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Hawley WR, Cancilla BA, Barnes JL, Morrow GD. Social Perceptions of Masculinity and Sexual Esteem Are Impacted by Viagra Use, Testosterone, and Sexual Performance. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2473-2488. [PMID: 38740630 DOI: 10.1007/s10508-024-02880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
Sexual behaviors play a role in the social construction of masculinity. Moreover, this stereotype has been capitalized upon by pharmaceutical companies, as well as those that sell products not approved by the U.S. Food and Drug Administration, for purposes of marketing sexual medicines. Stereotypical notions of masculinity, however, also emphasize the importance of self-reliance, which may cause some to look unfavorably upon the use of sexual medicine. Consistent with this notion, a male target was viewed as more masculine when his female partner consistently reached orgasm, unless he had no history of erectile dysfunction (ED), but was taking Viagra anyway (Experiment 1; N = 522). In addition, when his partner consistently reached orgasm, ratings of his sexual esteem were also lower if he used Viagra than if he did not, but only if he had no history of ED. In Experiment 2 (N = 711), although there was no effect of a male target's use of testosterone, social perception of his masculinity and sexual esteem increased as his "natural" levels of testosterone increased. In addition, exploratory analysis revealed that if the male target had low (but not normal or high) "natural" levels of testosterone, ratings of his masculinity were higher if his female partner consistently had an orgasm, which suggests that female orgasm served to "rescue" masculinity. Because expectations about drugs drive their use, it is important to address preconceived notions about the use of sexual medicines for purposes of enhancing masculinity and sexual esteem, as the social perception of their use is much more complex.
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Affiliation(s)
- Wayne R Hawley
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA.
| | - Bryn A Cancilla
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
| | - Julia L Barnes
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
| | - Gregory D Morrow
- Department of Psychology, Counseling, and Art Therapy, Pennsylvania Western University-Edinboro, 210 East Normal Street, Edinboro, PA, 16444, USA
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Miller K, May U, Beecken WD, Hatzichristodoulou G, Böhm M, Fink S. Evidence for benefits and risks of tadalafil as a non-prescription medicine: review and evaluation using the Group Delphi technique to achieve consensus amongst clinical experts. Front Pharmacol 2023; 14:1254706. [PMID: 37876727 PMCID: PMC10590875 DOI: 10.3389/fphar.2023.1254706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/19/2023] [Indexed: 10/26/2023] Open
Abstract
An evidence-based consensus meeting was held with urologists, a pharmacist and a cardiologist to perform a structured benefit-risk analysis of reclassifying tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor for treatment of erectile dysfunction (ED), to be available without prescription in Germany. As per the Brass process endorsed by regulatory authorities, an evidence-based Brass value tree was developed, which identified the incremental benefits and risks that should be considered above the safety and efficacy evidence required for prescription medicines. During the Group Delphi consensus meeting, the expert panel rated the likelihood and clinical impact of each benefit and risk on a scale of 0 (none) to 3 (high). Overall attribute scores were calculated from the product of the mean likelihood and mean clinical impact scores giving a possible score of 0-9. The overall benefit attribute scores ranged from 2.8 to 5.4. The overall risk attribute scores ranged from 0.2 to 2.2 though most were 1.0 or less (3 or more is generally considered to be of concern). On balance, the independent meeting scored the benefits of reclassification of tadalafil higher than the risks and considered the risk mitigation strategies of the packaging label and patient information leaflet (PIL) sufficient.
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Affiliation(s)
- Kurt Miller
- Department of Urology, Charité Campus Benjamin Franklin, Berlin, Germany
| | - Uwe May
- Department of Health Economics and Pharmacoeconomics, Fresenius University of Applied Sciences, Wiesbaden, Germany
| | | | | | - Michael Böhm
- Department of Internal Medicine, University of the Saarland, Homburg Saar, Germany
| | - Stefan Fink
- State Pharmacists’ Association of Thuringia, Erfurt, Germany
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Fusco GM, Cirillo L, Mastrangelo F, Romano F, Di Mauro E, Cacace G, Spena G, Iannicelli A, Franzese CA, Mirone V, La Rocca R, Napolitano L. Recreation use of phosphodiesterase type 5 inhibitors, the other side of erectile dysfunction. Arch Ital Urol Androl 2023; 95:11350. [PMID: 37254932 DOI: 10.4081/aiua.2023.11350] [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: 04/02/2023] [Accepted: 04/06/2023] [Indexed: 06/01/2023] Open
Abstract
To the Editor, In 1998 Sildenafil was approved by the Food and Drug Administration as first line therapy for erectile dysfunction. Since then, phosphodiesterase type 5 inhibitors (PDE5i) represent the first-line treatment of erectile dysfunction (ED), improving physiological erectile function, sexual orgasmic function, psychological self-esteem, couples' relationship, and quality of life. [...].
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Affiliation(s)
- Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Francesco Mastrangelo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Francesco Romano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Ernesto Di Mauro
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Gianluigi Cacace
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Gianluca Spena
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Annamaria Iannicelli
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples.
| | | | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples.
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Almannie R, Alzahrani MA, Almuhaideb M, Abunohaiah I, Habous M, Binsaleh S. Recreational use of oral erectile dysfunction medications among male physicians - A cross-sectional study. Urol Ann 2023; 15:148-157. [PMID: 37304517 PMCID: PMC10252768 DOI: 10.4103/ua.ua_33_22] [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: 02/21/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 06/13/2023] Open
Abstract
Introduction Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. Bypassing health-care providers and obtaining ED medications (EDM) without a prescription are an issue that is faced globally. Aim We attempt to assess erectile function (EF) among a local sample of physicians, the psychological effects of recreational EDM use, and compare EF among different user groups. Methods This is a cross-sectional study done solely on physicians in Saudi Arabia. A self-designed questionnaire including demographics, sexual characteristics, use of ED medication, sexual satisfaction, and the validated international index of EF (IIEF). Outcome Physicians misused EDM. Results A total of 503 physicians completed the questionnaire. Among participants reporting sexual problems, only 23% received counseling and 3.4% were professionally diagnosed with ED. Among users, 71.2% were using EDM recreationally, 14.4% prophylactically, and 14.4% were prescribed. Participants aged 20-29 IIEF-5 score was significantly lower than participants aged 30-39 years. Prescribed users had a lower IIEF-5 score compared to both recreational users and nonusers. Clinical Implications Many healthy sexually active men use EDMs recreationally to increase sexual performance. Strengths and Limitations One of the limitations of our study is that we did not use standardized tools to determine the diagnosis of some important disorders like premature ejaculation. Our study strengths include the very high response rate, with our results truly showing a nationwide self-assessment of sexual dysfunction. Conclusion Recreational use of oral EDMs may adversely impact the psychological aspects of sexual function. In our study, physicians misused EDM. We recommend labeling EDMs as restricted medication that requires a prescription to use by a licensed physician.
