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Burnett AL, Edwards NC, Barrett TM, Nitschelm KD, Bhattacharyya SK. Addressing Health-Care System Inequities in the Management of Erectile Dysfunction: A Call to Action. Am J Mens Health 2021; 14:1557988320965078. [PMID: 33045918 PMCID: PMC7557698 DOI: 10.1177/1557988320965078] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Erectile dysfunction (ED) is a common, burdensome, and costly urologic condition strongly related to all aspects of general health, from physical to mental. ED has profound consequences as it may interfere physical well-being, quality of life (QoL), self-esteem, relationships, self-worth, and productivity. It is therefore important to ensure that all types of effective ED treatments are consistently accessible to patients. While federal and state mandates ensure access to treatment for women’s breast health, female-factor infertility, and gender affirmation to ensure that these individuals do not experience a diminished QoL, there are no comparable mandates for men’s sexual and reproductive health. The burden of ED necessitates a call to action to improve the accessibility of ED treatments. The call to action steps include: (a) coverage for pharmacological, surgical, and other ED treatments should be viewed in the same way as coverage for other health issues, whether male or female and regardless of the stages of treatment, physical dysfunction, or physical changes; (b) American Urological Association (AUA) guidelines for the management of ED should be followed, including implementation of templates in electronic medical records (EMRs) to support adherence to the guidelines; and (c) coverage criteria should explicitly state that the criteria are intended to support gender equity for sexual and reproductive health care and should not be used to prevent men from receiving medically necessary ED treatments. This call to action offers a pathway to support every man who seeks treatment for ED as a medically necessary intervention by removing systemic health-care barriers.
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Affiliation(s)
- Arthur L Burnett
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natalie C Edwards
- Health Economics and Outcomes Research, Health Services Consulting Corporation, Boxborough, MA, USA
| | - Tonya M Barrett
- Global Health Economics & Market Access, Women's Health & Prosthetic Urology-Men's Health, Boston Scientific Corporation, Urology Pelvic Health Division, Marlborough, MA, USA
| | - Krista D Nitschelm
- Global Health Economics & Market Access, Women's Health & Prosthetic Urology-Men's Health, Boston Scientific Corporation, Urology Pelvic Health Division, Marlborough, MA, USA
| | - Samir K Bhattacharyya
- Health Economics and Market Access, Boston Scientific Corporation, Marlborough, MA, USA
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Garijo BM, Katz JE, Greer A, Gonzalgo M, López AG, Deane L, Ramasamy R. Increase in searches for erectile dysfunction during winter: seasonal variation evidence from Google Trends in the United States. Int J Impot Res 2021; 34:172-176. [PMID: 33574574 PMCID: PMC8964410 DOI: 10.1038/s41443-020-00397-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/10/2020] [Accepted: 12/02/2020] [Indexed: 12/12/2022]
Abstract
AbstractSeveral diseases associated with erectile dysfunction (ED), such as type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD), are known to have seasonal variation, with increased incidence during winter months. However, no literature exists on whether this chronological-seasonal evolution is also present within ED symptomatology. We hypothesized ED would follow the seasonal pattern of its lifestyle-influenced comorbid conditions and exhibit increased incidence during winter months. In order to investigate the seasonal variation of ED in the United States between 2009 and 2019, Internet search query data were obtained using Google Trends. Normalized search volume was determined during the winter and summer seasons for ED, other diseases known to be significantly associated with ED (T2DM and CAD), kidney stones (positive control), and prostate cancer (negative control). There were significantly more internet search queries for ED during the winter than during the summer (p = 0.001). CAD and T2DM also had significantly increased search volume during winter months compared to summer months (p < 0.001 and p = 0.011, respectively). By contrast, searches for kidney stones were significantly increased in the summer than in the winter (p < 0.001). There was no significant seasonal variation in the relative search frequency for prostate cancer (p = 0.75). In conclusion, Google Trends internet search data across a ten-year period in the United States suggested a seasonal variation in ED, which implies an increase in ED during winter. This novel finding in ED epidemiology may help increase awareness of ED’s associated lifestyle risk factors, which may facilitate early medical evaluation and treatment for those at risk of both ED and cardiovascular disease.
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Lin YH, Liao CH, Wong SM, Chiang BJ, Chen HC, Wu YN. A short term follow up for intracavernosal injection of platelet rich plasma for the treatment of erectile dysfunction. UROLOGICAL SCIENCE 2021. [DOI: 10.4103/uros.uros_22_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Alwaal A, Awad M, Boggs N, Kuzbel J, Snoad B. Sexual Health Inventory for Men Questionnaire as a Screening Method for Erectile Dysfunction in a General Urology Clinic. Sex Med 2020; 8:660-663. [PMID: 32919921 PMCID: PMC7691874 DOI: 10.1016/j.esxm.2020.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Sexual Health Inventory for Men (SHIM) is a validated questionnaire that is widely used in urology clinics to evaluate and assess treatment efficacy for erectile dysfunction (ED). AIM In this study, we evaluated the benefit of using the SHIM questionnaire as a screening tool for ED in a general urology clinic MATERIAL AND METHODS: We retrospectively reviewed records of patients presenting to our general urology clinic from October 2018 to June 2019. During this period, all new male urology patients who are 40 years of age or older visiting the general urology clinic for any urologic condition received the SHIM questionnaire. We excluded all patients whose chief complaint was ED, Peyronie's disease, and hypogonadism. Patients were then asked if they want treatment for ED, and those patients who did, received a full ED evaluation and treatment. Factors associated with desire for ED treatment were analyzed using logistic regression. MAIN OUTCOME MEASURES SHIM score, desire for ED treatment, and factors influencing desire for treatment. RESULTS Three hundred seventy-nine patients received the SHIM questionnaire. Of which, 48 patients (12.7%) declined to fill the questionnaire. We excluded all patients presenting for sexual health issues (67 patients, 17.7%). We included the remaining 264 patients (69.6%). The mean age was 61.7 years (range 40 to 85). Older patients were more likely to want ED treatment and had lower SHIM scores. However, older than the age of 70 years, there was a decline in the number of patients wanting treatment. In a multivariate regression analysis, age between 61 and 70 years and having diabetes mellitus were associated with the desire for ED treatment. CONCLUSIONS The SHIM questionnaire is a useful tool in the general urology clinic. It can serve as an efficient tool to screen for and quantify ED in patients presenting for other urologic issues. Maximum benefit is seen in patients between the age of 51 and 70 years and in patients with diabetes. Alwaal A, Awad M, Boggs N, et al. Sexual Health Inventory for Men Questionnaire as a Screening Method for Erectile Dysfunction in a General Urology Clinic. Sex Med 2020;8:660-663.
