Awareness and knowledge of andropause among Chinese males in Hong Kong

Characterizing patient attitudes and beliefs towards testosterone therapy in Veterans Affairs: A qualitative study

OBJECTIVE

We examined patient attitudes and beliefs and provider perspectives on patients' attitudes and beliefs towards testosterone therapy in Veterans Affairs (VA).

METHODS

We used a thematic analysis approach to understand variation in patient attitudes and beliefs towards testosterone at six VA sites with high and low levels of testosterone prescribing in VA. Semi-structured phone interviews with 18 patients and 22 providers at these sites were transcribed and coded using a priori theoretical constructs and emergent themes. A cross-case matrix of coded data was used to evaluate themes related to patient-level factors.

RESULTS

Patients' beliefs toward testosterone did not differ across sites. Patients, not providers, generally initiated conversations about testosterone. We identified five key domains related to patient beliefs and provider perceived patient beliefs towards testosterone: reasons for initiating testosterone, patient information sources and expectations about testosterone, receptivity towards discontinuation of testosterone, patient/provider engagement in information sharing, and self-advocacy by the patients in decision-making.

CONCLUSIONS

Patient factors play an important role in testosterone prescribing decisions.

PRACTICE IMPLICATIONS

By considering these patient factors, providers can potentially help create a partnership with patients and foster shared decision-making for testosterone and other, similar medications.

Androgen Deficiency in Aging Males: Translation and Validation Study of the Iranian Version

Background:

Considering the importance of psychometric evaluation of the male sex hormone deficiency questionnaire by Iranian nurses, this study aimed to determine the translation and validation of the Iranian version of the Androgen Deficiency in Aging Males (ADAM) questionnaire.

Materials and Methods:

This study was cross-sectional. After obtaining permission from the instrument maker, translating it into Farsi, retranslated it into English, and determining validity and reliability. The study population was 200 Iranian men who admitted to hospitals affiliated with Iran University of medical science and were older than 50 years and selected by convenience sampling method. They were evaluated and monitored based on the Iranian version of the ADAM questionnaire. Sensitivity and specificity were assessed and analyzed by Rock Chart analysis. Descriptive and analytical statistical tests were used at a significant level of 0.05.

Results:

Findings showed that the Iranian version of the ADAM questionnaire had good face validity. Results showed that Cronbach's alpha in this questionnaire was 0.93, which indicates high reliability, and all the valid questionnaires were reported for the Scale-Content Validity Index (SCVI) calculation. Hence, the questionnaire has good content validity. The Iranian version of the ADAM questionnaire has a sensitivity of 93.85% and a specificity of 77.14% at the cut-off point of 2.2, indicating high sensitivity and specificity.

Conclusions:

The Iranian version of the ADAM questionnaire is valid and reliable and has high sensitivity and specificity. Nurses can also use it as an adjunctive scale to screen andropause men over 50 years of age.

Environmental Factors-Induced Oxidative Stress: Hormonal and Molecular Pathway Disruptions in Hypogonadism and Erectile Dysfunction

Hypogonadism is an endocrine disorder characterized by inadequate serum testosterone production by the Leydig cells of the testis. It is triggered by alterations in the hypothalamic–pituitary–gonadal axis. Erectile dysfunction (ED) is another common disorder in men that involves an alteration in erectile response–organic, relational, or psychological. The incidence of hypogonadism and ED is common in men aged over 40 years. Hypogonadism (including late-onset hypogonadism) and ED may be linked to several environmental factors-induced oxidative stresses. The factors mainly include exposure to pesticides, radiation, air pollution, heavy metals and other endocrine-disrupting chemicals. These environmental risk factors may induce oxidative stress and lead to hormonal dysfunctions. To better understand the subject, the study used many keywords, including “hypogonadism”, “late-onset hypogonadism”, “testosterone”, “erectile dysfunction”, “reactive oxygen species”, “oxidative stress”, and “environmental pollution” in major online databases, such as SCOPUS and PUBMED to extract relevant scientific information. Based on these parameters, this review summarizes a comprehensive insight into the important environmental issues that may have a direct or indirect association with hypogonadism and ED in men. The study concludes that environmental factors-induced oxidative stress may cause infertility in men. The hypothesis and outcomes were reviewed critically, and the mechanistic approaches are applied through oxidant-sensitive pathways. This study also provides reccomendations on future therapeutic interventions and protective measures against such adverse environmental factors-induced hypogonadism and ED.

Assessment of the validity and reliability of a questionnaire on knowledge and attitude of general practitioners about andropause

BACKGROUND AND OBJECTIVE

Andropause is one of the clinical and biochemical syndromes in aging men associated with the decrease in serum testosterone levels. With the increase in aging male population, life span in Iran, and focus on quality of life, andropause will become a major health issue that needs to be addressed in order to prevent disability. General practitioners, as the first level of health care providers, are in the best position to assess their knowledge and attitude about andropause period, so a structured instrument is necessary to assess them. This study aimed at the assessment of the validity and reliability of the self-made questionnaire on knowledge and attitude of general practitioners about andropause.

