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Andersen ML, Lavigne G, Dal Fabbro C, Tufik S. Erectile dysfunction and sleep related bruxism: An exploratory review of an improbable association. Sleep Med Rev 2024; 77:101970. [PMID: 38964237 DOI: 10.1016/j.smrv.2024.101970] [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: 12/28/2023] [Revised: 04/26/2024] [Accepted: 06/14/2024] [Indexed: 07/06/2024]
Abstract
The World Health Organization recognizes sexual health as not merely the absence of disease, but a state of physical, mental, and social well-being in relation to one's sexuality. Achieving sexual satisfaction is pivotal for many individuals, as it significantly contributes to their quality of life. Among various sexual disorders, erectile dysfunction (ED) is notably prevalent, affecting an estimated 10-20 million men in the United States alone. This condition impacts not just the person experiencing it but also significantly influences their intimate connections with partners. Although the causes of ED are multifactorial, recent research highlights a compelling association between sleep disorders, such as sleep deprivation, obstructive sleep apnea (OSA), and insomnia, and the incidence of ED. Furthermore, engaging in night work has been observed to exacerbate the risk of developing ED. One common sleep disorder, sleep related bruxism (SRB), despite its prevalence, has not generally been associated with ED. However, there is some interesting evidence hinting at a potential relationship, including a few studies reporting a high prevalence of ED in individuals with SRB. This review delves into the epidemiological, etiological, and mechanistic links between ED and SRB, aiming to uncover potential intersections between these two conditions. These insights could pave the way for innovative research avenues, possibly exploring treatments like vasodilation medication, that might concurrently address both ED and SRB.
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Affiliation(s)
- Monica Levy Andersen
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil.
| | - Gilles Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Cibele Dal Fabbro
- Sleep Institute - São Paulo, Brazil; Faculté de Médecine Dentaire, Université de Montréal, Canada; Center for Advanced Research in Sleep Medicine, CIUSS Nord Lle de Montreal and Stomatology, CHUM, Montreal, Canada
| | - Sergio Tufik
- Departamento de Psicobiologia - Universidade Federal de São Paulo - São Paulo, Brazil; Sleep Institute - São Paulo, Brazil
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Genetics and erectile dysfunction: leveraging early foundations for new discoveries. Int J Impot Res 2020; 34:252-259. [PMID: 33173200 DOI: 10.1038/s41443-020-00372-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 11/08/2022]
Abstract
There is considerable interest in understanding the genetics of erectile dysfunction (ED). Since early twin studies that suggested a genetic component to ED, multiple candidate gene studies have identified genetic variants that may be associated with ED. Genome-wide association studies (GWAS) have overcome some of the criticism of the candidate gene approach. Two recent GWAS studies have identified loci near SIM1 that may be associated with ED and have renewed interest in the leptin melanocortin signaling pathway. We review the current literature on the genetic basis of ED by highlighting several candidate genes and genetic variants associated with ED.
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Andersen ML, Tufik S. A Review of Sleep Disturbance and Sexual Function: the Effect of Sleep Apnea on Erectile Function. CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Aqueous extract of Lespedeza cuneata improves male menopause by increase of nitric oxide and dihydrotestosterone. Food Sci Biotechnol 2019; 28:253-260. [PMID: 30815317 DOI: 10.1007/s10068-018-0434-x] [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: 05/03/2018] [Revised: 06/20/2018] [Accepted: 07/04/2018] [Indexed: 10/28/2022] Open
Abstract
This study aimed to evaluate the effect of aqueous extract of Lespedeza cuneata (ALC) on men menopause induced erectile dysfunction (ED) and testosterone deficiency syndrome (TDS) in vitro and in vivo. Nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) have been fundamental factors of ED, and free testosterone such as dihydrotestosterone (DHT) has a crucial role in mitigation of TDS. ALC increased the production of NO in a dose-dependent manner in vitro and in vivo. The level of neuronal nitric oxide synthase and cGMP was increased in the ALC group. The level of DHT and 17-beta hydroxysteroid dehydrogenases (17β-HSD) was also increased in the ALC group. There was no significant change of hepatotoxicity, renal toxicity, lipid metabolism, and glucose. These results suggest that ALC enhanced NO, cGMP and free testosterone which could be developed as a health supplement for improving male menopause.
