Article

The Effect of Fasting on Erectile Function and Sexual Desire on Men in the Month of Ramadan

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Abstract

To determine the effect of Ramadan intermittent fasting on erectile function (EF), sexual desire and serum hormone levels. Eligible male participants completed the two domains of International Index of Erectile Function (IIEF) questionnaire for EF and sexual desire. They also provided information on any known disease, treat­ment taking, smoking habits and frequency of sexual intercourse. Frequency of sexual intercourse, two domains of IIEF questionnaire, serum hormone levels, body weight before and four-weeks after the end of month of Ramadan were also recorded. Overall, 45 men, with a mean age of 37 ± 7.2 years, participated in the study. Frequency of sexual intercourse (P = .046), sexual desire (P = .002), body weight (P = .009) and serum follicle stimulating hormone (FSH) level (P = .016) decreased significantly at the end of month of Ramadan compared to baseline. No statistically significant differ­ences were found on EF (P = .714), serum testosterone (P = .847), luteinizing hormone (P = .876), estradiol (P = .098) and dehydroepiandrosterone sulfate levels (P = .290). Ramadan intermittent fasting might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level.

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... In overall 8 studies assessed the changes of Sex hormones (Testosterone, LH, FSH) among men during Ramadan fasting. Analysis of pooled data of participants did not show a significant change in Testosterone [1,17,20,30,32,36,42,44], LH [1,17,20,32,36,44], FSH [1,17,20,36,44], Prolactin [17,20] levels as it is shown in Fig 4. Heterogeneity of studies were high regarding Testosterone, LH, FSH, Prolactin levels. ...
... In overall 8 studies assessed the changes of Sex hormones (Testosterone, LH, FSH) among men during Ramadan fasting. Analysis of pooled data of participants did not show a significant change in Testosterone [1,17,20,30,32,36,42,44], LH [1,17,20,32,36,44], FSH [1,17,20,36,44], Prolactin [17,20] levels as it is shown in Fig 4. Heterogeneity of studies were high regarding Testosterone, LH, FSH, Prolactin levels. ...
... In overall 8 studies assessed the changes of Sex hormones (Testosterone, LH, FSH) among men during Ramadan fasting. Analysis of pooled data of participants did not show a significant change in Testosterone [1,17,20,30,32,36,42,44], LH [1,17,20,32,36,44], FSH [1,17,20,36,44], Prolactin [17,20] levels as it is shown in Fig 4. Heterogeneity of studies were high regarding Testosterone, LH, FSH, Prolactin levels. ...
Article
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Background Ramadan Intermittent Fasting (RIF) has the potential to alter hormonal levels in the body. This study investigates the impact of RIF on hormonal levels among healthy individuals during Ramadan. Methods A systematic review and meta-analysis of previously published studies were conducted, focusing on healthy non-athlete adults. The intervention examined was Ramadan Intermittent Fasting, and the primary outcomes assessed were changes in endocrine hormonal and biochemical parameters. The pooled effect measure was expressed as odds ratio (OR) and 95% confidence interval (CI) using the random-effects model. Results A total of 35 original articles were retrieved, with a combined sample size of 1,107 participants eligible for the meta-analysis. No significant relationship was found between pre- and post-Ramadan hormonal levels of T3, T4, TSH, FT3, FT4, Testosterone, LH, FSH, Prolactin, PTH, Calcium, and Phosphorus (P-value<0.05). However, a substantial decrease in morning cortisol levels was observed across the studies (P-value: 0.08, Hedges’ g = -2.14, 95% CI: -4.54, 0.27). Conclusions Ramadan Intermittent Fasting results in minimal hormonal changes and is a safe practice for healthy individuals. The fasting regimen appears to disrupt the circadian rhythm, leading to a decrease in morning cortisol levels.
... Even with no advice on lifestyle changes, there are consistent-albeit transient-reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity (Rouhani and Azadbakht, 2014). Ramadan intermittent fasting might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level (Talib et al., 2015). Remarkably, IF during early adulthood, and also during mid-life, was sufficient to extend lifespan, indicating a "memory" effect hormesis (a phenomenon by which "lowlevel" toxic stress elicits response mechanisms that protect against similar but higher-level stresses associated with aging). ...
... In humans, limited insights based on questionnaires are available in this regard. Dieting during Ramadan was suggested to be linked to reduced sexual activity levels (Talib et al., 2015). In contrast to these observations, one recent study suggested that two years CER intervention may be associated with increased libido in men, but a trend towards the opposite effect was detected in women exposed to CER . ...
