studies frequently relied on the Female Sexual Function Index to assess sexual health in women. For men, the International Index of Male Function and hospital diagnoses were commonly used to assess sexual health. Currently, there is conflicting evidence regarding the impact of COVID-19 on sexual health. However, since most studies were observational in nature, additional study designs are necessary to draw definitive conclusions across different contexts. CONCLUSION Our findings highlight the importance of sexual health among COVID-19 patients and people affected due to COVID-19. Further critical studies should investigate the mechanism underlying the association between COVID-19 and sexual health.
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Affiliation(s)
- Wen-Yi Liu
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- Department of Health Policy Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Shanghai Bluecross Medical Science Institute, Shanghai, China
- Shanghai International Medical Center, Shanghai, China
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Zhu Liduzi Jiesisibieke
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen, China
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, China
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Enze Hospital, Taizhou Enze Medical Center (Group), Affilitated to Hangzhou Medical College, Taizhou, China
- Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, China
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Gutierrez-Velarde P, Valladares-Garrido MJ, Peralta CI, Vera-Ponce VJ, Grandez-Urbina JA. Poor sleep quality and erectile dysfunction in students from a Peruvian University: A cross-sectional study. Front Public Health 2023; 11:932718. [PMID: 36817877 PMCID: PMC9928877 DOI: 10.3389/fpubh.2023.932718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
Objective We aimed to evaluate the association between sleep quality and erectile dysfunction in young university students. Methods A cross-sectional survey was conducted in men aged 18-30 years from Universidad Ricardo Palma, Lima, Peru. The survey comprised the International Index of Erectile Function, Pittsburgh Sleep Quality Index, Berlin questionnaire, and questions related to sociodemographic data. Prevalence ratios were estimated with generalized linear models. Results Of 381 participants, the median age was 23 years. Half of the students (50.9%) had poor sleep quality, of which 72.7% had mild erectile dysfunction and 20.6% mild to moderate dysfunction. Prevalence of erectile dysfunction was significantly higher in students with poor sleep quality than in students with good sleep quality (aPR = 6.48; 95% CI: 4.58-9.17) after adjusting for age, academic year, nutritional status, and sleep apnea. In a subsequent exploratory analysis, sleep apnea was associated with a higher prevalence of erectile dysfunction (aPR = 1.19; 95% CI: 1.01-1.39), while overweight (aPR = 0.85; 95% CI: 0.76-0.95) and obesity (aPR = 0.65; 95% CI: 0.52-0.82) were associated with a lower prevalence of this condition. Conclusion Poor sleep quality was independently associated with erectile dysfunction in young university students. This finding suggests that male students are at risk for sexual problems due to possible academic demands and relationship issues.
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Affiliation(s)
| | - Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru,Epidemiology Office, Hospital Regional Lambayeque, Chiclayo, Peru,*Correspondence: Mario J. Valladares-Garrido ✉
| | - C. Ichiro Peralta
- School of Medicine, Universidad Nacional Federico Villarreal, Lima, Peru,C. Ichiro Peralta ✉
| | - Victor J. Vera-Ponce
- Facultad de Medicina, Instituto de Investigación en Ciencias Biomédicas de la Universidad Ricardo Palma, Lima, Peru,Universidad Tecnológica del Perú, Lima, Peru
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Ciaccio V, Di Giacomo D. Psychological Factors Related to Impotence as a Sexual Dysfunction in Young Men: A Literature Scan for Noteworthy Research Frameworks. Clin Pract 2022; 12:501-512. [PMID: 35892440 PMCID: PMC9326597 DOI: 10.3390/clinpract12040054] [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: 05/11/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the increasing interest in clinical practice in sexual dysfunction (SD) and the related relevance of psychological outcomes for young people, this area has been neglected in scientific scenarios. This study aims to draw on recent scientific findings and propose future research perspectives on the risk factors, diagnostic issues, and therapies that address SD for the under-40 age category, with particular attention paid to various psychological aspects. A literature search was conducted on studies published between March 2011 and March 2021. Anxiety, depression, and relational conflicts can both cause and affect sexual dysfunction. Psychological interventions have also proved to be important to organic causes; however, no review has found either sex education programs or multidisciplinary therapies. A multidisciplinary approach involving medical doctors and psychologists (trained in psychosexology) would improve not only the recognition of disorders through organic and psychogenic symptoms, but also treatment effectiveness.
