Prevalence of erectile dysfunction among young adults: results of a large-scale survey.
ABSTRACT Erectile dysfunction (ED) can be an early and first sign of an underlying systemic disease. A screening program is offered by the Medical services of the Israel Defense Force for career servicemen at the Staff Periodic Examination Center (SPEC) aimed at early detection of morbidity. The Sexual Human Inventory for Males (SHIM) questionnaire was introduced to these men in order to identify ED, to offer men with ED suitable treatment options, and to investigate underlying systemic diseases.
To provide epidemiological data regarding the prevalence of ED among a large-scale young adult population.
Subjects aged 25-50 years are undergoing a routine check-up at SPEC. Blood samples, physiological measures, demographic variables, information on health status and smoking habits are recorded and documented. The SHIM self-administrated questionnaire was used to characterize ED.
During 2001-2003, 11,914 males reported to SPEC (average age 34.8 +/- 7.1 years). Five thousand eight hundred thirty-six of them chose to answer the SHIM questionnaire (compliance of 48.9%). According to the SHIM scores, at least one out of three men (26.9%) suffered from ED (19%, 7%, and 1% had mild, moderate, and severe ED, respectively). ED was prevalent also among young adults: 22.1% of males under-40 had low SHIM scores (<21). Severity of ED correlated with age and diabetes mellitus.
In light of these results, we conclude that ED is a major health concern among young men as well. Incorporating questions regarding sexual health in a routine check-up may encourage more men to seek treatment, not only for ED, but also for underlying diseases.
- SourceAvailable from: Ashok Agarwal
Chapter: Male Factor Infertility01/2014;
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ABSTRACT: Surrogate partner therapy (SPT) is a controversial and often misunderstood practice. The aim of this study was to review the history and evidence-based literature regarding SPT, describe and provide a model for ethical SPT practice, and present two case examples illustrating ethical concerns. Literature review and report of clinical experience were the methods used. Results of literature review and clinical experience were assessed for this study. Sex therapy pioneers Masters and Johnson introduced surrogacy in sex therapy; however, there is a lack of published evidence supporting treatment efficacy and ethico-legal questions have limited the practice from becoming a common intervention. SPT can be an effective intervention that may enhance sexual medicine practice. However, SPT must be offered according to legal, professional, and ethical standards. Sexual medicine practitioners should consider SPT based on the ethical paradigms offered, and sex therapy practices utilizing SPT should collect and publish outcome data. Rosenbaum T, Aloni R, and Heruti R. Surrogate partner therapy: Ethical considerations in sexual medicine. J Sex Med **;**:**-**.Journal of Sexual Medicine 11/2013; · 3.15 Impact Factor
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ABSTRACT: Insulin resistance (IR) triggers endothelial dysfunction, which contributes to erectile dysfunction (ED) and cardiovascular disease. To evaluate whether IR was related to ED in young adult patients. A total of 283 consecutive men complaining of ED at least six months were enrolled, with a full medical history, physical examination, and laboratory tests collected. Quantitative Insulin Sensitivity Check Index (QUICKI) was used to determine IR. The severity of ED was assessed by IIEF-5 questionnaire. Endothelial function was assessed by ultrasonographic examination of brachial artery flow mediated dilation (FMD). IR was detected in 52% patients. Subjects with IR had significant higher total cholesterol, triglycerides, low density lipoprotein-cholesterol (LDL-c), glycated haemoglobin (HBA1c), high sensitivity C-reactive protein (hs-CRP) and body mass index (BMI), but showed significant lower IIEF-5 score, FMD%, high density lipoprotein -cholesterol (HDL-c), testosterone, sex hormone binding globulin (SHBG) levels than patients without IR. Multiple regression analysis showed QUICKI and testosterone were independent predictors of IIEF-5 score. Furthermore, the incidence of IR was correlated with the severity of ED. Compared with other CVFs, IR was found as the most prevalent in our subjects. Besides, IR was independently associated with ED and its severity, suggesting an adverse effect of insulin resistance on erectile function.PLoS ONE 12/2013; 8(12):e83951. · 3.53 Impact Factor