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Yao HX, Ma FZ, Tan YY, Liu LY. Endothelial nitric oxide synthase gene polymorphisms and risk of erectile dysfunction: An updated meta-analysis of genetic association studies. Int J Surg 2018; 54:141-148. [DOI: 10.1016/j.ijsu.2018.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 04/06/2018] [Indexed: 02/07/2023]
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Gao L, Zhao Z, Guo F, Liu Y, Guo J, Zhao Y, Wang Z. Association of endothelial nitric oxide synthase polymorphisms with an increased risk of erectile dysfunction. Asian J Androl 2018; 19:330-337. [PMID: 26908069 PMCID: PMC5427790 DOI: 10.4103/1008-682x.163300] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The purpose of our meta-analysis is to examine the associations between three single nucleotide polymorphisms of endothelial nitric oxide synthase (eNOS) gene, G894T, intron 4 and T-786C, and the risk of erectile dysfunction. An electronic database search was performed to identify case-control studies reporting the association between single nucleotide polymorphisms of eNOS gene and erectile dysfunction. Stringent inclusion and exclusion criteria were employed to select high-quality studies for this meta-analysis. Comprehensive Meta-analysis 2.0 software (Biostat Inc., Englewood, New Jersey, USA) was used for statistical analysis of the data extracted from the selected studies. From the initial 203 articles retrieved from database search, this meta-analysis finally selected 12 high-quality case-control studies that conformed to our inclusion criteria. The 12 studies contained a total of 1962 patients with erectile dysfunction and 1752 healthy controls. The results of our meta-analysis showed that G894T correlated with an increased risk erectile dysfunction under both the allele and dominant models (allele: OR = 1.556, 95% CI = 1.064–2.275, P = 0.023; dominant: OR = 1.613, 95% CI = 1.050–2.476, P = 0.029). A similar association was found between T-786C and erectile dysfunction under the allele model (OR = 1.679, 95% CI = 1.341–2.102, P < 0.001), but not under the dominant model (all P > 0.05). Our meta-analysis showed that the two single nucleotide polymorphisms in eNOS gene, G894T and T-786C, are strongly associated with the risk of erectile dysfunction.
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Affiliation(s)
- Lei Gao
- Department of Urinary Surgery, Linyi People's Hospital, Linyi 276000, China
| | - Zhifeng Zhao
- Department of Urinary Surgery, Linyi People's Hospital, Linyi 276000, China
| | - Fengfu Guo
- Department of Urinary Surgery, Linyi People's Hospital, Linyi 276000, China
| | - Yan Liu
- Department of Urinary Surgery, Linyi Cancer Hospital, Linyi 276000, China
| | - Jianhua Guo
- Department of Urology and Andrology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China.,Department of Urology, Shanghai Pudong Hospital, Fudan University Pudong Medical Centre, Shanghai 200011, China
| | - Yang Zhao
- Department of Urology and Andrology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Zhong Wang
- Department of Urology and Andrology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
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Ning L, Yang L. Hypertension might be a risk factor for erectile dysfunction: a meta-analysis. Andrologia 2016; 49. [PMID: 27491642 DOI: 10.1111/and.12644] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 12/21/2022] Open
Abstract
The study aimed to evaluate whether hypertension was a risk factor for erectile dysfunction (ED). Databases including PubMed and Embase were retrieved to identify studies related to hypertension in ED patients. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect size. Subgroup analyses stratified by total number of enrolled subjects and research regions were performed. Sensitivity analysis was performed by removing a single study at one time. Egger's test was used to evaluate the publication bias. Totally, 40 studies including 121,641 subjects were included in the meta-analysis. As a result, hypertension was closely related to ED (OR = 1.74, 95% CI, 0.63-0.80, p < .01). Subgroup analysis indicated hypertension was the risk factor for ED whatever the participants numbers. When stratified by different regions, hypertension was a risk factor for ED in Africa (OR = 3.35, 95% CI, 1.45-7.77, p < .01), Americas (OR = 1.97, 95% CI, 1.68-2.31, p < 0.01), Asia (OR = 1.46, 95% CI, 1.16-1.84, p < .01) and Europe (OR = 1.83, 95% CI, 1.34-2.49, p < .01), but not in Australia. Hypertension may be a potential risk factor for ED.