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Affiliation(s)
- Valentina Ciaccio
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
- Postgraduate School on Clinical Psychology, University of L’Aquila, 67100 L’Aquila, Italy
| | - Dina Di Giacomo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
- Postgraduate School on Clinical Psychology, University of L’Aquila, 67100 L’Aquila, Italy
- Laboratory of Clinical Psychology and Psychoncology of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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Manalo TA, Biermann HD, Patil DH, Mehta A. The Temporal Association of Depression and Anxiety in Young Men With Erectile Dysfunction. J Sex Med 2022; 19:201-206. [PMID: 34969613 DOI: 10.1016/j.jsxm.2021.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is a multidimensional sexual disorder that is being increasingly diagnosed in younger men. Although mental illnesses such as depression and anxiety are known risk factors for ED, the association between these conditions and ED has been understudied in young men. AIM To explore the temporal association between depression, anxiety, and ED in a population-based cohort of young men. METHODS Using 2009-2018 MarketScan Commercial Claims data, we identified all men with ED aged 18-40 years (cases). Using ICD-9/-10 codes and prescription data, we evaluated the prevalence and incidence of depression and anxiety in this cohort. Cases were matched with men without a diagnosis of ED (controls) based on age, Charlson Comorbidity Index, history of hypertension, geographic region, and year of presentation. We examined the prevalence of depression and anxiety within 12 months prior to ED diagnosis and incidence of depression and anxiety up to 36 months after ED diagnosis in cases vs controls. Differences between cases and controls were tested with Wilcoxon rank-sum test for numerical covariates, and chi-square test for categorical covariates. Significance was set at P < .05. OUTCOMES Prevalence and incidence of depression and anxiety in young men with and without ED. RESULTS Within the 12-month period preceding ED diagnosis, the prevalence of depression and anxiety in cases vs controls were 17.1% vs 12.9%, respectively (P < .001). The incidence of depression and anxiety were higher amongst cases vs controls at 12- (11.7% vs 6.3%), 24- (14.5% vs 9.0%,) and 36- (15.9% vs 10.6%) months following ED diagnosis (P < .001). CLINICAL IMPLICATIONS High incidence and prevalence of depression and anxiety in young men diagnosed with ED highlight the importance of normalizing mental health screenings and routine psychiatric follow-up in this population. STRENGTHS & LIMITATIONS Our contemporary, case-control study utilizes a population-based cohort of young men with ED to study the temporal association between depression, anxiety, and ED, which is understudied to date. The MarketScan commercial claims database used in this analysis includes men covered by private insurers only and lacks data on symptoms and treatments. CONCLUSION Young men with ED had significantly higher rates of depression and anxiety both before and after ED diagnosis in comparison to young men without ED. Manalo TA, Biermann HD, Patil DH, et al. The Temporal Association of Depression and Anxiety in Young Men With Erectile Dysfunction. J Sex Med 2022;19:201-206.
