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Gerbild H, Areskoug Josefsson K, Marie Larsen C, Schantz Laursen B. Communication about physical activity to reduce vascular erectile dysfunction - A qualitative interview study among men in cardiac rehabilitation. Scand J Caring Sci 2021; 36:839-851. [PMID: 34288023 DOI: 10.1111/scs.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals' communicative component of the complex intervention 'Physical Activity to reduce Vascular Erectile Dysfunction' (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. AIM To elucidate men's perspectives on cardiac health professionals' communication about PAVED. ETHICAL ISSUES An Institutional Data Protection Agency approved the study. METHODS An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. RESULTS The men wanted health professionals' communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals' communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals' communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. STUDY LIMITATIONS Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. CONCLUSION Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals' communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.
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Affiliation(s)
- Helle Gerbild
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Sandnes, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Camilla Marie Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgitte Schantz Laursen
- Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Nursing Research Unit & Sexological Centre, Aalborg University Hospital, Aalborg, Denmark
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Dávolos I, González Naya E, Marini Marcilla M. Sexual Activity After Myocardial Revascularization Surgery. Curr Probl Cardiol 2020; 46:100678. [PMID: 32861464 DOI: 10.1016/j.cpcardiol.2020.100678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
After a cardiovascular event, patients and their families often face numerous changes in their lives. Poorly addressing physical and psychological challenges can lead to an impaired quality of life. Sexuality is an important quality of life aspect to many patients and couples who can be negatively affected by a cardiovascular event. Sexual health requires a positive and respectful approach to sexuality and sexual relationships. Time to resume sexual activity after myocardial revascularization surgery is a gap in cardiologic practice. We know from literature that coronary patients have decreased sexual activity. There are barriers from the medical environment such as lack of knowledge, confidence and training, and many others that arise from the patient's perspective, which do not allow generating a space to address sexual problems. This review aims to familiarize and update cardiologists, providing knowledge and resources to face the impact of myocardial revascularization surgery on the quality of sexual life, promoting multidisciplinary management among doctors and other health professionals.
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Affiliation(s)
- Ignacio Dávolos
- Cardiologist, MTSAC. Cardiovascular Rehabilitation at Hospital de Clínicas José de San Martín and Sanatorio Juncal, Exercise Cardiology Council of the Argentine Society of Cardiology; Corresponding author: Ignacio Dávolos, Cardiology Division at Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
| | - Enrique González Naya
- Cardiologist, Specialist in Sports Medicine. Head of Cardiovascular Rehabilitation at IADT; Exercise Cardiology Council of the Argentine Society of Cardiology
| | - Maya Marini Marcilla
- Gynecologist, Obstetrician, Sexologist. Obstetrics Coordinator at Sanatorio de la Trinidad Palermo. Collaborator in the Sexology and Sexual Medicine Area, Urology Division, Dr. Enrique Tornú Hospital, Member of the Society of Obstetrics and Gynecology of Buenos Aires and of the Argentine Society of Human Sexuality
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Dávolos I, González Naya E, Marini Marcilla M. Sexual Activity After Myocardial Revascularization Surgery. Curr Probl Cardiol 2020; 46:100660. [PMID: 32829934 DOI: 10.1016/j.cpcardiol.2020.100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
After a cardiovascular event, patients and their families often face numerous changes in their lives. Poorly addressing physical and psychological challenges can lead to an impaired quality of life. Sexuality is an aspect of quality of life that is important to many patients and couples who can be negatively affected by a cardiovascular event. Sexual health requires a positive and respectful approach to sexuality and sexual relationships. The timing of return to sexual activity after myocardial revascularization surgery is a gap in cardiology practice. We know from the literature that coronary patients have a decrease in sexual activity. There are barriers from the medical environment such as lack of knowledge, confidence, and training, and many others that arise from the patient's perspective, which do not allow generating a space to address sexual problems. This review aims to familiarize and update the cardiologist, bringing knowledge and resources closer to the impact of myocardial revascularization surgery on the quality of sexual life of patients, always encouraging multidisciplinary management among doctors and other professionals in health.