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Affiliation(s)
- Amjad Alwaal
- Department of Urology, Marshall University, Huntington, WV, USA.
| | - Mohannad Awad
- Department of Surgery, Division of Urology, University of Vermont Medical Center, Burlington, VT, USA; Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Nathan Boggs
- Department of Urology, Marshall University, Huntington, WV, USA
| | - Jake Kuzbel
- Department of Urology, Marshall University, Huntington, WV, USA
| | - Brian Snoad
- Department of Urology, Marshall University, Huntington, WV, USA
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Tridiantari DK, Saraswati LD, Udiyono A. Epidemiology of erectile dysfunction in men with diabetes mellitus: a study in a primary health care center in Indonesia. MEDICAL JOURNAL OF INDONESIA 2020. [DOI: 10.13181/mji.oa.192070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is one of the factors causing erectile dysfunction (ED) and may affect a person's quality of life. This study was aimed to describe the epidemiology of ED in men with DM in a primary health care.
METHODS The study used a cross-sectional study design conducted from January to March 2017 at the Tlogosari Kulon Health Center, Semarang. There were 122 diabetic men who were all included in the study. The data were collected using interviewerassisted questionnaires. The status of ED was measured by the erectile dysfunction intensity scale adapted to the International Index of Erectile Function.
RESULTS The results showed that the prevalence of diabetic men with ED was 84.4%. Most men with ED had age of ≥46 years (91.0%), experienced work stress (88.5%), had low physical activity (93.1%), had obesity (88.0%) of which 86.3% had central obesity, smoking (84.6%), had DM >5 years (91.2%), and took antihypertensive drugs (90.0%). The fasting blood glucose level of respondents ≥126 mg/dl was 86.0%, and 91.7% had sexual desire disorder. The duration of DM and aging are contributing factors of ED in males with DM, with a p-value of 0.016 and 0.013, respectively.
CONCLUSIONS The prevalence of ED in primary health care is still high, and the determining factors were the duration of DM and aging. Public health centers are advised to undertake health promotion on the prevention of factors that can lead to sexual dysfunction in males with DM.
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Lin H, Zhao L, Wu H, Cao M, Jiang H. Sexual life and medication taking behaviours in young men: An online survey of 92 620 respondents in China. Int J Clin Pract 2020; 74:e13417. [PMID: 31512342 DOI: 10.1111/ijcp.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/15/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To assess sexual life and medication taking behaviours in young Chinese men. METHODS An online survey was conducted across China between January 2017 and April 2017. Among the participants, men aged 19-40 years were included in the analysis. The respondents filled in the online questionnaire assessing sexual life and medication taking behaviours by themselves, including general information, cognition of erectile dysfunction (ED) and treatment-related questions. Erection hardness score (EHS) was used to measure the erection hardness status. RESULTS Among the young respondents, 20.54% had grade I-II EHS, 58.14% searched the internet for online ED-related information, 26.49% took an ED medication and 50.89% took an ED medication without the advice of a physician or pharmacist. The respondents who took medication had less sexual intercourse per week (P < .001) and worse EHS (P < .001), and were more willing to seek information from physicians, pharmacists, friends and relatives instead of online sources (P < .001), compared with those not taking medication. The most common comorbidities in patients with grade I-II EHS were hyperlipidaemia, cardiovascular disease (CVD), prostate diseases and diabetes mellitus. CONCLUSION About 20% of young Chinese men needed further assessment for ED. The majority of respondents obtained ED-related information by online search and took an ED medication without professional advice. These data could help clinicians understand the current status of sexual life and medication taking behaviours of young Chinese men.
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Affiliation(s)
- Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Han Wu
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Mengyang Cao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Andrology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing, China
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Goldstein I, Goren A, Li VW, Tang WY, Hassan TA. Epidemiology Update of Erectile Dysfunction in Eight Countries with High Burden. Sex Med Rev 2020; 8:48-58. [DOI: 10.1016/j.sxmr.2019.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/04/2019] [Accepted: 06/24/2019] [Indexed: 12/31/2022]
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Campos-Juanatey F, Amado Diago CA, Varea Malo R, Agüero Calvo J, Correas Gómez MÁ, Portillo Martín JA. [Assessment of the impact of pulmonary rehabilitation on sexual activity in patients with chronic obstructive pulmonary disease]. Rev Int Androl 2019; 18:144-150. [PMID: 31561976 DOI: 10.1016/j.androl.2019.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/06/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) affects life quality, and also sexual activity. Pulmonary rehabilitation (PR) is a helpful treatment in COPD patients. The aim of this study is to assess sexual activity on COPD patients, and the effect of PR over it. PATIENTS AND METHODS Single cohort prospective study over male COPD candidates to PR. Clinical, respiratory and biochemical assessment (FSH, LH, T, and progesterone) was performed. Patients were asked to fill baseline International Index of Erectile Function (IIEF) questionnaire, and 6 months after PR. A descriptive initial analysis compared respiratory values between patients with and without sexual activity. Changes in IIEF results were assessed after PR, and satisfaction with treatment using Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTS Between 2014 and 2016, 62 male COPD patients enlisted. Mean age: 66.5 years (SD 7.2). 52 Ex-smokers. 10 declared being sexually active (16.1%). No hormonal levels alterations. No significant differences on respiratory parameters between sexually active and non-active patients (FEV1, 6-minutes walking test, number of exacerbations, CAT score). Baseline mean IIEF values: Erectile function 8, orgasmic function 4, sexual desire 5.6, intercourse satisfaction 5.3, and overall satisfaction 4.5. After PR, significant increase in mean IIEF value: 6.1 (CI95% 1.9-10.3). Improvement was found in all domains, with statistical significance on intercourse satisfaction 0.9 (CI95% 0.2-1.6). Moderate satisfaction with treatment was achieved according to EDITS. CONCLUSIONS Only a low percentage of COPD males included in PR is sexually active. No pulmonary differences were found between sexually active and non-active patients. PR improves sexual function, particularly intercourse satisfaction domain.