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Affiliation(s)
- Tad A Manalo
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Henry D Biermann
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Dattatraya H Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
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Feng C, Yang Y, Chen L, Guo R, Liu H, Li C, Wang Y, Dong P, Li Y. Prevalence and Characteristics of Erectile Dysfunction in Obstructive Sleep Apnea Patients. Front Endocrinol (Lausanne) 2022; 13:812974. [PMID: 35250871 PMCID: PMC8896119 DOI: 10.3389/fendo.2022.812974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/12/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common and severe social problem. Erectile dysfunction (ED) is an important health concern. The prevalence of OSA with ED is increasing, which significantly affects the quality of life and work efficiency of patients. However, the mechanism underlying the comorbidity of these two diseases remains unclear. OBJECTIVES (1) Investigate the prevalence of OSA with ED; (2) analyze the correlation between OSA and ED; and (3) explore the treatment response to and possible mechanism of uvulapalatopharyngoplasty (UPPP) in patients with OSA and ED. This study aims to provide a theoretical basis for the clinical diagnosis and comprehensive treatment of OSA with ED and improve prevention and treatment strategies. MATERIALS AND METHODS In total, 135 subjects were enrolled in the study. Clinical data, polysomnography, the ESS score, Beck anxiety score, Beck depression score, IIEF-5 score and ASEX score were recorded before UPPP and 6 months after UPPP. Sex hormones were measured for all subjects using a Roche electrochemiluminescence analyzer. RESULT The prevalence of OSA with ED was 64.52%, and the prevalence of severe OSA with ED was 73.02%. The prevalence of OSA with ED increased with age, BMI and apnea-hypopnea index (AHI) value. Among polysomnography indicators, minimum oxygen saturation and average oxygen saturation may predict the occurrence of OSA with ED. Improving the patient's anxiety and depression is very important for treating OSA with ED. Sex hormone levels were not significantly correlated with the occurrence of OSA with ED. CONCLUSION ED is a common symptom of OSA patients. This study showed that sex hormone levels in OSA patients with ED were not significantly correlated with the condition, but further investigation of this relationship is worthwhile. It is recommended that the free and combined types of sex hormones be further distinguished during testing because the free type is the active form. UPPP surgical treatment is effective for OSA with ED, and its possible mechanism is protection of the peripheral nerves of the sex organs by improving nighttime hypoxia and arousal.
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Affiliation(s)
- Chen Feng
- Department of Otolaryngology Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Yan Yang
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Lixiao Chen
- Department of Otolaryngology Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruixiang Guo
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Huayang Liu
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Chaojie Li
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Yan Wang
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
| | - Pin Dong
- Department of Otolaryngology Head and Neck Surgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Pin Dong, ; Yanzhong Li,
| | - Yanzhong Li
- Department of Otorhinolaryngology, Qilu Hospital, Shandong University Cheeloo College of Medicine, Jinan, China
- NHC Key Laboratory of Otorhinolaryngology (Shandong University), Jinan, China
- *Correspondence: Pin Dong, ; Yanzhong Li,
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Sansone A, Mollaioli D, Limoncin E, Ciocca G, Bắc NH, Cao TN, Hou G, Yuan J, Zitzmann M, Giraldi A, Jannini EA. The Sexual Long COVID (SLC): Erectile Dysfunction as a Biomarker of Systemic Complications for COVID-19 Long Haulers. Sex Med Rev 2021; 10:271-285. [PMID: 34933829 PMCID: PMC8604714 DOI: 10.1016/j.sxmr.2021.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/30/2021] [Accepted: 11/09/2021] [Indexed: 02/08/2023]
Abstract
Introduction Long term complications of COVID-19, the disease caused by the SARS-CoV-2, involve many organ systems, dramatically worsening the quality of life, and finally contributing to impaired physical functioning. Despite the presence of well-identified pathogenetic mechanisms, the effect of “Long COVID” on sexual health has been only marginally addressed. Objectives To provide coverage of the current literature on long COVID, its epidemiology, pathophysiology, and relevance for erectile function. Methods. Comprehensive review of literature pertaining to the epidemiology and pathophysiology of long COVID, and its relevance for erectile function. Results Symptoms of long COVID are highly prevalent and involve almost all systems of the human body, with a plethora of clinical manifestations which range from minor nuisances to life-threatening conditions. “Brain fog” and fatigue are the most common complaints, although other neuropsychiatric complications, including sensory dysfunctions, anxiety, depression, and cerebrovascular events have also been reported. The respiratory and cardiovascular systems are also affected, with dyspnea, pulmonary fibrosis, endothelial dysfunction, and myocarditis occurring in some COVID long haulers. A subset of patients might develop endocrine manifestations, including onset of diabetes, thyroid dysfunction, and hypogonadism. Overall, long COVID features many complications which can impair erectile function by multiple pathogenetic mechanisms, and which could require tailored treatment: (i) careful investigation and management from the sexual medicine expert are therefore much needed, (ii) and future research on this topic is warranted. Conclusion in COVID-19 long haulers, several complications can adversely affect erectile function which, upon future tailored studies, could be used as biomarker for the severity of the long COVID disease and for its follow-up. Sansone A, Mollaioli D, Limoncin E et al. The Sexual Long COVID (SLC): Erectile Dysfunction as a Biomarker of Systemic Complications for COVID-19 Long Haulers. Sex Med Rev 2022;10:271–285.