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Affiliation(s)
- Raed Almannie
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mana Almuhaideb
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Ibrahim Abunohaiah
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
| | - Mohamad Habous
- Urology Unit, Al-Themal Medical Center, Abha, Saudi Arabia
| | - Saleh Binsaleh
- Department of Surgery, Division of Urology, College of Medicine, King Saud University, King Saud University Medical City, Saudi Arabia
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Nimbi FM, Rosati F, Esposito RM, Stuart D, Simonelli C, Tambelli R. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021; 18:1955-1969. [PMID: 34756552 DOI: 10.1016/j.jsxm.2021.09.013] [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: 05/10/2021] [Revised: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances. AIM The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex. METHODS Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed. OUTCOMES An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews. RESULTS Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety. CLINICAL TRANSLATION These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects. STRENGTHS & LIMITATIONS Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use. CONCLUSION The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;XX:XXX-XXX.
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Affiliation(s)
- Filippo Maria Nimbi
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy.
| | - Fau Rosati
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Rita Maria Esposito
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy; IRCCS Foundation Santa Lucia, Rome, Italy
| | - David Stuart
- Chelsea and Westminster hospital NHS Foundation Trust, London, UK
| | - Chiara Simonelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy
| | - Renata Tambelli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, Italy
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Sansone A, Cuzin B, Jannini EA. Facing Counterfeit Medications in Sexual Medicine. A Systematic Scoping Review on Social Strategies and Technological Solutions. Sex Med 2021; 9:100437. [PMID: 34619517 PMCID: PMC8766274 DOI: 10.1016/j.esxm.2021.100437] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction The counterfeit phenomenon is a largely under-reported issue, with potentially large burden for healthcare. The market for counterfeit drugs used in sexual medicine, most notably type 5 phosphodiesterase inhibitors (PDE5i), is rapidly growing. Aims To report the health risks associated with the use of counterfeit medications, the reasons driving their use, and the strategies enacted to contain this phenomenon. Methods A systematic scoping review of the literature regarding counterfeit PDE5i was carried between January and June 2021, then updated in August 2021. Main Outcome Measure We primarily aimed to clarify the main drivers for counterfeit PDE5i use, the health risks associated, and the currently available strategies to fight counterfeiters. Results One hundred thirty-one records were considered for the present scoping review. Production of fake PDE5i is highly lucrative and the lacking awareness of the potential health risks makes it a largely exploitable market by counterfeiters. Adulteration with other drugs, microbial contamination and unreliable dosages make counterfeit medications a cause of worry also outside of the sexual medicine scope. Several laboratory techniques have been devised to identify and quantify the presence of other compounds in counterfeit medications. Strategies aimed at improving awareness, providing antitampering packaging and producing non-falsifiable products, such as the orodispersible formulations, are also described. Clinical implications Improving our understanding of the PDE5i counterfeit phenomenon can be helpful to promote awareness of this issue and to improve patient care. Strengths & Limitations Despite the systematic approach, few clinical studies were retrieved, and data concerning the prevalence of counterfeit PDE5i use is not available on a global scale. Conclusion The counterfeit phenomenon is a steadily growing issue, with PDE5i being the most counterfeited medication with potentially large harmful effects on unaware consumers. Sansone A, Cuzin B, and Jannini EA. Facing Counterfeit Medications in Sexual Medicine. A Systematic Scoping Review on Social Strategies and Technological Solutions. Sex Med 2021;9:100437.
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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
| | - Béatrice Cuzin
- Division of Urology and Transplantation, Edouard Herriot Hospital, Lyon, France
| | - 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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Kim JN, Oh JJ, Park DS, Hong YK, Yu YD. Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle- to Old-Aged Men: A Comparative Study of Adverse Events. Sex Med 2019; 7:425-432. [PMID: 31444051 PMCID: PMC6963111 DOI: 10.1016/j.esxm.2019.07.004] [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: 05/25/2019] [Revised: 07/22/2019] [Accepted: 07/28/2019] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Some previous studies reported recreational use of phosphodiesterase type 5 (PDE-5) inhibitors by ingesting the medicine with alcohol in patients with erectile dysfunction, but the rate of misuse in general population has never been researched. AIM To investigate the frequency of concomitant alcohol consumption with PDE-5 inhibitors in the general male population. We secondarily analyzed the influence of alcohol on PDE-5 inhibitor. METHODS 325 men with erectile dysfunction (age 34-78) who received PDE-5 inhibitors at a single medical institution from January 2016-February 2018 were included in the study. All patients fulfilled a survey questionnaire assessing (i) average alcohol consumption amount, (ii) previous use of PDE-5 inhibitors with alcohol and purpose of concomitant alcohol use, (iii) and background knowledge about PDE-5 inhibitors' side effects. MAIN OUTCOMES MEASURES The main outcome measure was frequency of concomitant alcohol consumption with PDE-5 inhibitors in the general male population. RESULTS Overall 148 patients committed concomitant alcohol use (group 1), and 177 patients did not (group 2). No significant differences were observed between 2 groups regarding types of PDE-5 inhibitors used and underlying disease. Group 2 had significantly more patients with the correct knowledge concerning concomitant alcohol use than group 1 (24.9% vs 13.5%). Group 1 had more patients with average alcohol consumption >15 drinks/week (64.8% vs 14.1%). The reasons for concomitant alcohol use were curiosity (35.1%), enhancing sexual desire (27%) and recommendation from friends (16.9%). Group 1 showed significantly greater complications, including headache (23.6% vs 7.3%) and facial flushing (69.6% vs 12.4%), than group 2. 1 patient in group 1 experienced severe chest discomfort and underwent coronary artery angiography, but no severe obstructive lesion was observed. CONCLUSION 45.5% of middle- to old-age men committed concomitant use of PDE-5 inhibitor with alcohol because of recreational purpose, and this alcohol abuse might lead to severe complications, including chest discomfort and dizziness. Kim JN, Oh JJ, Park DS, et al. Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle- to Old-Aged Men: A Comparative Study of Adverse Events. Sex Med 2019;7:425-432.