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Affiliation(s)
- Félix Campos-Juanatey
- Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España.
| | | | - Raquel Varea Malo
- Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España
| | - Juan Agüero Calvo
- Servicio de Neumología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - Miguel Ángel Correas Gómez
- Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España
| | - José Antonio Portillo Martín
- Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España
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Semple E, Shalabi F, Hill JW. Oxytocin Neurons Enable Melanocortin Regulation of Male Sexual Function in Mice. Mol Neurobiol 2019; 56:6310-6323. [PMID: 30756300 PMCID: PMC6684847 DOI: 10.1007/s12035-019-1514-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/28/2019] [Indexed: 12/13/2022]
Abstract
The melanocortin pathway has been implicated in both metabolism and sexual function. When the melanocortin 4 receptor (MC4R) is knocked out globally, male mice display obesity, low sexual desire, and copulatory difficulties; however, it is unclear whether these phenotypes are interdependent. To elucidate the neuronal circuitry involved in sexual dysfunction in MC4R knockouts, we re-expressed the MC4R in these mice exclusively on Sim1 neurons (tbMC4RSim1 mice) or on a subset of Sim1 neurons, namely oxytocin neurons (tbMC4Roxt mice). The groups were matched at young ages to control for the effects of obesity. Interestingly, young MC4R null mice had no deficits in sexual motivation or erectile function. However, MC4R null mice were found to have an increased latency to reach ejaculation compared to control mice, which was restored in both tbMC4RSim1 and tbMC4Roxt mice. These results indicate that melanocortin signaling via the MC4R on oxytocin neurons is important for normal ejaculation independent of the male's metabolic health.
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Affiliation(s)
- Erin Semple
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA
| | - Firas Shalabi
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA
| | - Jennifer W Hill
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA.
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Goldstein I, Goren A, Liebert R, Tang WY, Hassan TA. National Health and Wellness Survey exploratory cluster analysis of males 40-70 years old focused on erectile dysfunction and associated risk factors across the USA, Italy, Brazil and China. Int J Clin Pract 2019; 73:1-15. [PMID: 31120179 DOI: 10.1111/ijcp.13376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/25/2019] [Accepted: 05/20/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Prior studies of erectile dysfunction (ED) tend to narrowly focus on relationships with specific comorbidities, rather than evaluating a more comprehensive array of risk factors and assessing naturalistic patterns among them. This study identifies natural clusters of male characteristics from a general population sample per country, quantifies ED dynamics in these profiles and compares profiles across the US, Italy, Brazil and China samples. METHODS National Health and Wellness Survey 2015 and 2016 patient-reported data on men aged 40-70 years (USA n = 15,652; Italy n = 2,521; Brazil n = 2,822; China n = 5,553) were analysed. Hierarchical agglomerative clustering identified clusters where predictors included demographics, health characteristics/behaviours, ED risk factors and provider visits in the past 6 months. Multinomial logistic regression assessed the independent utility of variables in predicting cluster membership, compared with the healthiest control cluster per country. RESULTS Different natural clusters were found across countries, with four clusters for the USA, Italy and China and three clusters for Brazil. Age, income, employment, health behaviours and ED risk factors predicted different cluster membership across countries. In the USA, Italy and Brazil, younger clusters were predicted by ED, unhealthy behaviours and ED risk factors. Unique cluster profiles were identified in China, with ED and ED risk factors (aside from hypertension) not predicting cluster membership, while socio-demographics and health behaviours were strongly predictive. CONCLUSIONS Natural cluster profiles revealed notable ED rates among adult males of age 40-70 in four different countries. Clusters were mainly predicted by unhealthy behaviours, ED risk factors and ED, regardless of level or presence of positive health characteristics and behaviours. This analysis identified meaningful subgroups of men with heightened ED risk factors, which can help healthcare providers to better recognise specific populations with the greatest need for intervention.
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Affiliation(s)
- Irwin Goldstein
- Director of Sexual Medicine, Alvarado Hospital, San Diego, California
| | - Amir Goren
- Health Outcomes Practice, Kantar Health, New York, New York
| | - Ryan Liebert
- Health Outcomes Practice, Kantar Health, New York, New York
| | - Wing Yu Tang
- Patient and Health Impact, Health Economics and Outcomes Research, Pfizer Inc, New York, New York
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Ng YL, Teoh SH, Mohd Radzniwan AR, Syahnaz MH. Prevalence and associated factors of undiagnosed glycaemic disorders in men with erectile dysfunction attending a primary care clinic. J Taibah Univ Med Sci 2019; 14:88-94. [PMID: 31435395 PMCID: PMC6695078 DOI: 10.1016/j.jtumed.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives Undiagnosed glycaemic disorders remain a major health concern as in such cases the opportunity for early interventions that can potentially prevent complications is missed. Erectile dysfunction (ED) has been suggested as a predictor for glycaemic disorders in men. However, data on men with ED having undiagnosed glycaemic disorders is limited, especially in the Malaysian context. This study aimed to identify prevalence and associated factors of undiagnosed glycaemic disorders in men with ED. Methods We applied a cross-sectional purposive sampling technique on a group of 114 men with ED without underlying glycaemic disorders. They underwent a 2-h oral glucose tolerance test and the cases were then classified into two groups: normal and undiagnosed glycaemic disorders groups. The glycaemic disorders group consisted of patients with diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG). The patients were interviewed, and their medical records were reviewed for their sociodemographic and clinical profiles. Results Prevalence of undiagnosed glycaemic disorders in men with ED was 41.2%. Higher age (adjusted OR = 1.10, 95% CI: 1.03, 1.17, p = 0.002) and BMI (adjusted OR = 1.16, 95% CI: 1.05, 1.29, p = 0.003) were found to be significantly associated with undiagnosed glycaemic disorders. Conclusion This study found that men with ED had a high prevalence of undiagnosed glycaemic disorders. ED was associated with advancing age and higher BMI. Further research to validate the findings of this study is needed to increase the prevalence of DM screening among men with ED.
