Hypertension and obesity comorbidities increases coronary risk, affects domains of sexual function and sexual quality of life

About 25% of the world's adult population suffers from arterial hypertension with about 1.5 billion estimated to develop hypertension by 2025. Hypertensive patients have been reported to have a higher risk of developing diabetes and sexual dysfunction. Hypertension have been linked with lubricative and orgasmic difficulties in females, as wel as ED and vascular disease in men. Obesity has also been linked to ED in diabetic males as well as several aspects of female sexuality. Hypertension and obesity are closely related, each occurring in greater frequency with the other, it is only logical to think that comorbidities of obesity and hypertension could increase the risk of cardiovascular disease and SD. This research looks at the relationship between hypertension and obesity comorbidities and its association with sexual function in type II diabetics. Diabetic patients who were at least 18 years old and were engaged in a stable heterosexual relationships for at least 1 year were recruited for this study. Participants were categorized into the -HYP/-OB, +HYP/-OB and the +HYP/+OB groups. Sexual function was assessed using the GRISS-M and GRIS-F for the diabetic males and females respectively. Early morning fasting blood samples was used in lipid profile as well as FBG assay. The Coronary risk was estimated as Total/HDL Cholesterol. Triglyceride levels and coronary risk were highest in the +HYP/+OBES group, followed by the +HYP/-OBES group, with the -HYP/-OBES group recording the lowest levels. PE and infrequency recorded the highest score among the +HYP/+OBES group with the +HYP/-OBES group recording the lowest scores. SQoL was highest amongst the -HYP/-OBES group, with the +HYP/+OBES group recording the lowest scores. Anorgasmia and avoidance increased along the shades of HYP/OBES groups. Comorbidities of hypertension and obesity increases the risk of coronary disease, affects some domains of sexual function and decreases the SQoL of diabetics.

The inter-relational effect of metabolic syndrome and sexual dysfunction on hypogonadism in type II diabetic men

We sought to establish the interplay of metabolic syndrome (MetS) and/or sexual dysfunction (SD) on hypogonadism. Sexual functioning was assessed using Golombok Rust Inventory of Sexual Satisfaction in 274 consecutive diabetic men visiting the diabetic clinic of the Tema General Hospital between November 2010 and March 2011. MetS was assessed employing the criteria of World Health Organization, International Diabetic Federation and the National Cholesterol Education Program Adult Treatment Panel III while testosterone levels were estimated. The mean ages and duration of diabetes from this study were 59.9±11.3 and 6.8±5.9 years, respectively. The prevalence of hypogonadism was 7.3%, with the -SD/+MetS subjects showing the highest prevalence of hypogonadism, irrespective of the criteria used. Additionally, subjects with MetS and its components had a significantly lower level of testosterone compared with those without MetS and its components. Using standard nine-point scale, it was observed that subjects who avoided sexual act had significantly (P=0.0410) lower testosterone values (5.8±2.3 ng ml^-1) than subjects who did not avoid sexual act (6.4±2.6 ng ml^-1). MetS alone impacted more on hypogonadism than SD alone or both conditions altogether.

Sexual dysfunction and sexual quality of life among the physically challenged in the Kumasi metropolis, Ghana

Background

Despite the fact that the physically disabled have difficulties in many aspects of their lives, including sexuality, society often ignores these needs or assume that they have no such needs. This cross-sectional study therefore seeks to determine the prevalence of sexual dysfunction (SD) and its impact on the quality of life among persons with physical disability residing in the Kumasi metropolis, Ghana.

Method

This study was conducted among 235 persons with physical disability dwelling in communities within the Kumasi metropolis, Ghana between September 2011 and April 2012. All participants were evaluated by using a semi-structured questionnaire, the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire and the Sexual Quality of Life questionnaire (SQoL). Self-designed semi-structured questionnaire was also administered to each consented study participant for socio-demographic information.

Results

The response rates were 72% and 63.6% for male and female respectively. The age range of the male was 19–74 years with 61.1% being married whilst the age range of the female was 20–66 years with 54.3% being married. 30% and 7.1% of the male and female respectively consumed alcohol beverage. The mean Sexual quality of life (SQoL) score was slightly higher in the females (57.7 ± 15.8), ranging from 25.6 to 97.8. Univariate analysis of the male data showed that the only significant factor that tends to increase the male SD was alcohol (OR: 24.6; CI: 1.4 - 14.9; p = 0.0071). The prevalence of SD was higher among the female populace (65.7%) compared to the 64.4% for the male populace though very closely comparable. Except for non-communication (NC) and anorgasmia (impotence in males), all other areas of difficulty had higher percentages in males than females.

Conclusion

The prevalence of sexual dysfunction among the physically challenged is comparable to prevalence rates in the able male and female population. This could impact significantly on their self-esteem and quality of life via avoidance, impotence and vaginismus thereby causing emotional distress leading to relationship problems. Alcohol increases the risk of developing SD by five-fold in physically challenged men.

Association between metabolic syndrome and sexual dysfunction among men with clinically diagnosed diabetes

BACKGROUND

The worldwide epidemic of diabetes and obesity has resulted in a rapid upsurge in the prevalence of metabolic syndrome (MetS). MetS makes the individual liable to endothelial dysfunction which can initiate sexual dysfunction (SD). This study assessed the association between MetS and SD among clinically diagnosed diabetic subjects in Tema, Greater Accra Region of Ghana.

METHOD

Sexual functioning was assessed using Golombok Rust Inventory of Sexual Satisfaction in 300 consecutive diabetic men visiting the diabetic clinic of Tema General Hospital between November, 2010 and March, 2011. Anthropometric data including waist and hip circumference as well as blood pressure were measured. The levels of fasting blood glucose and serum lipid profile were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study.