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Affiliation(s)
- Jong Nyeong Kim
- Department of Urology, CHA Medical University, College of Medicine, Bundang CHA Hospital, Seongnam, Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Soo Park
- Department of Urology, CHA Medical University, College of Medicine, Bundang CHA Hospital, Seongnam, Korea
| | - Young Kwon Hong
- Department of Urology, CHA Medical University, College of Medicine, Bundang CHA Hospital, Seongnam, Korea
| | - Young Dong Yu
- Department of Urology, CHA Medical University, College of Medicine, Bundang CHA Hospital, Seongnam, Korea.
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Corona G, Maggi M, Jannini EA. EDEUS, a Real-Life Study on the Users of Phosphodiesterase Type 5 Inhibitors: Prevalence, Perceptions, and Health Care-Seeking Behavior Among European Men With a Focus on 2nd-Generation Avanafil. Sex Med 2018; 6:15-23. [PMID: 29275958 PMCID: PMC5815971 DOI: 10.1016/j.esxm.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/19/2017] [Accepted: 10/26/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is a multidimensional disorder with an estimated prevalence of 1% to 10% in men younger than 40 years and up to 100% in men in their 70s and 80s. AIM To evaluate the real-life characteristics and unmet needs of men with ED, its impact on well-being, and treatment rates across Europe. METHODS Adult men in Belgium, France, Germany, Italy, Poland, Portugal, and Spain were invited to participate in the survey. Men who did not use at least a drug for sexual health in the past 3 months, had cancer or spinal cord injuries, and/or underwent non-nerve-sparing radical prostatectomy were excluded. MAIN OUTCOME MEASURES The 15-item International Index of Erectile Function (IIEF-15) with study-specific, self-constructed questions was used. RESULTS Overall, 940 subjects (age = 46.2 ± 13.4 years) were considered. Subjects (n = 778) using on-demand phosphodiesterase type 5 inhibitors (PDE5is) were designated "performers" (60%) without a formal ED diagnosis or "patients" with a medical diagnosis. Patients were older than performers, with more self-reported comorbidities; patients used a higher PDE5i dosage and purchased it from official pharmacies more often than performers did. Of avanafil users (n = 39), no differences in total IIEF or subdomain scores were observed after adjusting for confounders. However, avanafil users less often declared its use without an ED diagnosis and a physician prescription. Overall, the latter condition was associated with higher PDE5i-related satisfaction. CONCLUSION The survey shows 2 different attitudes toward ED and PDE5i use: for recreational use and without a medical prescription or with a formal diagnosis and medical prescription. Avanafil, a 2nd-generation PDE5i with a good balance between efficacy and tolerability profile, is more frequently prescribed by doctors than self-prescribed compared with other PDE5is. Because the major challenge is to decrease the high dropout of 1st-generation PDE5is, further studies will be needed to clarify this topic. Corona G, Maggi M, Jannini EA. EDEUS, a Real-Life Study on the Users of Phosphodiesterase Type 5 Inhibitors: Prevalence, Perceptions, and Health Care-Seeking Behavior Among European Men With a Focus on 2nd-Generation Avanafil. Sex Med 2018;6:15-23.
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Affiliation(s)
- Giovanni Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl Bologna, Bologna, Italy; Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Mario Maggi
- Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology and Sexual Medicine (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Gebregeorgise DT, Belay YM, Kälvemark Sporrong S. Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists' dispensing practices. Int J Clin Pharm 2017; 40:67-73. [PMID: 29134487 DOI: 10.1007/s11096-017-0558-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/02/2017] [Indexed: 12/17/2022]
Abstract
Background Studies have reported misuse of sildenafil citrate for recreational purpose, not least by healthy young men. This is becoming a major concern, for medical and other reasons. Objective The aim of this study was to document the characteristics of sildenafil citrate users and to explore the dispensing practices of the medicine in selected community pharmacies in Addis Ababa, Ethiopia. Setting Data was collected in community pharmacies in Addis Ababa, Ethiopia. Method A survey, using a self-administrated questionnaire, was conducted among customers who purchased sildenafil citrate from community pharmacies. Simple descriptive statistics were used to analyse data. Also, semi-structured interviews were conducted with community pharmacists. These were analysed thematically. Main outcome measures Socio-demographic characteristics (survey), themes (interviews). Results All survey respondents (n = 197) were men, 57.9% were below 40 years old, 53.8% had never been married and 58.4% had used sildenafil citrate before. A minority (16.2%) were diagnosed with erectile dysfunction. The main reason for buying sildenafil citrate was experimentation (45.7%). Pharmacists reported that sildenafil citrate was often dispensed without a prescription. The reason for this was, according to the interviewees, competition in the market. Also, the medicine was often dispensed without adequate information or counselling. Conclusions Selling and buying sildenafil citrate without a prescription seems to be common practice in pharmacies in Addis Ababa. It is crucial to strengthen the regulatory activity to protect customers from health risks. In addition pharmacy professionals should be supported to work in accordance with professional and legal standards.
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Affiliation(s)
- Dawit Teshome Gebregeorgise
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yajeb Melesse Belay
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Duarte DV, Restrepo-Méndez MC, Silveira MFD. Prevalence of erectile dysfunction oral drugs use in a city of southern Brazil. CIENCIA & SAUDE COLETIVA 2017; 22:2763-2770. [PMID: 28793090 DOI: 10.1590/1413-81232017228.24952015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 03/23/2016] [Indexed: 12/25/2022] Open
Abstract
The last decade has seen a breakthrough in the treatment of erectile dysfunction (ED) with the advent of phosphodiesterase-5 inhibitors. There are few population-based observational studies on the prevalence of use of these drugs. We conducted a cross-sectional population-based study in the city of Pelotas (Brazil). Our sample comprised 1,082 men aged 20 years or older who answered a confidential and self-administered questionnaire. Prevalence of EDD use was 5% (IC95% = 4%;7%). ED and advanced age were strongly associated with a higher prevalence of EDD use. ED prevalence in men who used EDD was 68%, which was much higher than the one found in the entire sample (27%). The use of EDD was more frequently reported among separated men, respondents with higher level of education and those without ED. A high proportion of respondents (68%) did not seek medical advice on the use of EDD. Sildenafil was the most commonly used drug (38%) but non-regulated and non-evidence-based drugs were also frequently used (14%). Prevalence of EDD use is higher among individuals with ED, opposing to the notion of recreational use of EDD.
