Sexual function and quality of life in Korean women with chronic renal failure on hemodialysis: case-control study.
ABSTRACT To assess sexual function and quality of life (QOL) in Korean women with chronic renal failure (CRF) receiving hemodialysis.
Between March 2006 and February 2007, we enrolled 38 consecutive patients between 30 and 64 years old (mean age, 46.1 years old). We enrolled 37 age-matched individuals who visited health promotion center in the study as controls. All were evaluated for estradiol, testosterone, prolactin, and follicle-stimulating hormone (FSH) levels. To obtain sexual function and QOL assessments, the patients and controls were asked to fill out the Female Sexual Function Index (FSFI) and the Medical Outcomes Study Short Form (SF-36).
The rate of menopause was significantly different between groups (78.9% in the patient group and 27.0% in the control group, P <0.001). The patient group had lower levels of estradiol and testosterone and higher levels of prolactin and FSH than the control groups (all P <0.05). Of the six domains in the FSFI questionnaire, scores of all domains, namely, desire, arousal, lubrication, orgasm, satisfaction, and pain were significantly lower in the patient group than in the control group (all P <0.05). Regarding the SF-36, the patient group had lower scores on physical functioning, role-physical functioning, role-emotional functioning, vitality, and general health perception (all P <0.05).
Hormone disturbances and early menopause are common in Korean women with CRF receiving hemodialysis. In addition, our findings suggest that these patients have higher disturbances in sexual function and QOL than the normal population.
Article: Di-(2 ethylhexyl) phthalate and flutamide alter gene expression in the testis of immature male rats.[show abstract] [hide abstract]
ABSTRACT: We previously demonstrated that the androgenic and anti-androgenic effects of endocrine disruptors (EDs) alter reproductive function and exert distinct effects on developing male reproductive organs. To further investigate these effects, we used an immature rat model to examine the effects of di-(2 ethylhexyl) phthalate (DEHP) and flutamide (Flu) on the male reproductive system. Immature male SD rats were treated daily with DEHP and Flu on postnatal days (PNDs) 21 to 35, in a dose-dependent manner. As results, the weights of the testes, prostate, and seminal vesicle and anogenital distances (AGD) decreased significantly in response to high doses of DEHP or Flu. Testosterone (T) levels significantly decreased in all DEHP- treated groups, whereas luteinizing hormone (LH) plasma levels were not altered by any of the two treatments at PND 36. However, treatment with DEHP or Flu induced histopathological changes in the testes, wherein degeneration and disorders of Leydig cells, germ cells and dilatation of tubular lumen were observed in a dose-dependent manner. Conversely, hyperplasia and denseness of Leydig, Sertoli and germ cells were observed in rats given with high doses of Flu. The results by cDNA microarray analysis indicated that 1,272 genes were up-regulated by more than two-fold, and 1,969 genes were down-regulated in response to DEHP, Flu or both EDs. These genes were selected based on their markedly increased or decreased expression levels. These genes have been also classified on the basis of gene ontology (e.g., steroid hormone biosynthetic process, regulation of transcription, signal transduction, metabolic process, biosynthetic process...). Significant decreases in gene expression were observed in steroidogenic genes (i.e., Star, Cyp11a1 and Hsd3b). In addition, the expression of a common set of target genes, including CaBP1, Vav2, Plcd1, Lhx1 and Isoc1, was altered following exposure to EDs, suggesting that they may be marker genes to screen for the anti-androgenic or androgenic effects of EDs. Overall, our results demonstrated that exposure to DEHP, Flu or both EDs resulted in a alteration of gene expression in the testes of immature male rats. Furthermore, the toxicological effects of these EDs on the male reproductive system resulted from their anti-androgenic effects. Taken together, these results provide a new insight into the molecular mechanisms underlying the detrimental impacts of EDs, in regards to anti-androgenic effects in humans and wildlife.Reproductive Biology and Endocrinology 09/2009; 7:104. · 2.05 Impact Factor
Article: Prevalence and correlates of self-reported sexual dysfunction in CKD: a meta-analysis of observational studies.[show abstract] [hide abstract]
ABSTRACT: Sexual dysfunction is an under-recognized problem in men and women with chronic kidney disease (CKD). The prevalence, correlates, and predictors of this condition in patients with CKD have not been evaluated comprehensively. Systematic review and meta-analysis. Patients treated using dialysis (dialysis patients), patients treated using transplant (transplant recipients), and patients with CKD not treated using dialysis or transplant (nondialysis nontransplant patients with CKD). Observational studies conducted in patients with CKD only or including a control group without CKD. Type of study population. Sexual dysfunction in men and women with CKD using validated tools, such as the International Index of Erectile Function, the Female Sexual Function Index (FSFI), or other measures as reported by study investigators. 50 studies (8,343 patients) of variable size (range, 16-1,023 patients) were included in this review. Almost all studies explored sexual dysfunction in men and specifically erectile dysfunction. The summary estimate of erectile dysfunction in men with CKD was 70% (95% CI, 62%-77%; 21 studies, 4,389 patients). Differences in reported prevalence rates of erectile dysfunction between different studies were attributable primarily to age, study populations, and type of study tool used to assess the presence of erectile dysfunction. In women, the reported prevalence of sexual dysfunction was assessed in only 306 patients from 2 studies and ranged from 30%-80%. Compared with the general population, women with CKD had a significantly lower overall FSFI score (8 studies or subgroups, 407 patients; mean difference, -9.28; 95% CI, -12.92 to -5.64). Increasing age, diabetes mellitus, and depression consistently were found to correlate with sexual dysfunction in 20 individual studies of patients with CKD using different methods. Suboptimal and lack of uniform assessment of outcome measures. Sexual dysfunction is highly prevalent in both men and women with CKD, especially among those on dialysis. Larger studies enrolling different ethnic groups, using validated study tools, and analyzing the influence of various factors on the development of sexual dysfunction are needed.American Journal of Kidney Diseases 10/2010; 56(4):670-85. · 5.43 Impact Factor