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Affiliation(s)
- L Ning
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - L Yang
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Abstract
BACKGROUND Erectile dysfunction (ED) is a common disorder in man that influences the quality of life of the patient and his partner. Known risk factors for ED comprise diabetes, coronary artery disease, hypertension but also lifestyle modifications such as smoking, diminished physical activity as well as obesity. In this manuscript the current scientific literature about genetics and erectile dysfunction is reviewed. MATERIALS AND METHODS A literature search using the databank PubMed covering the topics genetics and erectile dysfunction was performed and relevant papers selected for presentation. RESULTS Several aspects of genetics and ED are described in the current literature. Association studies of candidate polymorphisms and ED risk in comparison to healthy controls is a major area of research. Another topic is the genome-wide search for candidate polymorphisms with erectile dysfunction. The paper closes with the presentation of the pharmacogenomic analysis of treatment response to phosphodiesterase-5 inhibitors. DISCUSSION The heterogeneous results of genetic association studies are possibly due to small sample sizes of the study population and/or due to ethnic differences of the analyzed populations. This underlines the need for validation of this data in larger prospective multinational multicenter studies.
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Affiliation(s)
- A Eisenhardt
- Praxisklinik Urologie Rhein Ruhr, Schulstr. 11, 45468, Mülheim an der Ruhr, Deutschland,
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Dai F, Zhu L, Mi Y, Feng N. An Updated Meta-Analysis of the Effects of the Endothelial Nitric Oxide synthase Gene G894T Polymorphism and Erectile Dysfunction Risk. Cell Biochem Biophys 2015; 72:821-8. [DOI: 10.1007/s12013-015-0540-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Yun Z, Yu-Ping Y, Zong-Wu T, Yang S, Fang Y, Fang S. Association of endothelial nitric oxide synthase gene polymorphisms with end-stage renal disease: a systematic review and meta-analysis. Ren Fail 2014; 36:987-93. [DOI: 10.3109/0886022x.2014.900601] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Matos G, Hirotsu C, Alvarenga TA, Cintra F, Bittencourt L, Tufik S, Andersen ML. The association between TNF-α and erectile dysfunction complaints. Andrology 2013; 1:872-8. [DOI: 10.1111/j.2047-2927.2013.00136.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/07/2013] [Accepted: 08/29/2013] [Indexed: 01/10/2023]
Affiliation(s)
- G. Matos
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - C. Hirotsu
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - T. A. Alvarenga
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - F. Cintra
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - L. Bittencourt
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - S. Tufik
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
| | - M. L. Andersen
- Departamento de Psicobiologia; Universidade Federal de São Paulo; São Paulo Brazil
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Affiliation(s)
| | - Kanchan Chitaley
- Department of Urology, University of Washington, Seattle, Washington
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Hermans MP, Ahn SA, Rousseau MF. eNOS [Glu298Asp] polymorphism, erectile function and ocular pressure in type 2 diabetes. Eur J Clin Invest 2012; 42:729-37. [PMID: 22224829 DOI: 10.1111/j.1365-2362.2011.02638.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Imbalance in nitric oxide (NO), an atheroprotective vasodilator, is associated with endothelial dysfunction, cardiovascular diseases (CVD) and diabetic complications. Various endothelial NO synthase (eNOS) polymorphisms may affect NO bioavailability, thereby promoting adverse cardiovascular milieu. MATERIALS AND METHODS To analyze glucose homeostasis, cardiometabolic phenotype, and micro- and macroangiopathies associated with eNOS G894T gene polymorphism in type 2 diabetes (T2DM). 