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Affiliation(s)
- Daniel Vanti Duarte
- Departamento Materno-Infantil, Faculdade de Medicina, Universidade Federal de Pelotas. Av. Duque de Caxias 250, Fragata. 96030-001 Pelotas RS Brasil.
| | - María Clara Restrepo-Méndez
- Departamento Materno-Infantil, Faculdade de Medicina, Universidade Federal de Pelotas. Av. Duque de Caxias 250, Fragata. 96030-001 Pelotas RS Brasil.
| | - Mariângela Freitas da Silveira
- Departamento Materno-Infantil, Faculdade de Medicina, Universidade Federal de Pelotas. Av. Duque de Caxias 250, Fragata. 96030-001 Pelotas RS Brasil.
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Kajbafzadeh AM, Abbasioun R, Sabetkish S, Sabetkish N, Rahmani P, Tavakkolitabassi K, Arshadi H. Future Prospects for Human Tissue Engineered Urethra Transplantation: Decellularization and Recellularization-Based Urethra Regeneration. Ann Biomed Eng 2017; 45:1795-1806. [PMID: 28536786 DOI: 10.1007/s10439-017-1857-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/17/2017] [Indexed: 01/03/2023]
Abstract
To evaluate the histological characteristics of decellularized human urethra after transplantation into the rat omentum and compare in vivo cell seeding with perfusion-based and cell sheet urethral regeneration. Eight adult human male urethras accompanied with the surrounding corpus spongiosum were obtained. The tissues were decellularized with detergent-based method. The efficacy of decellularization and extracellular matrix preservation was evaluated by several techniques. Decellularized scaffolds were transplanted into the omentum of 12 male rats and located into the scrotum. Biopsies were taken 1, 3, and 6 months postoperatively to assess the natural recellularization. Mesenchymal stem cells obtained from preputial tissue were seeded with perfusion-based and cell sheet techniques as well. Immunohistochemical staining with α-actin, cytokeratin AE1/AE3, synaptophysin, and CD31 antibodies were performed. Removal of nuclear components and preservation of biomechanical properties was confirmed. In-vivo recellularization revealed promising results in progressive angiogenesis and cell seeding of epithelium-like cells in the lining of the urethra as well as smooth muscle cells in the wall structure. In-vitro urethral regeneration revealed that cell sheet engineering was the technique of choice compared to perfusion-based technique. This study may paw the road for clinical application of acellular urethral matrix with the surrounding corpus spongiosum in urological reconstructive surgery.
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Affiliation(s)
- Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran.
| | - Reza Abbasioun
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran
| | - Shabnam Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran
| | - Nastaran Sabetkish
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran
| | - Parvin Rahmani
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran
| | - Kamyar Tavakkolitabassi
- Department of Urology and Renal Transplantation, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Arshadi
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran
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Gebreyohannes EA, Bhagavathula AS, Gebresillassie BM, Tefera YG, Belachew SA, Erku DA. Recreational Use of Phosphodiesterase 5 Inhibitors and Its Associated Factors among Undergraduate Male Students in an Ethiopian University: A Cross-Sectional Study. World J Mens Health 2017; 34:186-193. [PMID: 28053948 PMCID: PMC5209559 DOI: 10.5534/wjmh.2016.34.3.186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 01/23/2023] Open
Abstract
Purpose To assess the prevalence of phosphodiesterase 5 (PDE5) inhibitor use and associated factors among University of Gondar undergraduate students. Materials and Methods An institution-based, cross-sectional study, using a survey questionnaire, was conducted from October to December 2015 to assess PDE5 inhibitor use and associated factors among male students at the University of Gondar. A Self-Esteem and Relationship questionnaire (14 items), an International Index of Erectile Function questionnaire (15 items) and a questionnaire on PDE5 inhibitor use (14 items) were included in the survey. Results Across all respondents (age, 21.9±1.88 years), more than half (55.7%, n=233) had heard about PDE5 inhibitors, but only 23 men (5.5%) reported trying a PDE5 inhibitor drug at least once. Older students were more likely to use PDE5 inhibitors compared to younger students (adjusted odds ratio [AOR], 1.40; 95% confidence interval [CI], 1.109~1.768). Those students who were smokers were 5.15 times more likely to use PDE5 inhibitors as compared to their non-smoking counterparts (AOR, 5.15; 95% CI, 2.096~12.687). In addition, multivariate logistic regression showed that being in a relationship, alcohol use, greater number of cigarettes smoked per day, and more sexual partners were significantly associated with PDE5 inhibitor use. Conclusions The prevalence of PDE5 inhibitor use among undergraduate students was 5.5%. Cigarette smoking and other substance use, older age, and greater number of sexual partners were significantly associated factors for PDE5 inhibitor use. These findings suggest that restricting access to PDE5 inhibitor drugs is essential to curtailing misuse among university students.
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Affiliation(s)
- Eyob Alemayehu Gebreyohannes
- Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
| | - Akshaya Srikanth Bhagavathula
- Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
| | - Begashaw Melaku Gebresillassie
- Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
| | - Yonas Getaye Tefera
- Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
| | - Sewunet Admasu Belachew
- Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
| | - Daniel Asfaw Erku
- Department of Pharmaceutical Chemistry, University of Gondar College of Medicine and Health Sciences, School of Pharmacy, Gondar, Ethiopia
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Di Luigi L, Sansone M, Sansone A, Ceci R, Duranti G, Borrione P, Crescioli C, Sgrò P, Sabatini S. Phosphodiesterase Type 5 Inhibitors, Sport and Doping. Curr Sports Med Rep 2017; 16:443-447. [DOI: 10.1249/jsr.0000000000000422] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Alshahrani S, Ahmed AF, Gabr AH, Al Ansari A, El-feky M, Elbadry MS. Phosphodiesterase type 5 inhibitors: Irrational use in Saudi Arabia. Arab J Urol 2016; 14:94-100. [PMID: 27489735 PMCID: PMC4963165 DOI: 10.1016/j.aju.2016.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
Objective To identify the criteria of phosphodiesterase type 5 inhibitor (PDE5i) users and to analyse the knowledge, attitude, and practices of PDE5i use amongst Saudi men. Subjects and methods A web-based, cross-sectional survey was conducted in Saudi Arabia between January and April 2015. Sexually active adult men were interviewed using a website questionnaire designed by the authors. Descriptive statistics were used to analyse the data. Results In all, 1008 men participated in the survey with 378 (37.5%) reporting use of PDE5i. Of those using PDE5i, 144 (38.1%) reported erectile dysfunction and 234 (61.9%) reported normal erection (recreational users). We found several demographic features, including high education level, health field occupation, high income, smoking, and increased frequency of sexual intercourse amongst the PDE5i users. Most of the PDE5i users (92.3%) had knowledge about PDE5i and 84.1% of them bought it without medical prescription. The most commonly used PDE5i was tadalafil (46.1%) and most of the users (79.9%) reported improvement in their sexual activity after PDE5i usage. Amongst the recreational users, the main reasons for PDE5i usage were curiosity (38.5%) and improving self-confidence (25.6%). Of them, 69.2% reported benefits from PDE5i usage, mainly in the form of enhancement of erection (36.7%) and increasing erection duration (31.2%). Conclusion PDE5i use appears to be frequent in Saudi Arabia. Most of the users had knowledge about PDE5i and claimed to get benefits from it, even if used as a recreational drug.