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Affiliation(s)
- Ignacio Dávolos
- Cardiologist, MTSAC. Cardiovascular Rehabilitation at Hospital de Clínicas José de San Martín, Exercise Cardiology Council, Epidemiology and Cardiovascular Prevention Council of the Argentine Society of Cardiology; Cardiologist, Specialist in Sports Medicine. Head of Cardiovascular Rehabilitation at IADT, Exercise Cardiology Council of the Argentine Society of Cardiology; Gynecologist, Obstetrician, Sexologist. Obstetrics Coordinator at Sanatorio de la Trinidad Palermo. Collaborator in the Sexology and Sexual Medicine Area, Urology Division, Dr. Enrique Tornú Hospital. Member of the Society of Obstetrics and Gynecology of Buenos Aires and of the Argentine Society of Human Sexuality.
| | - Enrique González Naya
- Gynecologist, Obstetrician, Sexologist. Obstetrics Coordinator at Sanatorio de la Trinidad Palermo. Collaborator in the Sexology and Sexual Medicine Area, Urology Division, Dr. Enrique Tornú Hospital. Member of the Society of Obstetrics and Gynecology of Buenos Aires and of the Argentine Society of Human Sexuality
| | - Maya Marini Marcilla
- Gynecologist, Obstetrician, Sexologist. Obstetrics Coordinator at Sanatorio de la Trinidad Palermo. Collaborator in the Sexology and Sexual Medicine Area, Urology Division, Dr. Enrique Tornú Hospital. Member of the Society of Obstetrics and Gynecology of Buenos Aires and of the Argentine Society of Human Sexuality
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Kałka D, Zdrojowy R, Womperski K, Gebala J, Smoliński R, Dulanowska A, Stolarczyk K, Dulanowski J, Pilecki W, Rusiecki L. Should information about sexual health be included in education directed toward men with cardiovascular diseases? Aging Male 2018; 21:243-250. [PMID: 29463161 DOI: 10.1080/13685538.2018.1439911] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Modifiable risk factors contribute to the pathogenesis of cardiovascular disease (CVD) and erectile dysfunction (ED). We aimed to compare the knowledge about the contribution of modifiable risk factors to the pathogenesis of CVD and ED. The impact of patients' having modifiable risk factors on the awareness of their negative influence on the development of CVD and ED was examined. METHODS To this multicenter cohort study, we included 417 patients with CHD who had been hospitalized in the cardiology or cardiac surgery department during the previous six weeks and underwent cardiac rehabilitation in one of the five centers. Knowledge about modifiable risk factors was collected. ED was assessed by an abridged IIEF-5 questionnaire. Comparisons between groups were conducted using the Student's t-test, Mann-Whitney U test, and Kruskal-Wallis test. Relationships were analyzed with Spearman's rank correlation coefficient. RESULTS The mean number of correctly identified risk factors for CVD was significantly higher than those for ED (3.71 ± 1.87 vs. 2.00 ± 1.94; p < .0001). Smoking was the most recognized risk factor both for CVD and ED. Dyslipidemia was least frequently identified as a risk factor for CVD. Sedentary lifestyle was the only risk factor whose incidence did not affect the level of patient knowledge. CONCLUSIONS Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.