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Affiliation(s)
- Andrea Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Daniele Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Erika Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy
| | - Nguyễn Hoài Bắc
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Thắng Nguyễn Cao
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Michael Zitzmann
- Center of Reproductive Medicine and Andrology, Institute of Reproductive and Regenerative Biology, Münster, Germany
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Emmanuele A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB. Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review. Am J Mens Health 2021; 14:1557988320937200. [PMID: 32623948 PMCID: PMC7338652 DOI: 10.1177/1557988320937200] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia
compared to Europe due to conservative cultural and religious beliefs,
socioeconomic conditions, and lack of awareness. There is a tendency for the use
of traditional medicines and noncompliance with and reduced access to modern
healthcare. The present systematic review compared the incidence and factors of
MSD in European and Asian populations. English language
population/community-based original articles on MSDs published in MEDLINE from
2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50
(25 Asian and 25 European) were finally included in this review. The prevalence
of erectile dysfunction (ED) (0%–95.0% vs. 0.9%–88.8%), low satisfaction
(3.2%–37.6% vs. 4.1%–28.3%), and hypoactive sexual desire disorder (HSDD)
(0.7%–81.4 vs. 0%–65.5%) was higher in Asian than in European men, whereas the
prevalence of anorgasmia (0.4% vs. 3%–65%) was lower in Asian than in European
men. Age was an independent positive factor of MSD. In European men over 60
years old, the prevalence of premature ejaculation (PE) decreased. The
prevalence of MSD was higher in questionnaires than in interviews. The
significant factors were age, single status, low socioeconomic status, poor
general health, less physical activity, cardiovascular diseases, diabetes,
obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and
alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian
and European men. There is a need to conduct large studies on the various Asian
populations for the effective management of MSD.
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Affiliation(s)
- Muhammad Irfan
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Zhuravleva ZD, Johansson A, Jern P. Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms. J Sex Med 2020; 18:265-274. [PMID: 33243692 DOI: 10.1016/j.jsxm.2020.10.017] [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: 07/16/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The association between erectile dysfunction (ED), free testosterone (T), and androgenic genetic polymorphisms is still unclear. As most studies in the field have focused on older (>40 y.o.) men, data from young men is scarce. In addition, the clinically observed comorbidity between ED and premature ejaculation (PE) has not been explained. AIM The aim of the present study was 3-fold: to assess in a sample of young men (1) the association between ED and T; (2) the role of androgenic genetic polymorphisms in the aforementioned association; and (3) comorbidity between ED and PE symptoms. METHODS Statistical analyses were performed on a population-based sample of 2,302 Finnish men, (Mage = 26.8 years). Hormone samples were available from 317 men, and genotype information was available from a minimum of 1,144 men depending on genetic locus. For twin analyses, the sample contained 533 male individuals from opposite-sex fraternal twin pairs, 491 identical male individuals (110 complete pairs), 493 male individuals from male fraternal twin pairs (92 complete pairs), and 658 siblings of twins. OUTCOMES The main outcome measure includes association between levels of salivary T and ED, main effects of the androgen-related genetic polymorphisms on ED scores. Bivariate twin models of PE and ED were fitted to elucidate possible shared etiology. RESULTS We found no significant association between T levels and ED and no significant main effects of the androgenic genetic polymorphisms on ED. We found no evidence