210 T2DM outpatients (mean age (1SD) 70 (12); diabetes duration 19 (9) years; males:females 64:36%; metabolic syndrome 87%) had insulin sensitivity and b-cell function modelled with HOMA, alongside routine laboratory and endothelin measurements. RESULTS GG, GT and TT genotypes represented 48% (n = 100), 39% (n = 83) and 13% (n = 27). Overall microangiopathy (retinopathy, neuropathy and/or nephropathy) was present in 74%, and overall macroangiopathy (CAD, PAD and/or TIA/stroke) in 45%. The TT genotype did not translate into a more severe vascular phenotype, as TT patients carrying the proposed risk genotype did not suffer a higher rate of micro- and macrovascular complications. On the other hand, erectile dysfunction, present in 60% of males (n = 135), was much more prevalent in TT males: 57% [GG & GT] vs. 93% in TT (p 0.0088). Ocular hypertension/glaucoma frequency (18% of the whole group) was also markedly different, albeit in opposing directions, between eNOS G894T gene polymorphism subgroups: 21% [GG & GT] vs. 0% prevalence (TT; p 0.0057). CONCLUSIONS eNOS G894T gene polymorphism in homozygous TT carriers translates into opposing effects on erectile function (detrimental) and ocular hypertension/glaucoma (protective) in T2DM, without affecting glucose homeostasis determinants or the presence of micro- and macrovascular complications.
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Affiliation(s)
- Michel P Hermans
- Service d'Endocrinologie et Nutrition, Université catholique de Louvain, avenue Hippocrate UCL 54, Brussels, Belgium.
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Lee Y, Huang S, Liu C, Yang Y, Yeh H, Li W, Wu W, Wang C, Juan Y, Huang C, Hour T, Chang C, Huang C. The Association of eNOS G894T Polymorphism with Metabolic Syndrome and Erectile Dysfunction. J Sex Med 2012; 9:837-43. [DOI: 10.1111/j.1743-6109.2011.02588.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wu X, Song B, Zhang J, Li L, Ji H, Lu G, Chen Z, Li W, Zhou Z. Human Telomerase Reverse Transcriptase Transfection Reduces Apoptosis in Human Penile Smooth Muscle Cells and Slows Down Cellular Aging. J Sex Med 2012; 9:494-504. [DOI: 10.1111/j.1743-6109.2011.02603.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Lippi G, Plebani M, Montagnana M, Cervellin G. Biochemical and genetic markers of erectile dysfunction. Adv Clin Chem 2012; 57:139-62. [PMID: 22870589 DOI: 10.1016/b978-0-12-394384-2.00005-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Erectile dysfunction (ED) is a very common pathology, affecting over 150 million men worldwide. The pathogenesis is typically multifactorial, involving a kaleidoscope of organic, endocrine, and psychogenic factors. In general, ED is divided into organic and psychogenic impotence, but most men with organic etiologies have an associated psychogenic component. Given the high frequency of this pathology, the identification of biochemical and genetic correlates and/or markers is of pivotal interest not only for treating preciously these patients and preventing serious psychological consequences but also for the high risk for occult cardiovascular disease (CVD) that often accompanies or follows this pathology. A variety of cardiovascular risk factors have been associated with both the onset and the severity of ED, including markers of endothelial function, thrombosis, and especially dyslipidemia, so that their measurement should now be considered as an important part of the increased global cardiometabolic risk profile in patients with ED. While nitric oxide (NO), asymmetric dimethylarginine (ADMA), and endothelin (ET) hold some promises as biochemical markers of both CVD and ED, there are several technical and clinical drawbacks that make their measurement overall meaningless in the clinical practice. As regards genetic polymorphisms, controversial results have been provided so far. Although some genetic markers were consistently associated with ED, other studies failed to demonstrate significant associations, highlighting a substantial bias in standardization of methodologies and patient enrolment. Nevertheless, further research in this area should be encouraged, since the first promising evidence that gene therapy might be effective to restore the decline in ED has been provided in the animal model.