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Affiliation(s)
- Dariusz Kałka
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
- b Centre for Men's Health in Wroclaw , Wroclaw , Poland
| | - Romuald Zdrojowy
- c Department and Clinic of Urology , Wroclaw Medical University , Wroclaw , Poland
| | - Krzysztof Womperski
- d Department of Cardiac Rehabilitation , Hospital of the Ministry of Interior , Głucholazy , Poland
| | - Jana Gebala
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | | | - Alicja Dulanowska
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Karolina Stolarczyk
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Jakub Dulanowski
- e Cardiosexology Students' Scientific Club , Wrocław Medical University , Wrocław , Poland
| | - Witold Pilecki
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
| | - Lesław Rusiecki
- a Cardiosexology Unit, Department of Pathophysiology , Wrocław Medical University , Wrocław , Poland
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Taylor DG, Giuliano F, Hackett G, Hermes-DeSantis E, Kirby MG, Kloner RA, Maguire T, Stecher V, Goggin P. The pharmacist's role in improving the treatment of erectile dysfunction and its underlying causes. Res Social Adm Pharm 2018; 15:591-599. [PMID: 30057329 DOI: 10.1016/j.sapharm.2018.07.014] [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: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 01/07/2023]
Abstract
Erectile dysfunction (ED), which worldwide is likely to affect in excess of 300 million men by 2025, is often either untreated or insufficiently treated. It can be a prelude to other serious illnesses and may be a cause or consequence of depression in affected individuals. Among men younger than 60 years of age, ED can be a robust early-stage indicator of vascular disease and type 2 diabetes. Untreated or inadequately treated ED can also be a sign of poor communication between health professionals and service users of all ages. Improved treatment of ED could cost-effectively prevent premature deaths and avoidable morbidity. The extension of community pharmacy‒based health care would enable more men living with ED to safely access effective medications, along with appropriate diagnostic services and support for beneficial lifestyle changes such as smoking cessation in conveniently accessible settings. The task of introducing improved methods of affordably addressing problems linked to ED exemplifies the strategic challenges now facing health care systems globally. Promoting professionally supported self-care in pharmacies has the potential to meet the needs of aging populations in progressively more effective ways.
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Affiliation(s)
- David G Taylor
- The UCL School of Pharmacy, 29-39 Brunswick Square, Bloomsbury, London, WC1N 1AX, UK.
| | - Francois Giuliano
- Neurourology R. Poincaré Hal Garches, Versailles Saint-Quentin University, 104 Boulevard Raymond Poincaré, Garches, 92380, France.
| | - Geoff Hackett
- Good Hope Hospital, Rectory Road, Sutton Coldfield, Birmingham, B75 7RR, UK.
| | - Evelyn Hermes-DeSantis
- Ernest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Road, New Brunswick, NJ, 08854, USA.
| | - Michael G Kirby
- The Prostate Centre, 32 Wimpole St, Marylebone, London W1G 8GT, UK; University of Hertfordshire, Centre for Research in Primary and Community Care, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Robert A Kloner
- Huntington Medical Research Institutes, 686 S Fair Oaks Ave, Pasadena, CA 91105, USA; Division of Cardiovascular Medicine, Dept. of Medicine, Keck School of Medicine at University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Terry Maguire
- Queens University Belfast, University Road, Belfast, BT7 1NN, UK, Ireland.
| | - Vera Stecher
- Pfizer Inc, 235 E 42nd St, New York, NY, 10017, USA.
| | - Paul Goggin
- Pfizer Ltd, Discovery Park, Ramsgate Rd, Sandwich, CT13 9ND, UK.