suggesting that any of the genetic polymorphisms would moderate the association between T and ED symptoms. We found shared unique environmental influences between PE and ED (rE = .28). CLINICAL TRANSLATION Obtained data suggest that ED has T-independent causes and that any comorbidity between PE and ED is not explained by a set of genes affecting both phenotypes. STRENGTHS & LIMITATIONS First, the sample size for both parts of the study was relatively small, which may make some statistical analyses underpowered. Furthermore, as the sample was a population-based sample of relatively young men, the number of clinically relevant ED cases was low. Second, some concerns about T derived from saliva exist because saliva sampling comes with increased risks of error particularly because saliva samples are more vulnerable to contamination. CONCLUSION We found no significant association between free T levels, androgenic genetic polymorphisms, and ED in the younger age cohort. Twin analysis suggested a common nonshared environmental component in PE and ED. Zhuravleva1 ZD, Johansson A, Jern P. Erectile Dysfunction in Young Men: Testosterone, Androgenic Polymorphisms, and Comorbidity With Premature Ejaculation Symptoms. J Sex Med 2021;18:265-274.
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Affiliation(s)
- Zoia D Zhuravleva
- Department of Fundamental and Applied Research, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia.
| | - Ada Johansson
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Patrick Jern
- Department of Psychology, Åbo Akademi University, Turku, Finland
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Kızılay F, Kalemci S, Şimşir A, Altay B. Predisposing factors for erectile dysfunction and response to treatment in younger males: Are they different from those of older men? An observational‐comparative study. Andrologia 2019; 52:e13495. [DOI: 10.1111/and.13495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/30/2019] [Accepted: 11/07/2019] [Indexed: 12/27/2022] Open
Affiliation(s)
- Fuat Kızılay
- Department of Urology Faculty of Medicine Ege University Izmir Turkey
| | - Serdar Kalemci
- Department of Urology Faculty of Medicine Ege University Izmir Turkey
| | - Adnan Şimşir
- Department of Urology Faculty of Medicine Ege University Izmir Turkey
| | - Barış Altay
- Department of Urology Faculty of Medicine Ege University Izmir Turkey
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Hobbs LJ, Mitchell KR, Graham CA, Trifonova V, Bailey J, Murray E, Prah P, Mercer CH. Help-Seeking for Sexual Difficulties and the Potential Role of Interactive Digital Interventions: Findings From the Third British National Survey of Sexual Attitudes and Lifestyles. JOURNAL OF SEX RESEARCH 2019; 56:937-946. [PMID: 30907691 PMCID: PMC6816537 DOI: 10.1080/00224499.2019.1586820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual difficulties are common and can negatively impact health and well-being. A wide range of support is available, but there are multiple barriers to accessing help. Interactive digital interventions (IDIs) for sexual difficulties have the potential to provide a convenient, wide-reaching, and cost-effective source of support, but little is known about who might use them. We explored the potential reach of IDIs by assessing the prevalence of help-seeking among people with distressing sexual difficulties, including who seeks which sources of help. Data came from sexually active men and women, ages 16 to 74, participating in Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) (N = 11,637). Help/advice was sought by less than half of those with distressing sexual difficulties, and help-seeking was associated with younger age in women but not men. The most popular sources of support were family doctor (47.5% to 54.8%), Internet (22.0% to 25.6%), and family/friend (20.7% to 41.8%), with older participants (≥ 35), particularly men, preferring to seek help from a family doctor, and younger participants (<35) preferring to seek help from the Internet or family/friend. Despite a paucity of good digital support sites for sexual function, the Internet is a common source of help. As Internet access continues to increase, so too does the potential for well-designed IDIs to support those with sexual difficulties.