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Andersen ML, Guindalini C, Tufik S. Genetics of Erectile Dysfunction: A Review of the Interface between Sex and Molecular Biomarkers. J Sex Med 2011; 8:3030-9. [DOI: 10.1111/j.1743-6109.2011.02422.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Pu X, Zheng X, Zhang Y, Xiao H, Xu Z, Liu J, Wang H, Wen A, Zhou X, Wu Y. Higher Expression of mRNA and Protein of Insulin‐Like Growth Factor Binding Protein‐3 in Old Rat Penile Tissues: Implications for Erectile Dysfunction. J Sex Med 2011; 8:2181-90. [DOI: 10.1111/j.1743-6109.2011.02318.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Andersen ML, Alvarenga TA, Mazzotti DR, Guindalini C, Pellegrino R, Barrueco KF, Santos-Silva R, Bittencourt LR, Tufik S. Hormonal profile, the PROGINS polymorphism, and erectile dysfunction complaints: data from a population-based survey. Fertil Steril 2011; 95:621-4. [DOI: 10.1016/j.fertnstert.2010.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 09/25/2010] [Accepted: 10/12/2010] [Indexed: 12/20/2022]
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Wang JL, Wang HG, Gao HQ, Zhai GX, Chang P, Chen YG. Endothelial nitric oxide synthase polymorphisms and erectile dysfunction: a meta-analysis. J Sex Med 2010; 7:3889-98. [PMID: 20722785 DOI: 10.1111/j.1743-6109.2010.01968.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: 11/27/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common disorder noted for affecting quality of life. Several studies have reported the influence of endothelial nitric oxide synthase (eNOS) polymorphisms on ED susceptibility. However, results of association studies with individually low statistical power are conflicting. AIM Our study aimed to carry out a meta-analysis estimating the association between eNOS variants and the risk of ED. METHODS Studies regarding the association between eNOS polymorphisms and ED were searched in Medline and Embase databases. The relevant studies that met the inclusion criteria were eligible for the analysis. MAIN OUTCOME MEASURES Five genetic models and a generalized odds ratio (OR(G) ) were used to estimate the association between eNOS G894T and variable number of 27-bp tandem repeats in intron 4 (4 VNTR) and the risk of ED. RESULTS Nine articles were included in our meta-analysis. Overall, significant association between the 894T variant and an increased risk of ED was derived for all genetic contrasts except for the recessive model (allele contrast: OR = 1.64, 95% confidence interval [CI]: 1.03-2.60). The meta-analysis based on the OR(G) also produced significant results: OR(G) = 1.64, 95% CI: 1.03-2.61. Significant heterogeneity and publication bias were detected. The cumulative meta-analysis showed the OR increased from 2003 to 2009 and then declined in 2010. Instability in the relative change of OR was observed. Regarding 4 VNTR and its association with ED, the overall analysis showed a lack of significant association (OR = 0.96, 95% CI: 0.72-1.28). No evidence for heterogeneity among studies was observed. Subgroup analysis by ethnicity and recruitment strategy also yielded nonsignificant results. CONCLUSION The result supports that G894T variant is associated with an increase in the risk of ED. No evidence for a significant association between 4VNTR and ED is observed. The results of the present meta-analysis should be interpreted with caution. Further confirmation in large and well-designed studies is needed.
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Affiliation(s)
- Jia-Li Wang
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, China
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Andersen ML, Guindalini C, Santos-Silva R, Bittencourt LR, Tufik S. Angiotensin-Converting Enzyme Polymorphism and Erectile Dysfunction Complaints in the Brazilian Population. J Sex Med 2010; 7:2791-7. [DOI: 10.1111/j.1743-6109.2010.01796.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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