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Kałka D, Karpiński Ł, Gebala J, Rusiecki L, Biełous-Wilk A, Krauz ES, Piłot M, Womperski K, Rusiecka M, Pilecki W. Sexual health of male cardiac patients - present status and expectations of patients with coronary heart disease. Arch Med Sci 2017; 13:302-310. [PMID: 28261282 PMCID: PMC5332461 DOI: 10.5114/aoms.2017.65332] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/17/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Due to the pathogenetic association between erectile disorders and cardiovascular diseases, cardiologists consult many patients with erectile dysfunction (ED). The aim of the study was to evaluate sexual function in patients with coronary heart disease (CHD) and the use of sexual knowledge in cardiology practice, both current use and that expected by patients. MATERIAL AND METHODS One thousand one hundred and thirty-six patients (average age: 60.73 ±9.20) underwent a dedicated survey which encompassed demographic data and the presence of modifiable ED risk factors. The presence of ED was assessed using the International Index of Erectile Function (IIEF-5) Questionnaire. RESULTS Sexual problems were discussed by cardiologists with 45 (3.96%) patients. The frequency of initiating the topic was significantly associated with the respondents' education level (p = 0.0031); however, it was not associated with the patients' age, duration of CHD, presence of ED, or modifiable risk factors. Four hundred and sixteen (36.62%) respondents indicated that they expect their cardiologist to take an interest in their ED. Nine hundred and twenty-six (81.51%) patients claimed good sexual function to be important or very important to them. Attitude to sexual function was significantly associated with age (p < 0.0001), duration of CHD (p = 0.0018), education (p = 0.0011), presence of ED (p = 0.0041), diabetes (p = 0.0283) and hyperlipidaemia (p = 0.0014). CONCLUSIONS The low frequency with which cardiologists initiate the topic of ED is in contrast to the expectations of patients with CHD. The majority of these patients regard good sexual maintenance as an important part of their life.
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Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
- Center of Men’s Health, Wroclaw, Poland
| | - Łukasz Karpiński
- Center of Men’s Health, Wroclaw, Poland
- Center of Cardiac Prevention and Rehabilitation CREATOR, Wroclaw, Poland
| | | | - Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Biełous-Wilk
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
| | - Ewa S. Krauz
- Department of Cardiac Rehabilitation, Lower Silesian Heart Diseases Centre “Medinet”, Wroclaw, Poland
| | - Magdalena Piłot
- Department of Cardiac Rehabilitation, Centre of Cardiac Rehabilitation and Cardiac Prevention, Glucholazy, Poland
| | - Krzysztof Womperski
- Department of Cardiac Rehabilitation, Hospital of the Ministry of Interior, Glucholazy, Poland
| | - Małgorzata Rusiecka
- Department of Oncology and Gynaecologic Oncology, Medical University of Wroclaw, Wroclaw, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Medical University of Wroclaw, Wroclaw, Poland
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Kałka D, Gebala J, Borecki M, Pilecki W, Rusiecki L. Return to sexual activity after myocardial infarction - An analysis of the level of knowledge in men undergoing cardiac rehabilitation. Eur J Intern Med 2017; 37:e31-e33. [PMID: 27697352 DOI: 10.1016/j.ejim.2016.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 09/14/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, ul. K. Marcinkowskiego 1, 50-368 Wrocław, Poland; Centre for Men's Health in Wroclaw, ul. Saperów 19/21, 53-151 Wrocław, Poland.
| | - Jana Gebala
- Centre for Men's Health in Wroclaw, ul. Saperów 19/21, 53-151 Wrocław, Poland; Cardiosexology Students' Scientific Club, Wrocław Medical University, ul. K. Marcinkowskiego 1, 50-368 Wrocław, Poland.
| | - Michael Borecki
- Cardiosexology Students' Scientific Club, Wrocław Medical University, ul. K. Marcinkowskiego 1, 50-368 Wrocław, Poland.
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, ul. K. Marcinkowskiego 1, 50-368 Wrocław, Poland.
| | - Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, ul. K. Marcinkowskiego 1, 50-368 Wrocław, Poland.