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Affiliation(s)
- Yoke Lan Ng
- Klinik Kesihatan Inanam, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Soo Huat Teoh
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - A Rashid Mohd Radzniwan
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Hashim Syahnaz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Men with serious chronic illnesses and malignancies are less likely to seek treatment for erectile dysfunction. Int J Impot Res 2019; 32:180-185. [DOI: 10.1038/s41443-019-0139-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 03/02/2019] [Accepted: 03/11/2019] [Indexed: 11/09/2022]
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Salami SA, Salahdeen HM, Ugbebor EC, Murtala BA, Raji Y. Effects of aqueous leaf extract of Tridax procumbens on contractile activity of corpus cavernosum in N -nitro- l -arginine methyl ester-induced hypertensive male rats. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 16:51-56. [DOI: 10.1016/j.joim.2017.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/25/2017] [Indexed: 12/01/2022]
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Gökçe Mİ, Yaman Ö. Erectile dysfunction in the elderly male. Turk J Urol 2017; 43:247-251. [PMID: 28861293 DOI: 10.5152/tud.2017.70482] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022]
Abstract
Erectile dysfunction (ED) is a health problem which mainly effects elderly men and this problem has become a more important health problem with the increased life expectancy. The basic risk factors of ED are hypertension, dyslipidemia, diabetes mellitus, and atherosclerotic heart disease which also have a higher incidence in the elderly men. The aim of this review article is to highlight the age-related changes in ED together with recommendations for patient evaluation and treatment.
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Affiliation(s)
- Mehmet İlker Gökçe
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
| | - Önder Yaman
- Department of Urology, Ankara University School of Medicine, Ankara, Turkey
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Allergic Rhinitis and Sexual Dysfunction. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0112-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Huri HZ, Mat Sanusi ND, Razack AHA, Mark R. Association of psychological factors, patients' knowledge, and management among patients with erectile dysfunction. Patient Prefer Adherence 2016; 10:807-23. [PMID: 27257374 PMCID: PMC4874731 DOI: 10.2147/ppa.s99544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is one of the most common health problems in men. ED can significantly affect a man's psychological well-being and overall health. PURPOSE To investigate the association of psychological factors, patients' knowledge, and management among ED patients. PATIENTS AND METHODS A total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study. RESULTS It was found that the feeling of blame (P=0.001), guilt (P=0.001), anger or bitterness (P=0.001), depression (P=0.001), feeling like a failure (P=0.001), and the feeling of letting down a partner during intercourse (P=0.001) were significantly associated with ED. Age was also found to be significantly associated with patients' psychological scale (P=0.004). In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients' knowledge of ED therapy and demographic characteristics. CONCLUSION This study concluded that ED does affect psychological well-being of people. In addition, patient's knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy.
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Affiliation(s)
- Hasniza Zaman Huri
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Clinical Investigation Center, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Raymond Mark
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
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Williams P, Bandhoo S, McBain H, Mulligan K, Steggall MJ. The prevalence of erectile dysfunction in men attending cardiac rehabilitation: an audit in East London. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Paul Williams
- School of Health Sciences; City University London; London UK
| | - Swallay Bandhoo
- Newham Cardiac Rehabilitation Service; East London NHS Foundation Trust; London UK
| | - Hayley McBain
- School of Health Sciences; City University London; London UK
- Community Health Newham; East London Foundation Trust; London UK
| | - Kathleen Mulligan
- School of Health Sciences; City University London; London UK
- Community Health Newham; East London Foundation Trust; London UK
| | - Martin J. Steggall
- Faculty of Life Sciences and Education; University of South Wales; Pontypridd UK
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Echeverri Tirado LC, Ferrer JE, Herrera AM. Aging and Erectile Dysfunction. Sex Med Rev 2016; 4:63-73. [DOI: 10.1016/j.sxmr.2015.10.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/22/2015] [Indexed: 01/23/2023]
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Bosser G, Chodek-Hingray A, Kazmierczak C, Juillière Y. Activité sexuelle et risques cardiovasculaires. Presse Med 2014; 43:1097-105. [DOI: 10.1016/j.lpm.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 06/29/2014] [Indexed: 11/30/2022] Open
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Cellek S, Cameron NE, Cotter MA, Fry CH, Ilo D. Microvascular dysfunction and efficacy of PDE5 inhibitors in BPH–LUTS. Nat Rev Urol 2014; 11:231-41. [DOI: 10.1038/nrurol.2014.53] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dan A, Chakraborty K, Mondal M, Neogi R, Chatterjee S, Makhal M. Erectile dysfunction in patients with diabetes mellitus: its magnitude, predictors and their bio-psycho-social interaction: a study from a developing country. Asian J Psychiatr 2014; 7:58-65. [PMID: 24524711 DOI: 10.1016/j.ajp.2013.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 10/24/2013] [Accepted: 10/28/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Persons suffering from diabetes mellitus (DM) are at higher risk of developing erectile dysfunction (ED). Several factors contribute to ED in patients of DM. Only few studies have attempted to explore physical, psychological and social factors in a single study. The aim of the index study was to measure the prevalence of ED in patients of DM and to determine the contributory role of various socio-demographic, physical, and psychological variables. METHOD One hundred and thirteen (N = 113) consenting consecutive male married diabetic patients were assessed on International Index of Erectile Function Questionnaire (IIEFQ-5), Dyadic Adjustment Scale (DAS) and Beck's Depression Inventory (BDI) to measure erectile performance, quality of marriage and depressive symptoms respectively. Pretested Bengali versions of these scales were used in the index study. RESULTS Prevalence of ED was 38.94%. ED group significantly differed from non-ED group in current age, family type, type of treatment for diabetes, presence of micro/macrovascular complications, history of current tobacco use, quality of marriage, and presence of depressive symptoms. In logistic regression analysis current age, body mass index (BMI) and presence of depressive symptoms had significant predictive role on occurrence of erectile dysfunction. CONCLUSION Prevalence of ED among diabetic patients is high compared to general population. Both physical and psychosocial factors predict the occurrence of ED in this group. So, both physicians and psychiatrists should remain aware about the multi-faceted causative role of ED in DM.