METHOD

This is a descriptive study done on 402 general physicians working in public and private sectors. The instrument used was a self-administered questionnaire that was developed based on the literature review and recourses available on andropause and was designed to find out the level of knowledge and attitude of andropause. In order to determine the content and face validity of the questionnaire, judgments of experts were used. Cronbach's coefficient was used to determine the reliability of the questionnaire. SPSS 18 (SPSS Inc, Chicago, IL) was used to analyze the data.

RESULTS

Content and face validity of the questionnaire was confirmed by experts. The reliability was confirmed by Cronbach's alpha of (0).895 for the part on knowledge and (0).839 for the part on attitude.

CONCLUSION

Based on the results of the study, this questionnaire had appropriate validity and reliability to assess the knowledge and attitude of general practitioners about andropause.

Factors that may be influencing the rise in prescription testosterone replacement therapy in adult men: a qualitative study

OBJECTIVE

To explore and describe the factors that may be influencing the rise of prescribing and use of testosterone replacement therapy (TRT) in adult men.

DESIGN

A rapid qualitative research design using semi-structured interviews with providers and patients.

SETTING

Ontario, Canada.

PARTICIPANTS

Nine men who have used TRT (referred to as "patients"), and six primary care clinicians and seven specialists (collectively referred to as "providers") who prescribed or administered TRT.

METHOD

Patients' and providers' perspectives were investigated through semi-structured interviews. A purposive sampling approach was used to recruit all participants. We conducted qualitative analysis using the framework approach for applied health research.

MAIN FINDINGS

Participants perceived the following factors to have influenced TRT prescriptions and use in adult men: provider factors (diagnostic ambiguity of age-related hypogonadism and beliefs about appropriateness of TRT) and patient factors (access to information on TRT and drug seeking behavior). They perceived that these factors have perpetuated a rise in prescription in the absence of clear clinical guidelines and unclear research evidence on the safety and efficacy of TRT.

CONCLUSION

The findings of this study highlight that much work still needs to be done to improve diagnostic accuracy and encourage appropriate TRT prescription in adult men. In addition, both patients and providers need more information about the risks and long-term effects of TRT in men.

Different levels of awareness and knowledge of male climacteric in female nurses and female office workers

OBJECTIVE

The objective of this study was to examine levels of awareness and knowledge regarding male climacteric or andropause in Japanese women. We also examined whether there are differences in these levels between nurses as a health profession group and office workers as a general population group.

METHODS

Two thousand and eight hundred female registered nurses and women with office-related general occupations aged 20-65 years in Japan completed health questionnaires regarding awareness and knowledge of male climacteric, including male menopausal symptoms and treatments.

RESULTS

The proportion in women who had heard of the term male climacteric in nurses was significantly higher than that in office workers. Nurses with past or current experience of menopausal symptoms were likely to recognize male climacteric. Nurses also had a higher level of knowledge than did office workers regarding male menopausal symptoms. High proportions of both nurses and office workers acknowledged depressed mood, irritability, nervousness and sleep problems as male menopausal symptoms. The proportions of women with sympathy for men with male climacteric were high in women with experience of past or current menopausal symptoms and in women who were close to men who suffered from menopausal symptoms.

CONCLUSIONS

Nurses with past or current experience of menopausal symptoms had high levels of awareness and knowledge of male climacteric. To spread more information and knowledge regarding male climacteric, provision of education for these nurses may be needed.

Validity and reliability of male andropause symptoms self-assessment questionnaire among elderly males in Khuzestan province of Iran

Background:

Andropause is a condition of decreasing testosterone in men that usually begins to occur at about 40 years of age. Many men find it difficult to acknowledge there may be a problem by refusing to even talk about the symptoms.

Aims:

The study was conducted to the standards of MASSQ (2012) within male older adults to introduce a relevant criterion.

Materials and Methods:

About 382 men with age range of 50-80 and with the mean age of 65.3 ± 2.32 were sampled with the cluster-ratio sampling method from the eight cities of Khuzestan province in southwestern Iran. The aged samples replied to the 25 items of MASSQ.

Results:

Coefficients of Cronbach's alpha (α = 0.89), split-half (0.91), convergent validity (0.72), divergent validity (−0.32), and criterion validity (0.67) were estimated, which were significant at P < 0.01. The exploratory factor analysis demonstrated that the 25-items of MASSQ for aged samples are organized into four factors (sexual, somatic, psychic, and behavioral) which clarify 79% of the scale's variance. Second-order confirmatory factor analysis pointed out that the factors are well-matched up onto a principal factor. Consequently, the four-factor model was well appropriate for the data by the fit index techniques for adjusting the scale [adjusted goodness of fit index = 0.92, goodness-of-fit statistic = 0.91, root mean square error of approximation = 0.006, incremental fit index = 0.94, normed fit index = 0.91, comparative fit index = 0.97].

Conclusions:

The results pointed to the well-adjusted reliability and validity of MASSQ and its usefulness for the relevant studies as well.