RESULTS

The response rate was 91.3% out of the 300 subjects recruited for the study. Those with SD were significantly older and had diabetes for a longer period as compared to those without SD. The prevalence of MetS as defined by the various criteria was 78.8%, 43.4% and 51.8% for WHO, NCEP ATP III and IDF respectively. Central obesity (p = 0.0482) and raised blood pressure (p = 0.0309) are the significant MetS components when the studied population was stratified according to sexual functioning. Generally, SD as well as its sub-scales correlate positively with age, blood pressure, duration of diabetes and MetS score. Whereas TC and LDL-c correlated positively with non-communication, TG correlates positively with avoidance and infrequency.

CONCLUSION

SD and its sub-scales have a direct relationship with duration of diabetes, blood pressure and MetS score from this study. Central obesity and raised blood pressure seem to be the link between MetS and SD among this clinically diagnosed diabetic subjects.

Determinants of sexual dysfunction among clinically diagnosed diabetic patients

BACKGROUND

Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana.

METHOD

Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study.

RESULTS

Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference.

CONCLUSION

SD rate from this study is high but similar to that reported among self-reported diabetic patients in Kumasi, Ghana and vary according to the condition and age. The determinants of SD from this study are income level, exercise, obesity, higher perception of "desirable" and "too short" IELT.

Sexual dysfunction among married couples living in Kumasi metropolis, Ghana

Background

Sexuality and its manifestation constitute some of the most complex of human behaviour and its disorders are encountered in community. Sexual dysfunction is more prevalent in women than in men. While studies examining sexual dysfunction among males and females in Ghana exist, there are no studies relating sexual problems in males and females as dyadic units. This study therefore investigated the prevalence and type of sexual disorders among married couples.

Method

The study participants consisted of married couples between the ages of 19 and 66 living in the province of Kumasi, Ghana. Socio-demographic information and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaires were administered to 200 couples who consented to take part in the study. All 28 questions of the GRISS are answered on a five-point (Likert type) scale from "always", through "usually', "sometimes", and "hardly ever", to "never". Responses are summed up to give a total raw score ranging from 28-140. The total score and subscale scores are transformed using a standard nine point scale, with high scores indicating greater problems. Scores of five or more are considered to indicate SD. The study was conducted between July and September 2010.

Results

Out of a total of 200 married couples, 179 completed their questionnaires resulting in a response rate of 89.5%. The mean age of the participating couples as well as the mean duration of marriage was 34.8 ± 8.6 years and 7.8 ± 7.6 years respectively. The husbands (37.1 ± 8.6) were significantly older (p < 0.0001) than their corresponding wives (32.5 ± 7.9). After adjusting for age, 13-18 years of marriage life poses about 10 times significant risk of developing SD compared to 1-6 years of married life among the wives (OR: 10.8; CI: 1.1 - 49.1; p = 0.04). The total scores (6.0) as well as the percentage above the cut-off (59.2) obtained by the husbands compared to the total score (6.2) and the percentage above cut-off (61.5) obtained by the wives, indicates the likely presence of sexual dysfunction. The prevalence of impotence and premature ejaculation were 60.9% and 65.4% respectively from this study and the prevalence of vaginismus and anorgasmia were 69.3% and 74.9% respectively. The highest prevalence of SD subscales among the men was dissatisfaction with sexual act followed by infrequency, whereas the highest among the women was infrequency followed by anorgasmia. Dissatisfaction with sexual intercourse among men correlated positively with anorgasmia and wife's non-sensuality and infrequency of sex.

Conclusion

The prevalence of sexual dysfunction in married couples is comparable to prevalence rates in the general male and female population and is further worsened by duration of marriage. This could impact significantly on a couple's self-esteem and overall quality of life.

Sexual dysfunction among Ghanaian men presenting with various medical conditions

BACKGROUND

Several medical conditions can affect and disrupt human sexuality. The alteration of sexuality in these medical conditions often hinder effective communication and empathy between the patients and their sexual partners because of cultural attitudes, social norms and negative feelings such as anxiety and guilt. Validated and standardized sexual inventories might therefore help resolve this problem. The objective of this cross-sectional study was to obtain data on the prevalence of male sexual dysfunction (SD) among Ghanaians with various medical conditions residing in Kumasi.

METHODS

The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was administered to 150 Ghanaian men with various medical conditions between 19 and 66 years old (mean ± standard deviation: 40.01 ± 12.32 years) domiciled in the Kumasi metropolis.

RESULTS

Out of the total 150 questionnaires administered, 105 (70.0%) men returned the questionnaires. Questionnaires from 3 men were incomplete, leaving 102 complete and evaluable questionnaires, indicating a 68.0% response rate. Of the remaining 102 men, 88.2% were married, 70.6% had attained higher education, 88.2% were non-smokers. Whereas 54.9% were engaged in exercise, 61.8% indulged in alcoholic beverages. The prevalence of the various medical conditions include: diabetes (18%), hypertension (24.5%), migraine (11.8%), ulcer (7.8%), surgery (6.9%), STD (3.9) and others (26.5%). The prevalence of SD among the respondents in the study was 59.8%. The highest prevalence of SD was seen among ulcer patients (100%), followed by patients who have undergone surgery (75%), diabetes (70%), hypertension (50%), STD (50%) and the lowest was seen among migraine patients (41.7%).

CONCLUSIONS

SD rate is high among Ghanaian men with medical conditions (about 60%) and vary according to the condition and age.