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Affiliation(s)
- Lorna J. Hobbs
- eHealth Unit, Research Department of Primary Care and Population Health, University College London
| | | | | | | | - Julia Bailey
- eHealth Unit, Research Department of Primary Care and Population Health, University College London
| | - Elizabeth Murray
- eHealth Unit, Research Department of Primary Care and Population Health, University College London
| | - Phil Prah
- Institute for Global Health, University College London
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Yang Y, Song Y, Lu Y, Xu Y, Liu L, Liu X. Associations between erectile dysfunction and psychological disorders (depression and anxiety): A cross-sectional study in a Chinese population. Andrologia 2019; 51:e13395. [PMID: 31434163 DOI: 10.1111/and.13395] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/26/2019] [Accepted: 07/20/2019] [Indexed: 12/21/2022] Open
Abstract
The present cross-sectional survey was performed to evaluate the prevalences and correlations of depression and anxiety among Chinese erectile dysfunction (ED) men. Between February 2017 and January 2019, male patients with or without ED treated in andrology clinic and urology clinic were enrolled in the investigation. All enrolled patients were required to fill in the International Index of Erectile Function Questionnaire (IIEF-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) which intended to evaluate the diagnosis and severity of ED, depression and anxiety respectively. Of the 958 included participants, 79.82% (613/768) and 79.56% (611/768) ED patients appeared to have anxiety and depression; 13.68% (26/190) of men without ED had anxiety and depression. In addition, young ED patients (age ≤35 years) and long ED duration patients (duration >12 months) had higher incidences and severities of anxiety and depression (p < .05). After adjusting the age, IIEF-5 was negatively correlated with PHQ-9 (adjusted r = -.653, p < .001) and GAD-7 scores (adjusted r = -.607, p < .001). The prevalences of anxiety and depression were 79.82% and 79.56% in Chinese ED patients. The prevalences and severities of anxiety and depression increased as the ED severity increased. Based on the high incidences of anxiety and depression among Chinese ED patients, clinicians are supposed to pay more attention to early diagnosis and therapy of psychiatric symptoms for ED patients, especially among young patients and patients with long ED duration.
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Affiliation(s)
- Yongjiao Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yi Lu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yawei Xu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Dick B, Reddy A, T. Gabrielson A, Hellstrom WJ. Organic and Psychogenic Causes of Sexual Dysfunction in Young Men. ACTA ACUST UNITED AC 2018. [DOI: 10.29252/ijmr-040404] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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14
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Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors. Sex Med Rev 2018; 6:396-409. [DOI: 10.1016/j.sxmr.2017.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 12/27/2017] [Accepted: 12/28/2017] [Indexed: 11/22/2022]
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15
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Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile Dysfunction in Young Men-A Review of the Prevalence and Risk Factors. Sex Med Rev 2017. [PMID: 28642047 DOI: 10.1016/j.sxmr.2017.05.004] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is an important health concern that can significantly affect a man's psychosocial well-being. ED has traditionally been considered a disease of old age; however, contemporary evidence suggests a growing incidence of ED in men younger than 40 years. The process of achieving an erection is multifaceted; there are many potential mechanisms that can be disrupted. It is critical to identify the specific causes of ED before proceeding with potentially costly and invasive therapeutic options. Advances in diagnostic and treatment modalities offer opportunities to identify and manage young men with ED. AIM To provide an update on the prevalence and risk factors of ED in young men and to provide a framework to guide clinicians in identifying and managing the affected young man. METHODS Comprehensive review of the literature pertaining to ED in young men. MAIN OUTCOME MEASURES ED in young men was assessed by outlining the prevalence according to recent epidemiologic studies. The pathophysiology, diagnostic considerations, risk factors, and etiologies were reviewed. RESULTS Large multinational studies have estimated the prevalence of ED in young men to be as high as 30%. Several studies have stratified the etiologies of ED into psychogenic and organic causes. Psychogenic etiologies of ED include depression, anxiety, and partner-related difficulties. These patients tend to experience sudden onset of symptoms, with decreased libido and good quality of spontaneous or self-stimulated erections. Organic etiologies include vasculogenic, endocrinologic, neurogenic, iatrogenic, and structural components. These patients usually experience gradual onset of symptoms and a low to normal libido. Conservative treatments such as phosphodiesterase type 5 inhibitors continue to be the mainstay treatment. CONCLUSIONS ED in young men is an increasingly common condition. A careful diagnostic evaluation should focus on the identification of any underlying etiology to ensure appropriate management of patients. Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile Dysfunction in Young Men-A Review of the Prevalence and Risk Factors. Sex Med Rev 2017;5:508-520.