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Kałka D, Domagała Z, Rakowska A, Womperski K, Franke R, Sylwina-Krauz E, Stanisz J, Piłot M, Gebala J, Rusiecki L, Pilecki W. Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease. Int J Impot Res 2015; 28:14-9. [DOI: 10.1038/ijir.2015.26] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 04/28/2015] [Accepted: 08/12/2015] [Indexed: 11/09/2022]
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Kazer MW, Grossman S, Kerins G, Kris A, Tocchi C. Validity and Reliability of the Geriatric Sexuality Inventory. J Gerontol Nurs 2013; 39:38-45. [DOI: 10.3928/00989134-20130916-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/15/2013] [Indexed: 11/20/2022]
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Weber MF, Smith DP, OˈConnell DL, Patel MI, Souza PL, Sitas F, Banks E. Risk factors for erectile dysfunction in a cohort of 108 477 Australian men. Med J Aust 2013; 199:107-11. [DOI: 10.5694/mja12.11548] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 03/06/2013] [Indexed: 11/17/2022]
Affiliation(s)
| | - David P Smith
- Cancer Research Division, Cancer Council NSW, Sydney, NSW
| | | | - Manish I Patel
- Discipline of Surgery, University of Sydney, Westmead, NSW
| | | | - Freddy Sitas
- Cancer Research Division, Cancer Council NSW, Sydney, NSW
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
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Salonia A, Ferrari M, Saccà A, Pellucchi F, Castagna G, Clementi MC, Matloob R, Briganti A, Rigatti P, Montorsi F. Delay in Seeking Medical Help in Patients with New‐Onset Erectile Dysfunction Remained High Over and Despite the PDE5 Era—An Ecological Study. J Sex Med 2012; 9:3239-46. [DOI: 10.1111/j.1743-6109.2012.02953.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Corona G, Monami M, Boddi V, Rastrelli G, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, Maggi M. Pulse pressure independently predicts major cardiovascular events in younger but not in older subjects with erectile dysfunction. J Sex Med 2010; 8:247-54. [PMID: 20722787 DOI: 10.1111/j.1743-6109.2010.01966.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Pulse pressure (PP; i.e., the arithmetic difference between systolic and diastolic blood pressure) has been suggested to be an independent cardiovascular risk (CV) factor in the general population. We previously also reported a negative association between PP and arteriogenic erectile dysfunction (ED). This finding has recently been questioned. AIM To verify the association of PP with ED severity and to evaluate its role in predicting forthcoming CV events. METHODS This is an observational prospective cohort study evaluating a consecutive series of 1,687 patients attending our Andrological Unit for ED. MAIN OUTCOME MEASURES Several hormonal and biochemical parameters were studied, along with SIEDY structured interviews and penile Doppler ultrasound. RESULTS Subjects with PP in the lowest quartile (I: 20-45; II: 46-55; III: 56-62; IV: 63-115 mm Hg) had a significant reduction in the risk of severe ED (RR = 0.60[0.47-0.76]; P < 0.0001). When the same analysis was repeated as a function of age quartile (I = 17-44, II = 45-55, III = 56-62, and IV = 63-88 years old), after adjusting for testosterone levels, mean blood pressure, Chronic Disease Score, and body mass index, PP was inversely related to ED only in the youngest age group. During a mean follow up of 4.4 ± 2.6 years, 147 major cardiovascular events (MACE) were observed. In a Cox regression model, after adjusting for possible confounding factors, a lower PP was associated with a lower risk of MACE in the whole sample and in younger subjects, but not in the older ones. CONCLUSIONS Checking for blood pressure in ED subjects and calculating PP should become a routine practice in sexual medicine. In younger individuals, low PP reflects not only sexual health (better erection) but also cardiovascular health (less prevalence of MACE).
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Affiliation(s)
- Giovanni Corona
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
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Mohamed OA, Hamed HA, Roaiah MF, Helmy T, Mahran A, Bennett CJ. Correlation Between the European System for Cardiac Operative Risk Evaluation and Sexual Function After Coronary Artery Bypass Graft Surgery. J Sex Med 2010; 7:2158-2165. [DOI: 10.1111/j.1743-6109.2010.01727.x] [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]
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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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Broderick GA, Abdolrasulnia M. Men's Sexual Health: Evaluating the Effectiveness of Print- and PDA-based CME. J Sex Med 2009; 6:2417-24. [DOI: 10.1111/j.1743-6109.2009.01270.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Günzler C, Kriston L, Harms A, Berner MM. Association of Sexual Functioning and Quality of Partnership in Patients in Cardiovascular Rehabilitation—A Gender Perspective. J Sex Med 2009; 6:164-74. [DOI: 10.1111/j.1743-6109.2008.01039.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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