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Affiliation(s)
- Saad Alshahrani
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Abul-Fotouh Ahmed
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Corresponding author at: Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-kharj 11942, Saudi Arabia. Tel.: +966 15886100; fax: +966 15886101.Department of UrologyCollege of MedicinePrince Sattam Bin Abdulaziz UniversityP.O. Box 173Al-kharj11942Saudi Arabia
| | - Ahmed H. Gabr
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmed Al Ansari
- Bahrain Defence Force Hospital, Department of Surgery, Arabian Gulf University, Bahrain
| | - Mohamed El-feky
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed S. Elbadry
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
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15
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Bradley J, Rajaram SP, Isac S, Gurav K, Ramesh BM, Gowda C, Moses S, Alary M. Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:945-954. [PMID: 25905909 DOI: 10.1007/s10508-015-0486-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 01/13/2015] [Accepted: 01/16/2015] [Indexed: 06/04/2023]
Abstract
Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.
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Affiliation(s)
- Janet Bradley
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada.
- Centre for Global Public Health, Faculty of Medicine, University of Manitoba, 771 McDermot Avenue, Medical Rehabilitation Building, Room R070, Winnipeg, MB, R3E 0T6, Canada.
| | - Subramanian Potty Rajaram
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada
- CHARME-India Project, Bangalore, India
- India KHPT Office, Bangalore, India
| | | | | | | | | | - Stephen Moses
- Centre for Global Public Health, Faculty of Medicine, University of Manitoba, 771 McDermot Avenue, Medical Rehabilitation Building, Room R070, Winnipeg, MB, R3E 0T6, Canada
| | - Michel Alary
- Population Health and Optimal Health Practices Research Unit, Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, Quebec City, PQ, Canada
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16
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Eid AA, Badr El Dine FMM, Nabil IM. Histopathologic and Ultrastructural Changes in Seminiferous Tubules of Adult Male Albino Rats Following Daily Administration of Different Doses of Tadalafil. Urology 2016; 90:89-96. [PMID: 26772640 DOI: 10.1016/j.urology.2015.12.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 12/08/2015] [Accepted: 12/21/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To investigate the effect of chronic daily administration of different doses of tadalafil on the structure of the seminiferous tubules and on spermatogenesis. MATERIALS AND METHODS Sixty adult male Wistar rats were included; they were divided into four groups: a control group (group I) and groups II, III, and IV that received daily tadalfil in doses of 0.45, 0.9, and 1.8 mg/kg for 12 weeks (equivalent to human doses of 5, 10, and 20 mg daily), respectively. The epididymis was processed for evaluation of sperm parameters, serum testosterone was measured, Johnsen score for rats was calculated, and testicular histopathological and ultrastructural examinations were performed. RESULTS Serum testosterone was significantly lower in group IV than in groups I and II. Moreover, posttreatment values in group IV were significantly lower than pretreatment values. A significant decline in sperm motility and morphology was detected in groups III and IV compared to groups I and II. Sperm count was significantly lower in group IV compared to the other groups. Johnsen score was significantly lower in groups III and IV compared to groups I and II and in group IV compared to group III. In addition, histopathological and ultrastructural degenerative changes in rat testes were detected; these changes were dose dependent and increased with increasing the dose of tadalafil. CONCLUSION Chronic daily oral administration of tadalafil to male albino rats demonstrates a dose-dependent alteration to testicular histology and semen parameters. The influence of these changes on the actual fertility of these animals remains to be determined.
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Affiliation(s)
- Amira Abulfotooh Eid
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | | | - Iman Mohamed Nabil
- Department of Histology & Cell Biology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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17
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Rocha T, Amaral JS, Oliveira MBPP. Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review. Compr Rev Food Sci Food Saf 2015; 15:43-62. [PMID: 33371574 DOI: 10.1111/1541-4337.12173] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/02/2015] [Accepted: 09/03/2015] [Indexed: 12/16/2022]
Abstract
In the last few years, the consumption of dietary supplements, especially those having plants as ingredients, has been increasing due to the common idea that they are natural products posing no risks to human health. In the European Union and the United States, dietary supplements are legally considered as foods/special category of foods, thus are not being submitted to any safety assessment prior to their commercialization. Among the issues that can affect safety, adulteration by the illegal addition of pharmaceutical substances or their analogs is of major concern since unscrupulous producers can falsify these products to provide for quick effects and to increase sales. This review discusses the various classes of synthetic drugs most frequently described as being illegally added to dietary supplements marketed for weight loss, muscle building/sport performance and sexual performance enhancement. Information regarding regulation and consumption is also presented. Finally, several conventional and advanced analytical techniques used to detect and identify different adulterants in dietary supplements and therefore also in foods, with particular emphasis on plant food supplements, are critically described. This review demonstrates that dietary supplement adulteration is an emerging food safety problem and that an effective control by food regulatory authorities is needed to safeguard consumers.