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Affiliation(s)
- Amitava Dan
- Department of Psychiatry, Calcutta National Medical College, Kolkata, India
| | - Kaustav Chakraborty
- Department of Psychiatry, College of Medicine and J.N.M. Hospital, WBUHS, Kalyani, West Bengal, India.
| | - Manas Mondal
- Department of Medicine, NRS Medical College & Hospital, Kolkata, India
| | - Rajarshi Neogi
- Department of Psychiatry, Calcutta Medical College and Hospital, West Bengal, India
| | - Somsubhra Chatterjee
- Department of Psychiatry, College of Medicine & Sagore Datta Hospital, Panihati, West Bengal, India
| | - Manabendra Makhal
- Department of Psychiatry, North Bengal Medical College and Hospital, Darjeeling, West Bengal, India
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Jannini EA, Sternbach N, Limoncin E, Ciocca G, Gravina GL, Tripodi F, Petruccelli I, Keijzer S, Isherwood G, Wiedemann B, Simonelli C. Health-related characteristics and unmet needs of men with erectile dysfunction: a survey in five European countries. J Sex Med 2013; 11:40-50. [PMID: 24314303 DOI: 10.1111/jsm.12344] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Data suggest that ED is still an underdiagnosed and undertreated condition. In addition, it seems that men with ED are unsatisfied about their relationship with their physician and with the available drugs. AIM The study aims to identify health-related characteristics and unmet needs of patients suffering from erectile dysfunction (ED) in big 5 European Union (EU) nations (France, Germany, Italy, Spain, and UK). METHODS Data were collected from the 2011 5EU National Health and Wellness-Survey on a population of 28,511 adult men (mean age: 47.18; SD 16.07) and was focused on men (5,184) who self-reported ED in the past 6 months. In addition, the quality of life (QoL) and work productivity/activity were explored. MAIN OUTCOME MEASURES Health-related QoL (HRQoL) and work productivity were measured with SF-12v2 and WPAI validated psychometric tools. RESULTS One in every 20 young men (age 18-39) across 5EU experienced ED in the past 6 months. About half of men (2,702/5,184; [52%]) with ED across all ages did not discuss their condition with their physician. Interestingly, among those men who did discuss their condition with their physician, 68% (1,668/2,465) do not currently use medication. These findings were more evident in the age group of 18-39 years. Only 48% (2,465/5,184) had a closer relationship with their physician, suggesting that this quality of relationship may be unsatisfactory. Compared with controls, ED patients have a significantly higher intrapsychic and relational psychopathological comorbid burden and relevant decreasing in HRQoL, with a significantly higher impairment on work productivity/activity. CONCLUSION Data suggest that there is a need for a new therapeutic paradigm in ED treatment which images the achievement of a new alliance between physician and patient. Hence, alternative drug delivery strategies may reduce the psychological and social impact of this disease.
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Affiliation(s)
- Emmanuele A Jannini
- School of Sexology, Department of Clinical and Applied Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
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Salonia A, Capogrosso P, Clementi MC, Castagna G, Damiano R, Montorsi F. Is erectile dysfunction a reliable indicator of general health status in men? Arab J Urol 2013; 11:203-11. [PMID: 26558083 PMCID: PMC4443011 DOI: 10.1016/j.aju.2013.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 07/25/2013] [Indexed: 12/19/2022] Open
Abstract
Introduction Erectile dysfunction (ED) is a common risk factor in men and its incidence increases with age. Ageing and older men frequently have comorbidities such as cardiovascular diseases (CVD), diabetes mellitus (DM), hypertension, chronic obstructive pulmonary disease and dyslipidaemia; likewise, they concurrently refer to a clinician for impairments in sexual function, mostly for ED. The association of ED and other organic, multi-organic or even systemic diseases is widely described, with a specific emphasis on the fact that they often share common pathophysiological factors and mechanisms. Thus we reviewed previous reports assessing the role of ED as a sentinel marker of overall men’s health. Discussion ED is considered an important sentinel marker for CVD. Numerous studies have highlighted the predictive role of ED for subsequent CV events in patients with a silent history of coronary artery disease. Indeed, ED might be considered as a clinical manifestation of a generalised vascular disease, and it should provoke clinicians to check for CVDs in those patients complaining of impaired erectile function. This concept appears to be even more important for men with DM, where ED has already been shown to have a significant predictive ability for major vascular complications. Moreover, data from large population-based studies showed that ED is a significant predictor of all-cause mortality, in addition to CV outcomes. The severity of erectile function is assessed with the International Index of Erectile Function-Erectile Function domain score, and this has emerged as a proxy for men’s general health status, as assessed with the Charlson Comorbidity Index score. Conclusions Patients complaining of ED should be evaluated with a comprehensive medical and sexual history, and a thorough physical examination, regardless of their age, considering ED as an opportunity to screen for the presence of health-threatening concomitant comorbidities.