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Affiliation(s)
| | - Andrew T Gabrielson
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne J G Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
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Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol 2017; 6:79-90. [PMID: 28217453 PMCID: PMC5313296 DOI: 10.21037/tau.2016.09.06] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Epidemiological studies consistently show that prevalence of erectile dysfunction (ED) increases with ageing. Nonetheless, complaints of ED even in younger men are becoming more and more frequent. Healthcare professionals working in Sexual Medicine but even those operating in different clinical contexts might be adequately prepared to answer this increasing requirement. ED in younger men is likely to be overlooked and dismissed without performing any medical assessment, even the most basic ones, such as collection of medical history and physical exam. This is due to the widespread assumption that ED in younger individuals is a self-limiting condition, which does not deserve any clinical evaluation or therapy and can be managed only with patient reassurance. However, evidence shows that, in younger subjects, organic, psychological and relational conditions can contribute to the pathogenesis of ED and all these conditions might be evaluated and treated, whenever necessary. Among the organic conditions contributing to the onset of ED, metabolic and cardiovascular (CV) risk factors are surprisingly of particular relevance in this age group. In fact, in younger men with ED, even more than in older ones, recognizing CV risk factors or conditions suggestive of cardio-metabolic derangements can help identifying men who, although at low absolute risk due to young age, carry a high relative risk for development of CV events. In this view, the assessment of a possible organic component of ED even in younger individuals acquires a pivotal importance, because it offers the unique opportunity to unearth the presence of CV risk factors, thus allowing effective and high quality preventive interventions.
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Affiliation(s)
- Giulia Rastrelli
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy;; I.N.B.B. - Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
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Rajkumar RP, Kumaran AK. Depression and anxiety in men with sexual dysfunction: a retrospective study. Compr Psychiatry 2015; 60:114-8. [PMID: 25818906 DOI: 10.1016/j.comppsych.2015.03.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Comorbid anxiety disorders and depression are commonly seen in men with sexual disorders such as erectile dysfunction (ED) and premature ejaculation (PE). However, they are often undiagnosed and untreated, and their relationship to sexual dysfunction is complex. This study examines the frequency and correlates of comorbid anxiety and depression in men with ED or PE. METHODS The case records of 64 men with ED or PE attending a clinic for psychosexual disorders in a general hospital psychiatry unit during the period 2010-14 were reviewed. Information on comorbid anxiety disorders and depression was extracted from these records, and their clinical and demographic associations were analyzed. RESULTS Eight (12.5%) men had comorbid depressive disorders, and fifteen (23.4%) had anxiety disorders. These disorders predated the onset of sexual dysfunction in the majority of patients. Generalized anxiety disorder was the commonest anxiety disorder. Men with comorbid depression had significantly elevated rates of suicidal ideation or behavior related to their sexual dysfunction, and were more likely to report a lack of libido. Men with pre-existing anxiety disorders were more likely to experience performance anxiety related to sex, and to have PE without comorbid ED. CONCLUSIONS Depression and anxiety affect a substantial minority of men with sexual dysfunction. Men presenting for the evaluation of ED and PE should be carefully screened for these disorders. The links between anxiety disorders and sexual performance anxiety merit further investigation in this patient group.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantari Nagar, Pondicherry, 605 006, India.
