Background: Depression and erectile dysfunction (ED) are common in aging and the two conditions often co-exist. These conditions have been shown to be associated with hormonal changes in men. This paper examines the association between depression, ED, and hormonal status of men aged above 50 years in the Klang Valley, Malaysia. Methods: Five hundred men aged 50 years and above were randomly selected via the electoral roll and invited to participate in a community-based study on men's health: 351 men responded. Respondents were interviewed individually based on a self-developed questionnaire, which included information on socio-demographic data. Erectile function was measured using the International Index for Erectile Function-5 (IIEF-5) and depression was measured using the 15 item Geriatric Depression Scale (GDS-15). Results: Sixty-nine percent of the men were diagnosed with ED. Mean GDS score was 3.33 (SD = 3.29). Nineteen percent (n = 67) of the men had abnormal levels of testosterone ( 11 nmol/l) and this comprised 73% of men with ED (n = 49) and 27% of men without ED (n = 18). There was no significant association between testosterone level and ED (x 2 = 0.68, p = 0.41). Significant association was found between depression (GDS ! 5) and men with ED (x 2 = 6.07, p = 0.014). Sex hormone binding globulin and luteinising hormone were negatively correlated with erectile function. Results of the multiple linear regression showed that age and depression are predictors of erectile function. Conclusion: Depression and ED should be screened for when either exists in the male patient and treatment directed accordingly.

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Background: To study the effect of testosterone treatment on markers of inflammation in hypogonadal men with MS.Methods: 20 men with MS (IDF criteria) and LOH (total testosterone (TT) < 11 nmol/l) received 3 injections of testosterone undecanoate (Nebido) or placebo. Patients were divided into two groups according to TT levels 12 weeks after the third injection of Nebido/placebo: in group 1 (n = 13) TT was normalized to 15.75 [13.5-17.3] nmol/l and in group 2 (n = 7), TT was not normalized (8.3 [6.5-10.2] nmol/l). Interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor alpha (TNF alpha) were measured before and after 30 weeks. Statistical analysis was performed using Wilcoxon test.Results: In group 1, IL-6 decreased from 4.6 [3.0-3.8] to 3.8 [2.8-3.0] pg/ml (normal range (NR) < 4.1) (p = 0.04), TNF alpha decreased from 15.2 [12.3-15.3] to 12.2 [10.7-10.0] pg/ml (NR 0-8.21) (p = 0.005) and CRP decreased from 3.8 [1.4-4.1] to 1.9 [0.6-3.1] mg/L (NR 0-5) (p = 0.01). In group 2, there were no significant changes in IL-6, TNF alpha and CRP: IL-6 was 3.2 [2.8-3.2] and 3.2 [2.7-3.3] pg/ml (normal range (NR) < 4.1) (p = 1), TNF alpha was 13.2 [12.1-13.9] and 12.0 [11.5-12.1] pg/ml (NR 0-8.21) (p = 0.45) and CRP was 4.0 [0.6-6] and 4.9 [0.7-8.5] mg/L (NR 0-5) (p = 0.22) before and after 30 weeks of treatment, respectively.Conclusion: LOH correction in men with MS has beneficial effect on the process of chronic inflammation.17 Is sexual health the portal to men's health? -the experience of a primary men's health practice Background: The difference in health statistics between men and women is obvious in genderspecific medicine. Some of the reasons cited for this difference include men's attitude towards health and also a less than proactive approach of the medical community towards men's health. The Singapore Men's Health Clinic (SMHC) is a private community based men-only primary health care facility in practice since 2003. This study is to review the conditions that bring patients to the clinic and to examine the role the practice can play in men's health.Method: The presenting diagnoses of patients seen by the SMHC at locations where the clinic was first started and another after a move to new premises are reviewed. The case records of the first consecutive new patients seen in both locations for almost identical time periods (Location A: 17/11/03-17/06/04; Location B: 3/10/05-8/4/06) were retrieved. Relevant data are presented.Results: Fewer new patients were seen at B than at A (n = 140 vs. n = 482) although the hours of operation of the clinic were the same. The age distribution of patients was identical. Problems related to sexual health were the main diagnoses among patients at A and B (x 2 = 3.65) constituting 72.4% of all presenting

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