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Key Words
- CAD, coronary artery disease
- CCI, Charlson Comorbidity Index
- CHD, coronary heart disease
- COPD, chronic obstructive pulmonary disease
- CVD, cardiovascular disease
- Clinical practice
- Comorbidities
- DM, diabetes mellitus
- ED, erectile dysfunction
- EF, erectile function
- Erectile dysfunction
- HF, heart failure
- Health status
- IIEF, International Index of Erectile Function
- International Index of Erectile Function
- MMAS, Massachusetts Male Aging Study
- MeS, metabolic syndrome
- QoL, quality of life
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Affiliation(s)
- Andrea Salonia
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Paolo Capogrosso
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | | | - Giulia Castagna
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | - Rocco Damiano
- Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Francesco Montorsi
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
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Martin Morales A, Hatzichristou D, Ramon Lladós J, Pascual Renedo V, Pimenidou A. Community pharmacy detection of erectile dysfunction in men with risk factors or who seek treatment or advice but lack a valid prescription. J Sex Med 2013; 10:2303-11. [PMID: 23845082 DOI: 10.1111/jsm.12238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Pharmacists may be the first health care contact consulted about erectile dysfunction (ED). AIM To assess pharmacists' ability to detect ED and encourage patients to seek medical evaluation. METHODS This observational study conducted in Greece and Spain included men without a valid prescription for an ED medication but with a history indicating ED risk and/or who consulted a pharmacist about ED. Pharmacists completed a questionnaire about the patient. Patients completed the Sexual Health Inventory for Men (SHIM); men with a score ≤21 (cutoff for ED) were educated (by case pharmacists) and referred and encouraged to see a physician (by case and control pharmacists). MAIN OUTCOME MEASURES Proportion of men with a SHIM score ≤21 and, of those, the proportion who visited a physician and credited the pharmacist for their visit. ANCOVA and chi-square test were used for continuous and categorical data, respectively. RESULTS Among the 451 men (mean ± SD age, 54.9 ± 12.9 years) questioned about ED, 90% had a risk factor (usually hypertension, hypercholesterolemia, or diabetes), 28% had a previous diagnosis, 36% sought internet information, 38% self-medicated, 10% took medication obtained outside the pharmacy setting, and the first health care professional approached was a pharmacist (50%), physician (18%), or nurse (1%) at a median of 6 (range, 0-360) months after symptom onset. The SHIM score was ≤21 in 348 (77%) men. A lower score (indicating increased ED severity) was associated with increased age and with benign prostate hyperplasia, depression, diabetes, or prostate cancer. In the minority of men contacted for follow-up, less than one-third had visited their physician, despite pharmacist encouragement. CONCLUSIONS Pharmacists are often the first health care contact regarding ED and are highly accurate in its detection. Further research is needed to optimize the pharmacist's role in early detection, education, and motivating patients to be evaluated by a physician.
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Dean J, Shechter A, Vertkin A, Weiss P, Yaman O, Hodik M, Ginovker A. Sexual Health and Overall Wellness (SHOW) survey in men and women in selected European and Middle Eastern countries. J Int Med Res 2013; 41:482-92. [DOI: 10.1177/0300060513476429] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective To investigate whether better sexual health is associated with improvements in overall health and wellness, a more loving and intimate relationship, and a more positive outlook on life. Methods The Sexual Health and Overall Wellness survey used self-administered questionnaires to collect data from men and women aged 25–74 years who had had sexual intercourse at least once within the previous 12 months. Results Across nine countries, 3780 self-administered questionnaires were completed: 1893 from men (mean age, 44.6 years); 1887 from women (mean age, 44.2 years). The majority of men and women were satisfied with the frequency of sexual intercourse over the previous 4 weeks (59% and 66%, respectively); the majority (67% and 55%, respectively) reported that having sex was ‘very important’ or ‘absolutely essential’. For men and women, there was a strong association between satisfaction with sex and overall health, and between satisfaction with sex and an overall positive outlook on life. Conclusion For men and women, satisfaction with different aspects of sex was important, and was strongly associated with satisfaction with general health, relationships and other aspects of wellbeing.
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Affiliation(s)
- John Dean
- St Peter's Andrology Centre, London, UK
| | - Arik Shechter
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | | | - Petr Weiss
- Institute of Sexology, Charles University and General Faculty Hospital, Prague, Czech Republic
| | - Onder Yaman
- Ankara University, Ibni Sina Hospital, Sihhiye, Ankara, Turkey
| | - Michal Hodik
- Pfizer, Emerging Markets and Established Products, Brussels, Belgium
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Scranton RE, Goldstein I, Stecher VJ. Erectile Dysfunction Diagnosis and Treatment as a Means to Improve Medication Adherence and Optimize Comorbidity Management. J Sex Med 2013; 10:551-61. [DOI: 10.1111/j.1743-6109.2012.02998.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hintistan S, Cilingir D. Sexual Dysfunction in Turkish Men and Women with Type 2 Diabetes Mellitus. SEXUALITY AND DISABILITY 2012. [DOI: 10.1007/s11195-012-9271-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Miner MM. Men's health in primary care: an emerging paradigm of sexual function and cardiometabolic risk. Urol Clin North Am 2012; 39:1-23. [PMID: 22118341 DOI: 10.1016/j.ucl.2011.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
An office evaluation of men's health in primary care requires a thorough understanding of the implications of male sexual dysfunctions, hypogonadism, and cardiometabolic risk stratification and aggressive risk management. The paradigm of the men's health office visit in primary care is the recognition and assessment of male sexual dysfunction, specifically erectile dysfunction, and its value as a signal of overall cardiometabolic health, including the emerging evidence linking low testosterone and the metabolic syndrome. Indeed, erectile dysfunction may now be thought of as a harbinger of cardiovascular clinical events and other systemic vascular diseases in some men.
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Affiliation(s)
- Martin M Miner
- Department of Family Medicine and Urology, The Men's Health Center, The Miriam Hospital, The Warren Alpert School of Medicine, Brown University, Providence, RI 02906, USA.
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Kirby MG, Schnetzler G, Zou KH, Symonds T. Prevalence and detection rate of underlying disease in men with erectile dysfunction receiving phosphodiesterase type 5 inhibitors in the United Kingdom: a retrospective database study. Int J Clin Pract 2011; 65:797-806. [PMID: 21676121 DOI: 10.1111/j.1742-1241.2011.02693.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM To determine the rate of newly detected underlying disease in men receiving their first (index) phosphodiesterase type 5 inhibitor (PDE5i) prescription. METHODS This non-interventional, retrospective study used anonymised patient records from UK general practices identified from the THIN database. Records of men aged ≥ 18 years, who received an index PDE5i prescription between January 1999 and June 2008 and with a continuous medical history (≥ 60 months) before the index prescription were included. Primary end-points were the prevalence of underlying disease prior to the index prescription and to establish the detection rate, defined as cumulative incidence of such a diagnosis in the 3 months following the index prescription. Assessments included comparison with age-matched controls, comparison with identical time periods immediately before and 1 year after, index prescription, and changes over time during the study period. Descriptive statistics, analysis of proportions and multivariate logistic regression analysis were used. RESULTS Among the 24,708 patients receiving a PDE5i, the prevalence of any underlying diagnosis before the index prescription was 70.23%; prevalence of vasculogenic disease was highest (48.20%). The detection rate of any underlying disease was 11.53%, and again highest for vasculogenic disease (4.07%). Compared with an age-matched control population, the additional detection rate of an unknown underlying disease at PDE5i prescription was 45 for hypertension, 61 for hypercholesterolaemia, 38 for diabetes and 5 for hypogonadism per 10,000 men. CONCLUSION Only a minority of men with erectile dysfunction have a previously undiagnosed important underlying disease that is uncovered at the time of an initial PDE5i prescription by a GP.