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18
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O’Sullivan LF. Sexual Function and Problems with Adolescents and Young Adults. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0035-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Molina-Leyva A, Jiménez-Moleón J, Naranjo-Sintes R, Ruiz-Carrascosa J. Sexual dysfunction in psoriasis: a systematic review. J Eur Acad Dermatol Venereol 2014; 29:649-55. [DOI: 10.1111/jdv.12845] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 10/13/2014] [Indexed: 11/27/2022]
Affiliation(s)
- A. Molina-Leyva
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Torrecárdenas; Almería Spain
| | - J.J. Jiménez-Moleón
- Dpto de Medicina Preventiva y Salud Pública; Instituto de Investigación Biosanitaria ibs; GRANADA, Hospitales Universitarios de Granada/Universidad de Granada; Granada Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP); Granada Spain
| | - R. Naranjo-Sintes
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Universitario Granada; Granada Spain
| | - J.C. Ruiz-Carrascosa
- Servicio de Dermatología médico-quirúrgica y Venereología; Hospital Universitario Granada; Granada Spain
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Höglund J, Jern P, Sandnabba NK, Santtila P. Finnish women and men who self-report no sexual attraction in the past 12 months: prevalence, relationship status, and sexual behavior history. ARCHIVES OF SEXUAL BEHAVIOR 2014; 43:879-89. [PMID: 24558122 DOI: 10.1007/s10508-013-0240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 10/28/2013] [Accepted: 11/09/2013] [Indexed: 05/12/2023]
Abstract
The aim of the present study was to investigate the prevalence of not reporting sexual attraction in the past year and its associations with factors related to partner relations as well as sexuality-related characteristics in a population-based sample of Finnish twins. The present study was based on a total of 3,540 participants (1,304 men and 2,236 women) aged 33-43 years. A total of 19 men and 73 women reported complete absence of sexual interest in women or men during the past year. Older age was associated with absence of sexual interest in the past year in women, but not men. Individuals who reported absence of sexual interest in the past year were more likely than individuals who reported sexual interest to be single, but those who were in a relationship did not express more dissatisfaction with their relationships. Individuals who reported absence of sexual interest in the past year had had fewer sexual partners and reported less experience of sexual behavior in childhood. Women who reported no sexual interest in the past year, but who were nevertheless sexually active, reported higher frequencies of sexual dysfunctions than matched controls. No significant differences regarding the tendency to fake orgasm were found between the sexually active individuals who reported absence of sexual interest in the past year and the group of matched controls. The present study suggests that absence of sexual interest may be a lifelong phenomenon which does not necessarily affect relationship satisfaction, but is associated with variation in sexual behaviors.
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Affiliation(s)
- Jannike Höglund
- Department of Psychology and Logopedics, Abo Akademi University, Fabriksgatan 2, 20500, Åbo, Finland
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21
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Read J, Mati E. Erectile dysfunction and the internet: drug company manipulation of public and professional opinion. JOURNAL OF SEX & MARITAL THERAPY 2013; 39:541-559. [PMID: 23672238 DOI: 10.1080/0092623x.2012.736922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Given that the Internet is now a major source of information regarding health and mental health problems, and that it is in the interest of the pharmaceutical industry to influence public and professional opinion, this study evaluated 70 websites about erectile dysfunction. The 31 drug company-funded websites (44%) were, compared with the 39 websites that are not industry funded, significantly more biased toward biological factors in general, and toward medication in particular (p < .01). The high proportion of websites that are industry sponsored, and the bias of those websites, confirms previous studies on depression, posttraumatic stress disorder, schizophrenia, and attention deficit hyperactivity disorder, and demonstrates that drug companies are using their financial might to manipulate public and professional opinion on the Internet.
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Affiliation(s)
- John Read
- School of Psychology, University of Auckland, Auckland, New Zealand.
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