Association among hypogonadism, quality of life and erectile dysfunction in middle-aged and aged male in Taiwan

Hwang, Thomas I‐Sheng; Lo, H.-C.; Tsai, Tsung-Neng; Chiou, Hung Yi

doi:10.1038/sj.ijir.3901480

Cited by 27 publications

(18 citation statements)

References 28 publications

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“…Furthermore, hypogonadism is common in elderly men and men who have PCa: the symptoms of hypogonadism, such as depression, erectile dysfunction (ED), and lower urinary tract symptoms, can impair a man's quality of life (QoL) [7]. Therefore, androgens and AR play a critical role in management of elderly men with PCa.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Sexual Health in the Aging of PCa Survivors

Gacci

Baldi

Detti

et al. 2014

International Journal of Endocrinology

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Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.

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Section: Introductionmentioning

confidence: 99%

Quality of Life and Sexual Health in the Aging of PCa Survivors

Gacci

Baldi

Detti

et al. 2014

International Journal of Endocrinology

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“…14 IIEF was used to better define the erectile function. The possible scores for the IIEF-5 range from 5 to 25, and ED was classified into five categories based on the scores: severe (5-7), moderate (8)(9)(10)(11), mild to moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21) and no ED (22)(23)(24)(25). 15 …”

Section: Hrqol Measuresmentioning

confidence: 99%

“…8 Furthermore, hypogonadism is very common in elderly men and men who have PCa: the symptoms of hypogonadism, such as depression, erectile dysfunction (ED) and lower urinary tract symptoms, can significantly impair a man's QOL. 9 In a recent retrospective study, such as in several recent reviews, the authors suggested that testosterone replacement therapy can be achieved in hypogonadal men undergoing treatments for PCa. [10][11][12][13] The aim of the present study is to evaluate the influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy (RP) for clinically localized PCa.…”

Section: Introductionmentioning

confidence: 99%

Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer

Gacci

Corona

Apolone

et al. 2010

Prostate Cancer Prostatic Dis

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The aim of the present study was to evaluate how serum testosterone level (T) can affect urinary continence and erectile function in patients undergoing radical prostatectomy (RP). We included 257 patients with clinically localized prostate cancer, those who had filled out preoperative quality of life questionnaires (University of California, Los Angeles Prostate Cancer Index, International Index of Erectile Function (IIEF)), and those who had T and total PSA sampled the day before surgery. We calculated correlations between T and age, body mass index (BMI), PSA, urinary function or bother (UF, UB) and sexual function or bother (SF, SB) and IIEF-5 in the whole population and in sub-populations with normal (X10.4 nmol l À1 ) and low (o10.4 ng ml À1 ) T using Pearson's and Spearman's correlation coefficients. We evaluated differences in these parameters between patients with low and normal T using the unpaired samples t-test and Mann-Whitney test, and finally the correlation between UF and SF, UB and SB, and between PSA and T in the overall population, and separately in patients with low and normal T using the Pearson's correlation coefficient. Mean preoperative T was 13.5 nmol l À1 and 23.7% of patients presented a low T. Mean age, mean BMI and mean preoperative total PSA at RP were 64.3 years, 25.9 kg m À2 and 9.0 ng ml À1 , respectively. BMI was negatively correlated with T in the overall population (r ¼ À0.266; P ¼ 0.02); moreover, patients with normal T presented lower BMI compared with patients with low T (25.7 vs 27.6: P ¼ 0.02). We found a significant correlation between SF scores and T in patients with normal T (r ¼ 0.1777: P ¼ 0.05). SF was significantly higher in patients with normal T compared with those with low T (74.8 vs 64.8: P ¼ 0.05). Furthermore, UF and UB were significantly correlated with SF (r ¼ 0.2544: Po0.01) and SB (r ¼ 0.2512: P ¼ 0.01), respectively, in men with normal T. Serum T was significantly correlated with PSA in men with low T (r ¼ 0.3874: P ¼ 0.0029), whereas this correlation was missed in the whole population and in men with normal T. The correlation between preoperative PSA and T in men with low T is in agreement with the 'saturation' model proposed by Morgentaler. The correlation between basal T and preoperative erectile function and urinary continence underlines the importance of assessing T before RP.

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“…Within the follow-up data of the Massachusetts Male Aging Study, total testosterone declined 0.8%/year (Feldman et al 2002), whereas both free and albumin-bound testosterone declined about 1.4–2%/year (Feldman et al 2002; Vermeulen et al 1991). In our previous study (Hwang et al 2007), we found a significant association between low levels of serum calculated free testosterone (cFT), bioavailable testosterone, and severity of ED in middle-aged and aged males in Taiwan.…”

mentioning

confidence: 90%

Risk of Erectile Dysfunction Induced by Arsenic Exposure through Well Water Consumption in Taiwan

Hsieh

Hwang²,

Hsieh³

et al. 2008

Environ Health Perspect

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BackgroundErectile dysfunction (ED) has a profound impact on the quality of life of many men. Many risk factors are associated with ED, such as aging, sex hormone levels, hypertension, cardiovascular diseases, and diabetes mellitus. Arsenic exposure could damage peripheral vessels and increase the risk of cardiovascular disease. However, the relationship between arsenic exposure and ED has seldom been evaluated.ObjectivesIn this study we aimed to investigate whether exposure to arsenic enhances the risk of ED.MethodsWe recruited 177 males ≥ 50 years of age through health examinations conducted in three hospitals in Taiwan. We used a questionnaire (International Index of Erectile Function-5) to measure the level of erectile function. Sex hormones, including total testosterone and sex hormone–binding globulin, were determined by radioimmunoassay. We used another standardized questionnaire to collect background and behavioral information (e.g., cigarette smoking; alcohol, tea, or coffee drinking; and physical activity).ResultsThe prevalence of ED was greater in the arsenic-endemic area (83.3%) than in the non–arsenic-endemic area (66.7%). Subjects with arsenic exposure > 50 ppb had a significantly higher risk of developing ED than those with exposure ≤ 50 ppb, after adjusting for age, cigarette smoking, diabetes mellitus, hypertension, and cardiovascular disease [odds ratio (OR) = 3.4]. Results also showed that the risk of developing severe ED was drastically enhanced by arsenic exposure (OR = 7.5), after adjusting for free testosterone and traditional risk factors of ED.ConclusionsResults suggested that chronic arsenic exposure has a negative impact on erectile function.

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Association among hypogonadism, quality of life and erectile dysfunction in middle-aged and aged male in Taiwan

Cited by 27 publications

References 28 publications

Quality of Life and Sexual Health in the Aging of PCa Survivors

Quality of Life and Sexual Health in the Aging of PCa Survivors

Influence of serum testosterone on urinary continence and sexual activity in patients undergoing radical prostatectomy for clinically localized prostate cancer

Risk of Erectile Dysfunction Induced by Arsenic Exposure through Well Water Consumption in Taiwan

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