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Affiliation(s)
- M G Kirby
- Faculty of Health and Human Sciences, Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK.
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Mas M, García-Giralda L, Rey JR, Martínez-Salamanca JI, Guirao L, Turbí C. Evaluating a continuous medical education program to improve general practitioners awareness and practice on erectile dysfunction as a cardiovascular risk factor. J Sex Med 2011; 8:1585-93. [PMID: 21477015 DOI: 10.1111/j.1743-6109.2011.02244.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The clear link between erectile dysfunction (ED) and cardiovascular disease (CVD) together with the increased potential for effectively treating ED with oral pharmacological agents make the primary care setting the ideal place to detect and treat ED and its potential comorbidities. Given the observed shortcomings in knowledge related to ED among primary care physicians, continuous medical education (CME) on this topic stands out as a potentially effective way to improve patient care. AIM To assess general practitioners' (GPs) knowledge, attitudes, and self-confidence about ED management and the relationship between ED and CVD and to test whether these can be improved by means of a brief training program. METHODS Eighty GPs completed two similar questionnaires on ED issues, one prior to a CME intervention and one following it. The CME program consisted of reading an annotated set of four review articles and six research articles followed by a live half-day seminar conducted by a GP, a urologist, and a cardiologist. MAIN OUTCOME MEASURES Changes in the answers to the two questionnaires were evaluated by tests for matched pairs using both statistical significance and effect size estimates, and assessment of different predictors were evaluated by multivariate analysis. RESULTS A marked improvement was observed in physician knowledge, attitudes, and self-confidence with regard to diagnosing and treating ED following the CME training intervention. CONCLUSIONS The present study shows that a relatively simple educational procedure can substantially improve the awareness of primary care physicians about the cardiovascular implications of ED and their self confidence in the management of these patients.
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Affiliation(s)
- Manuel Mas
- University of La Laguna-Department of Physiology & CESEX, Tenerife, Spain.
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Chou KT, Huang CC, Chen YM, Perng DW, Chao HS, Chan WL, Leu HB. Asthma and risk of erectile dysfunction--a nationwide population-based study. J Sex Med 2011; 8:1754-60. [PMID: 21426497 DOI: 10.1111/j.1743-6109.2011.02242.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The increased prevalence of erectile dysfunction (ED) has been reported in patients with chronic obstructive pulmonary disease, and sustained systemic inflammation seems to play a central role in this linkage. Asthma is also a chronic inflammatory airway disorder, eliciting a low-grade systemic inflammation; however, the influence of asthma on ED has not been investigated. AIM Our study strived to explore the relationship of asthma and the subsequent development of ED using a nationwide, population-based database. METHODS From 2000 to 2007, we identified newly diagnosed asthma cases involving male patients 18-55 years old. A control cohort without asthma, which was matched for age and comorbidities, was selected for comparison. MAIN OUTCOME MEASURES The two cohorts were followed up, and we observed the occurrence of ED by registry of ED diagnosis in the database. RESULTS Of the 17,302 sampled patients (3,466 asthma patients vs. 13,836 control), 114 (0.66%) experienced ED during a mean follow-up period of 4.56 years, including 34 (0.98% of the asthma patients) from the asthma cohort and 80 (0.58%) from the control group. Subjects with asthma experienced a 1.909-fold (95% confidence interval [CI], 1.276-2.856; P=0.002) increase in incident ED, which was independent of age, the number of clinical visits for urologist, and other comorbidities. Kaplan-Meier analysis also revealed the tendency of asthma patients for ED development (log rank test, P=0.002). The risk of ED was higher in cases with more frequent clinical visits for asthma (asthma patients with clinical visits with >24 times/year vs. <12 times/year: hazard ratio [HR]: 4.154 [95% CI:1.392-12.396], P=0.011; clinical visits with 12-24 times/year vs. <12 times/year HR: 3.534 [95% CI:1.245-10.032], P=0.018). CONCLUSIONS Asthma may be an independent risk factor for ED, and risk of ED probably increases in accordance with asthma severity.
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Affiliation(s)
- Kun-Ta Chou
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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Baumhäkel M, Schlimmer N, Kratz M, Hackett G, Jackson G, Böhm M. Cardiovascular risk, drugs and erectile function--a systematic analysis. Int J Clin Pract 2011; 65:289-98. [PMID: 21314866 DOI: 10.1111/j.1742-1241.2010.02563.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
AIMS Erectile dysfunction is a major problem with an increasing prevalence in cardiovascular high-risk patients due to its association with cardiovascular risk factors. Drugs used for evidence-based treatment of cardiovascular diseases have been reported to decrease erectile function, but possible mechanisms are poorly characterised. METHODS MEDLINE, EMBASE and Cochrane Registry search were performed including manuscripts until January 2010. Searching terms are: 'erectile dysfunction or impotence' in combination with 'ACE-inhibitors', 'angiotensin', 'beta-blockers', 'calcium antagonist' and 'diuretics'. Animal studies, letters, reviews, case-reports and manuscripts other than English language and trials dealing with combination treatment are excluded. RESULTS Analysis of literature revealed five epidemiological trials evaluating the effect of different cardiovascular drugs on erectile function. There were eight trials evaluating the effect of beta-blockers, five trials evaluating the effect of ace-inhibitors or angiotensin-receptor-blockers and one trial evaluating the effect of diuretics on erectile function. Results of these trials demonstrate that only thiazide diuretics and beta-blockers except nebivolol may adversely influence erectile function. ACE-inhibitors, angiotensin-receptor-blockers and calcium-channel-blockers are reported to have no relevant or even a positive effect on erectile function. CONCLUSION Inappropriate patients' concerns about adverse effects of cardiovascular drugs on erectile function might limit the use of important medications in cardiovascular high-risk patients. Knowledge about the effects of drug-treatments on erectile function and about the major role of the endothelium in penile function might improve patients' adherence to evidence based treatment of cardiovascular diseases.