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Affiliation(s)
- Tiago Rocha
- REQUIMTE, Dept. of Chemical Sciences, Faculty of Pharmacy, Univ. of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal
| | - Joana S Amaral
- REQUIMTE, Dept. of Chemical Sciences, Faculty of Pharmacy, Univ. of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal.,ESTiG, Polytechnic Inst. of Bragança, Campus de Santa Apolónia, 5301-857, Bragança, Portugal
| | - Maria Beatriz P P Oliveira
- REQUIMTE, Dept. of Chemical Sciences, Faculty of Pharmacy, Univ. of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal
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18
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Sanders SA, Hill BJ, Janssen E, Graham CA, Crosby RA, Milhausen RR, Yarber WL. General Erectile Functioning among Young, Heterosexual Men Who Do and Do Not Report Condom-Associated Erection Problems (CAEP). J Sex Med 2015; 12:1897-904. [PMID: 26279414 DOI: 10.1111/jsm.12964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Condom-associated erection problems (CAEP) are an underestimated factor related to inconsistent or incomplete male condom use. The underlying mechanisms of CAEP are not understood, and whether men who report these difficulties are also likely to experience erectile problems in situations when condoms are not used has not been studied. AIM The aim of the study was to investigate, in a sample of condom-using young, heterosexual men (aged 18-24 years), whether men who report CAEP are more likely to (i) have erection problems when not using condoms and (ii) meet criteria for erectile dysfunction. METHODS A total of 479 men recruited online completed the International Index of Erectile Function (IIEF-5) and answered questions about erection problems experienced when using and not using condoms during the last 90 days. Demographic, sexual experience, and health status variables were investigated as correlates. MAIN OUTCOME MEASURES Self-reported frequency of erection loss during condom application or during penile-vaginal intercourse (PVI) in the past 90 days and IIEF-5 scores. RESULTS Of the men, 38.4% were classified in the no CAEP group, 13.8% as having CAEP during condom application, 15.7% as having CAEP during PVI, and 32.2% as having CAEP during both condom application and PVI. Men reporting any form of CAEP were significantly more likely than men reporting no CAEP to also report erection difficulties during sexual activity when not using condoms. Men who reported CAEP during PVI only or during both application and PVI scored significantly lower on the IIEF-5 than men without CAEP. CONCLUSION The findings suggest that men who report CAEP are also more likely to experience more generalized erection difficulties. Clinicians should assess whether men using condoms experience CAEP and where appropriate, refer for psychosexual therapy or provide condom skills education.
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Affiliation(s)
- Stephanie A Sanders
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA.,Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Brandon J Hill
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA
| | - Erick Janssen
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Institute for Family and Sexuality Studies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Cynthia A Graham
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA.,Department of Psychology, University of Southampton, Southampton, UK
| | - Richard A Crosby
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA.,Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Robin R Milhausen
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA.,Department of Family Relations and Applied Nutrition, University of Guelph, Ontario, Canada
| | - William L Yarber
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA.,Department of Gender Studies, Indiana University, Bloomington, IN, USA.,Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA.,Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
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Simsek A, Tugcu V, Erturkuner P, Alkan F, Ozbek E, Tasci AI. Effects of the recreational use of PDE5 inhibitors on the corpus cavernosum of young, healthy rats. Int Urol Nephrol 2014; 46:1889-93. [DOI: 10.1007/s11255-014-0746-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 05/11/2014] [Indexed: 01/22/2023]
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20
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Gareri P, Castagna A, Francomano D, Cerminara G, De Fazio P. Erectile dysfunction in the elderly: an old widespread issue with novel treatment perspectives. Int J Endocrinol 2014; 2014:878670. [PMID: 24744785 PMCID: PMC3976909 DOI: 10.1155/2014/878670] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 01/06/2014] [Accepted: 01/07/2014] [Indexed: 11/17/2022] Open
Abstract
Erectile dysfunction (ED) is one of the most common chronic diseases affecting men and its prevalence increases with aging. It is also the most frequently diagnosed sexual dysfunction in the older male population. A number of different diseases potentially worsening sexual function may occur in elderly people, together with polypharmacy. Related causes of ED are variable and can include arterial, neurogenic, hormonal, cavernosal, iatrogenic, and psychogenic causes. The aim of the present review was to examine the main aspects of erectile dysfunction going through epidemiology and pathophysiology and revise most of ED in elderly disabled men and in those affected with psychiatric disorders. Lastly we tried to focus on the main aspects of nonpharmacological and pharmacological treatments of ED and the recreational use in the elderly. Phosphodiesterase-5 inhibitors (PDE5-I) are commonly used for on-demand or chronic treatment of ED. It is widely known that PDE5-I have lower response rates in older men than in younger patients, but they have the advantages of ease of use and excellent safety profile, also in the elderly. The old and new PDE5-I as well as the alternative treatments for ED are extensively discussed.
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Affiliation(s)
- Pietro Gareri
- Elderly Health Care, ASP Catanzaro, Via Spasari, 3, 88100 Catanzaro, Italy
| | | | - Davide Francomano
- Department of Medical Pathophysiology, "Sapienza" University of Rome, 00198 Rome, Italy
| | - Gregorio Cerminara
- Department of Science of Health, School of Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy ; Psychiatry Unit, "Mater Domini" University Hospital, 88100 Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Science of Health, School of Medicine, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy ; Psychiatry Unit, "Mater Domini" University Hospital, 88100 Catanzaro, Italy
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Santi D, Brigante G, Zona S, Guaraldi G, Rochira V. Male sexual dysfunction and HIV--a clinical perspective. Nat Rev Urol 2014; 11:99-109. [PMID: 24394405 DOI: 10.1038/nrurol.2013.314] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ∼30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Giulia Brigante
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Stefano Zona
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Giovanni Guaraldi
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Vincenzo Rochira
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
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22
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Quinta Gomes AL, Nobre PJ. Prevalence of sexual problems in Portugal: results of a population-based study using a stratified sample of men aged 18 to 70 years. JOURNAL OF SEX RESEARCH 2013; 51:13-21. [PMID: 23573897 DOI: 10.1080/00224499.2012.744953] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Despite the use of different methodologies, target populations, and clinical definitions of sexual problems, recent epidemiological studies have shown that the occurrence of sexual difficulties is a very common experience among men from the general population regardless of their age. The objective of this study was to present epidemiological data on the prevalence of sexual difficulties in a community sample of 650 sexually active Portuguese men, stratified by age, marital status, and educational level. Participants completed a self-reported questionnaire assessing sexual function in the previous four weeks (International Index of Erectile Function). Results showed that sexual difficulties were relatively common among this sample. Rapid ejaculation was the most frequently reported sexual difficulty (23.2%), followed by erectile difficulties (10.2%), orgasm problems (8.2%), and low desire (2.9%) in the previous four weeks. With the exception of rapid ejaculation, all categories showed age-specific prevalence rates, with sexual difficulties increasing gradually in men above age 45. Age was a significant predictor of all sexual difficulties except rapid ejaculation, and lower educational levels were related to orgasm difficulties. Findings are consistent with the majority of epidemiological studies indicating a high prevalence of sexual difficulties among men in the general population and highlight the importance and the need to implement sexual health promotion programs in the target population.