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Affiliation(s)
- M Baumhäkel
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
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Clinical characteristics of older male military veterans seeking treatment for erectile dysfunction. Int Psychogeriatr 2011; 23:155-60. [PMID: 20619069 DOI: 10.1017/s1041610210001006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Male sexual dysfunction is a significant international public health issue affecting both middle-aged and older adults. To date, however, no studies have compared age differences in psychiatric issues, frequency of sexual activity and treatment recommendations between older and middle-aged male military Veterans seeking treatment for erectile dysfunction (ED) in the U.S.A. METHODS Data were collected between 1982 and 2003 at the Palo Alto Veterans Affairs Andrology Clinic. The 1,250 participants, aged 22 to 87 years (median = 63), completed a semi-structured interview. Using multiple linear regressions, we examined age differences in five domains: medical and endocrine risk factors; psychiatric and psychosocial risk factors; frequency of sexual behaviors; self-reported and objectively measured erectile function; and treatment recommendations. RESULTS Compared with middle-aged adults, older adults were more likely to present for ED treatment with medical risk factors and were more often recommended a vacuum pump treatment. Middle-aged male Veterans were more likely to experience psychiatric risk factors for ED and were more sexually active than older Veterans. Despite greater objective erectile ability in middle-aged adults, there were no age differences in maximum self-reported erectile functioning. CONCLUSIONS These results provide some evidence of age-related characteristics and treatment needs of male patients seeking treatment for sexual dysfunction. We encourage health care professionals working with adults across the lifespan to consider ways to individualize psychoeducation and brief psychotherapy for the treatment of ED to the specific needs of the patient, which may vary between middle-aged and older cohorts of patients.
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Sadovsky R, Brock GB, Gray M, Jensen PK, Gutkin SW, Sorsaburu S. Optimizing treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction: Opening windows to enhanced sexual function and overall health. ACTA ACUST UNITED AC 2011; 23:320-30. [DOI: 10.1111/j.1745-7599.2010.00590.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Holden CA, Allan CA, McLachlan RI. Windows of opportunity: a holistic approach to men's health*. Med J Aust 2010; 192:708-11. [DOI: 10.5694/j.1326-5377.2010.tb03708.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 02/15/2010] [Indexed: 11/17/2022]
Affiliation(s)
| | - Carolyn A Allan
- Andrology Australia, Monash University, Melbourne, VIC
- Prince Henry's Institute, Melbourne, VIC
| | - Robert I McLachlan
- Andrology Australia, Monash University, Melbourne, VIC
- Prince Henry's Institute, Melbourne, VIC
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Ziaei-Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in patients with diabetes: a study from Iran. Reprod Biol Endocrinol 2010; 8:50. [PMID: 20482781 PMCID: PMC2887879 DOI: 10.1186/1477-7827-8-50] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Accepted: 05/18/2010] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a chronic disease that causes short and long-term complications. This study aimed to investigate the prevalence of sexual dysfunctions (SD) among diabetic patients in Iran and to examine whether glycemic control has a role in SD. METHODS A consecutive sample of diabetic women and men who were registered in the Isfahan Endocrine and Metabolism Center, Iran were studied. Sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. In addition the level of glycosylated hemoglobin was assessed to classify the diabetes status in patients. RESULTS In all 200 patients (100 male and 100 female) were entered into the study. The mean age of patients was 48.6 (SD = 7.3) years and most had type 2 diabetes (91.0%). The results showed that sexual dysfunctions were widespread in both gender and 165 (82.5%) patients reported that experienced at least one sexual dysfunction. There were significant associations between sexual dysfunctions and gender and type of diabetes (P = 0.04). Women and patients with type 1 diabetes had higher rates of SD. No major differences were found between SD and age, diabetes status, duration of diabetes and hypertension. In addition, glycemic control did not show a significant association with SD in both genders. CONCLUSION The findings of this study showed that SD prevalence was high in diabetic patients of both genders and the glycemic control did not correlate with the frequency of SD in the study population. It is recommended that SD should be addressed more precisely in health care practice in Iran.
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Affiliation(s)
- Marzieh Ziaei-Rad
- Faculty of Nursing and Midwifery, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mariam Vahdaninia
- Department of Social Medicine, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Ali Montazeri
- Department of Mental Health, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Cook RL, McGinnis KA, Samet JH, Fiellin DA, Rodriguez-Barradas MC, Kraemer KL, Gibert CL, Braithwaite RS, Goulet JL, Mattocks K, Crystal S, Gordon AJ, Oursler KK, Justice AC, Justice AC. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men. J Gen Intern Med 2010; 25:115-21. [PMID: 19921112 PMCID: PMC2837496 DOI: 10.1007/s11606-009-1164-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 08/21/2009] [Accepted: 10/15/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior. OBJECTIVES To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. DESIGN Cross-sectional study. PARTICIPANTS Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data. MEASURES EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. RESULTS Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P < 0.001). Compared to men who did not receive EDD, men who received EDD were equally likely to report risky sexual behavior (11% vs. 10%, p = 0.9) and STDs (7% vs 7%, p = 0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men. CONCLUSION EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIV-infected men, indicating ongoing need for prevention interventions.
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Affiliation(s)
- Robert L Cook
- Department of Epidemiology and Biostatistics, University of Florida, PO Box 100231, Gainesville, FL 32610, USA.
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Miner MM. Erectile dysfunction: a harbinger for cardiovascular events and other comorbidities, thereby allowing a 'Window of Curability'. Int J Clin Pract 2009; 63:1123-6. [PMID: 19624780 DOI: 10.1111/j.1742-1241.2009.02084.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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