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Shaeer O. The Global Online Sexuality Survey (GOSS): The United States of America in 2011 Chapter II: Phosphodiesterase Inhibitors Utilization among English Speakers. J Sex Med 2013; 10:532-40. [DOI: 10.1111/j.1743-6109.2012.02972.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Melnik T. Sexual medicine: the psychological effects of recreational PDE5 inhibitor use. Nat Rev Urol 2012; 9:479-80. [PMID: 22847548 DOI: 10.1038/nrurol.2012.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kimura M, Shimura S, Kobayashi H, Tai T, Chikano Y, Baba S, Kano M, Nagao K. Profiling Characteristics of Men Who Use Phosphodiesterase Type 5 Inhibitors Based on Obtaining Patterns: Data from the Nationwide Japanese Population. J Sex Med 2012; 9:1649-58. [DOI: 10.1111/j.1743-6109.2012.02728.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Graham CA. Condom use in the context of sex research: a commentary. Sex Health 2012; 9:103-8. [DOI: 10.1071/sh11103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 10/21/2011] [Indexed: 02/04/2023]
Abstract
This commentary highlights some recent trends in sex research that have particular relevance for research on condom use, including studies investigating the meaning of sexual arousal, desire and pleasure; a focus on couple-level investigations; and the relevance of individual differences and personality characteristics to sexual risk-taking. Although historically, sexuality-related issues have received little systematic attention in the field of public health, researchers are now paying more attention to the role of pleasure and sexual arousal in condom use. It is argued that a better integration of findings from the area of sex research into the HIV and sexually transmissible infection (STI) field is needed to develop and improve programs to reduce the risk of STIs and unintended pregnancy.
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Harte CB, Meston CM. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:597-606. [PMID: 20358273 PMCID: PMC2909482 DOI: 10.1007/s10508-010-9619-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 02/19/2010] [Accepted: 02/19/2010] [Indexed: 05/10/2023]
Abstract
Mounting evidence indicates that erectile dysfunction medications (EDMs) have become increasingly used as a sexual enhancement aid among men without a medical indication. Recreational EDM use has been associated with increased sexual risk behaviors, an increased risk for STIs, including incident HIV infection, and high rates of concomitant illicit drug use. The aim of the present study was to investigate the characteristics and associated risk factors for recreational EDM use among young, healthy, undergraduate men. A cross-sectional sample of 1,944 men were recruited from 497 undergraduate institutions within the Unites States between January 2006 and May 2007. The survey assessed patterns of EDM use, as well as demographic, substance use, and sexual behavior characteristics. Four percent of participants had recreationally used an EDM at some point in their lives, with 1.4% reporting current use. The majority of recreational EDM users reported mixing EDMs with illicit drugs and particularly during risky sexual behaviors. Recreational EDM use was independently associated with increased age, gay, or bisexual sexual orientation, drug abuse, lifetime number of sex partners, and lifetime number of "one-night stands." Recreational EDM users also reported a 2.5-fold rate of erectile difficulties compared to nonusers. Overall, recreational use of EDMs was associated with sexual risk behaviors and substance abuse; however, a relatively small proportion of undergraduates reported using EDMs. Results also suggest that a sizable portion of recreational EDM users are heterosexual men, and that use does not solely occur within the environments of venues that cater to men having sex with men.
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Affiliation(s)
- Christopher B. Harte
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keeton, Austin, TX 78712, USA
| | - Cindy M. Meston
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keeton, Austin, TX 78712, USA
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Sanders SA, Reece M, Herbenick D, Schick V, Dodge B, Fortenberry JD. Condom Use During Most Recent Vaginal Intercourse Event Among a Probability Sample of Adults in the United States. J Sex Med 2010; 7 Suppl 5:362-73. [DOI: 10.1111/j.1743-6109.2010.02011.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bechara A, Casabé A, De Bonis W, Helien A, Bertolino MV. Recreational use of phosphodiesterase type 5 inhibitors by healthy young men. J Sex Med 2010; 7:3736-42. [PMID: 20722788 DOI: 10.1111/j.1743-6109.2010.01965.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In recent years, PDE5 inhibitors (PDE5i) use has become more popular among men without ED to enhance sexual performance. However, reports in the literature are scarce. AIM The aim of this study was to evaluate the recreational use of PDE5i in healthy young men. MAIN OUTCOME MEASURES We evaluated the recreational use of PDE5i among young and healthy men, their main reasons for use, how they were obtained these drugs, and the combination with alcohol or other drugs. METHODS Descriptive, transversal study consisting in 400 brief surveys with structured multiple choice and open questions. Nonprobability samples (quota samples) included young men between 18 and 30 years of age in a public area (high schools, universities, and gyms) between August and November 2009. Collecting the questionnaires in a sealed box enforced confidentiality. The survey included demographic and sexual health data and PDE5i use characteristics. For statistical analysis we used Fisher's exact and Mann-Whitney tests. RESULTS A total of 321 questionnaires were appropriate for the purposes of evaluation. Mean age and standard deviation were 25.1±3.3 years old. Regarding PDE5i use, 69 men (21.5%) mentioned trying the pill (being sildenafil the most commonly used one) at least one time in their lives and 37 (53.4%) men combined it with alcohol or drugs. Referred sources of acquisition PDE5i were 75.4% (N=52) from a friend, 17.4% (N=15) from a pharmacy/drugstore without a medical prescription, 4.3% (N=3) prescribed by a physician and 2.9% (N=2) through Internet. There were several reasons for taking PDE5i related to sexual confidence, erection quality, and better sexual performance. CONCLUSION According to our results, 21.5% of healthy men between 18 and 30 years old used PDE5i as a recreational drug, mostly associated with alcohol or other drugs without medical control. This could have led to misuse and a public health problem. Further studies are needed to evaluate not only PDE5i recreational use prevalence, but also psychosocial determinants, long term safety, misuse, and abuse related to it.
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Affiliation(s)
- Amado Bechara
- Instituto Médico Especializado, Buenos Aires, Argentina.
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Rynja S, Bosch R, Kok E, Wouters G, De Kort L. IIEF-15: Unsuitable for Assessing Erectile Function of Young Men? J Sex Med 2010; 7:2825-30. [DOI: 10.1111/j.1743-6109.2010.01847.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Schnetzler G, Banks I, Kirby M, Zou KH, Symonds T. Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. J Sex Med 2010; 7:1237-46. [PMID: 20136707 DOI: 10.1111/j.1743-6109.2009.01674.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Men may choose to bypass the healthcare system to obtain a phosphodiesterase type 5 inhibitor (PDE5i). AIM Evaluate the characteristics and purchasing patterns of men obtaining a PDE5i without prior healthcare professional (HCP) interaction. MAIN OUTCOME MEASURES Prior HCP interaction, defined as having a prescription for any PDE5i, having a PDE5i sample from a physician, or buying the PDE5i in a retail pharmacy; and erectile dysfunction (ED, the Massachusetts Male Aging Study single-item question) were assessed. A multivariate regression analysis determined predictive factors for PDE5i purchase without prior HCP interaction. Methods. A Web-based observational study was conducted in the United Kingdom, Germany, and Italy. RESULTS Of the 11,899 participants, 1,252 (10.5% [95% CI, 10.0-11.1%]) reported PDE5i use in the last 6 months. PDE5is were obtained without prior HCP interaction by 403 users (32.3% [95% CI, 29.6-34.8%]); 65.5% of them had ED. Overall prevalence of men using PDE5is without HCP interaction was 3.0% (95% CI, 2.6-3.5%), 4.1% (95% CI, 3.5-4.6%), and 2.8% (95% CI, 2.1-3.5%) for men aged 18-34, 35-50, and >50 years, respectively (P = 0.0045). Predictive factors for obtaining a PDE5i without prior HCP interaction were embarrassment to speak to a physician (P = 0.0009) and the perception that this would be the cheapest way to get the medicine (P = 0.03). CONCLUSIONS Based on these findings, it can be estimated that approximately 6 million men in Europe might currently bypass the healthcare system to obtain a PDE5i. In addition to the risks associated with use of PDE5is from uncontrolled sources, because most of these men have ED, they also miss the opportunity for important health information or medical follow-up. HCPs should actively address ED and offer treatment to discourage men from seeking uncontrolled sources of ED medicines.
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Oliveira LGD, Barroso LP, Wagner GA, Ponce JDC, Malbergier A, Stempliuk VDA, Andrade AGD. Drug consumption among medical students in São Paulo, Brazil: influences of gender and academic year. BRAZILIAN JOURNAL OF PSYCHIATRY 2010; 31:227-39. [PMID: 19784490 DOI: 10.1590/s1516-44462009000300008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 05/19/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze alcohol, tobacco and other drug use among medical students. METHOD Over a five-year period (1996-2001), we evaluated 457 students at the Universidade de São Paulo School of Medicine, located in São Paulo, Brazil. The students participated by filling out an anonymous questionnaire on drug use (lifetime, previous 12 months and previous 30 days). The influence that gender and academic year have on drug use was also analyzed. RESULTS During the study period, there was an increase in the use of illicit drugs, especially inhalants and amphetamines, among the medical students evaluated. Drug use (except that of marijuana and inhalants) was comparable between the genders, and academic year was an important influencing factor. DISCUSSION Increased inhalant use was observed among the medical students, especially among males and students in the early undergraduate years. This is suggestive of a specific behavioral pattern among medical students. Our findings corroborate those of previous studies. CONCLUSION Inhalant use is on the rise among medical students at the Universidade de São Paulo School of Medicine. Because of the negative health effects of illicit drug use, further studies are needed in order to deepen the understanding of this phenomenon and to facilitate the development of preventive measures.
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Affiliation(s)
- Lucio Garcia de Oliveira
- Department of Psychiatry, Medical School, School of Medicine, Universidade de São Paulo, Brazil.
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Shindel AW. Continuing Medical Education: 2009 Update on Phosphodiesterase Type 5 Inhibitor Therapy Part 2: Updates on Optimal Utilization for Sexual Concerns and Rare Toxicities in This Class (CME). J Sex Med 2009; 6:2352-64; quiz 2365-6. [DOI: 10.1111/j.1743-6109.2009.01447.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Prestage G, Jin F, Kippax S, Zablotska I, Imrie J, Grulich A. Use of illicit drugs and erectile dysfunction medications and subsequent HIV infection among gay men in Sydney, Australia. J Sex Med 2009; 6:2311-20. [PMID: 19493293 DOI: 10.1111/j.1743-6109.2009.01323.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Use of illicit drugs and oral erectile dysfunction medications (OEM) have been associated with risk behavior among gay men. AIM To determine the effects of illicit drugs and OEM as risk factors for HIV seroconversion in a community-based cohort of HIV-negative homosexually active men in Sydney, Australia. MAIN OUTCOME MEASURES Drug use in the previous 6 months and at the most recent sexual encounter; Most recent occasions of unprotected and protected anal intercourse; HIV-positive diagnosis. METHODS From June 2001 to June 2007, participants were followed up with 6-monthly detailed behavioral interviews and annual testing for HIV. Detailed information about sexual, drug-using and other behavior was collected. RESULTS Among 1,427 participants enrolled, 53 HIV seroconverters were identified by June 2007. At baseline, 62.7% reported using illicit drugs in the previous 6 months, including 10.7% who reported at least weekly use. Illicit drug use was associated with unprotected anal intercourse with casual partners (P < 0.001). Use of illicit drugs was associated with increased risk of HIV infection at a univariate level, and this risk increased with greater frequency of use. This was also true of the use of OEM. Use of each type of illicit drug was included in multivariate analysis, and after controlling for sexual risk behaviors, only use of OEM remained significantly predictive of HIV infection (Hazard ratios [HR] = 1.75, CI = 1.31-2.33, P < 0.001), although amyl nitrite was of borderline significance (HR = 1.26, CI = 0.98-1.62, P = 0.074). CONCLUSION The association between drug use and increased risk of HIV infection was strongest for drugs used specifically to enhance sexual pleasure, particularly OEM. The risk of infection was substantially increased when both OEM and methamphetamine were used. Within more "adventurous" gay community subcultures, the interconnectedness of sexual behavior and drug use may be key to understanding HIV risk and is an appropriate priority in HIV-prevention efforts in this population.
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Affiliation(s)
- Garrett Prestage
- National Center in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.
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Sanders SA, Milhausen RR, Crosby RA, Graham CA, Yarber WL. ORIGINAL RESEARCH–ED PHARMACOTHERAPY: Do Phosphodiesterase Type 5 Inhibitors Protect Against Condom-Associated Erection Loss and Condom Slippage? J Sex Med 2009; 6:1451-6. [DOI: 10.1111/j.1743-6109.2009.01267.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Costa RM, Brody S. ORIGINAL RESEARCH—PSYCHOLOGY: Condom Use for Penile–Vaginal Intercourse is Associated with Immature Psychological Defense Mechanisms. J Sex Med 2008; 5:2522-32. [DOI: 10.1111/j.1743-6109.2008.00987.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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