Article
Several laboratory animal models have shown that dietary energy restriction (ER) can promote longevity and improve various health aspects in old age. However, whether the entire spectrum of ER-induced short- and long-term physiological and metabolic adaptions is translatable to humans remains to be determined. In this review article, we present recent evidence towards the elucidation of the impact of ER on brain physiology and in age-related neurodegenerative diseases. We also discuss modulatory influences of ER on metabolism and overall on human health, limitations of current experimental designs as well as future perspectives for ER trials in humans. Finally, we summarize signaling pathways and processes known to be affected by both aging and ER with a special emphasis on the link between ER and cellular proteostasis.
... Even with no advice on lifestyle changes, there are consistent-albeit transient-reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity [25] . Ramadan IF might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level [26] . Resistance training (weight lifting) in a fasted state affects the post-workout anabolic response to weight training more favorably than training after a fed-state, but only when a carbohydrate/protein/ leucine mixture was ingested following a heavy resistance training session [27] . ...
... A similar 132 exemption applies to older people who may find it hard to complete the entire Ramadan month 133 and may miss some fasting days. 134 135 Exclusion criteria 136 The following exclusion criteria were applied on retrieved articles to eliminate factors that may 137 incur potential methodological and quality issues: 1) studies that were exclusively conducted on 138 fasting children and adolescents (less than 18 years old), 2) studies that included patients with 139 different diseases or conditions who were observing RDIF including diabetes; 3) studies on the 140 effect of RDIF on Muslim athletes who were observing Ramadan fasting; 4) lack of full text after 141 contacting the respective authors; 5) studies that expressed changes in body weight using bar 142 graphs and curves, without reporting exact numerical values; 6) studies on pregnant and/or 143 lactating women who were observing Ramadan fasting; 7) studies that reported the post- 144 Ramadan measurement after passing one month or longer, as mounting evidence supports that 145 biochemical variables induced by RDIF disappear or return to the pre-fasting level after one 146 month of Ramadan cessation [21-23]; 8) case reports, abstracts, review articles, editorials, and 147 non-English-language articles; 9) unpublished, non-peer-reviewed data; all of which were 148 excluded from the quantitative and qualitative analysis; and 10) studies that involved special 149 dietary and physical activity plans during the fasting month. Articles were excluded from the 150 current analysis if they met any of the aforementioned criteria. ...
Article
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Purpose: Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on body weight have yielded conflicting results. Therefore, we conducted a systematic review and meta-analysis to estimate the effect size of body weight changes in healthy, nonathletic Muslims practicing Ramadan fasting, and to assess the effect of covariates such as age, sex, fasting time duration, season, and country, using subgroup analysis and meta-regression. Covariate adjustments were performed to explain the variability of weight change in response to Ramadan fasting. Methods: CINAHL, Cochrane, EBSCOhost, EMBASE, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science databases were searched from date of inception in 1950 to the end of August 2019. Results: Eighty-five studies, conducted in 25 countries during 1982-2019, were identified. RDIF yielded a significant, but small reduction in body weight (K = 85, number of subjects, N = 4176 (aged 16-80y), Hedges’ g = - 0.360, 95% confidence interval (CI): - 0.405 to - 0.315, I 2 = 45.6%), this effect size translates to difference in means of - 1.022 kg (95% CI: - 1.164 kg to - 0.880 kg). Regression analysis for moderator covariates revealed that fasting time (min/day) is a significant ( P <0.05) moderator for weight change at the end of Ramadan, while age and sex are not. Variable effects for the season and country were found. Conclusion: RDIF may confer a significant small reduction in body weight in non-athletic healthy people aged 16 years and above, directly associated with fasting time and variably correlated with the season, and country
... Even with no advice on lifestyle changes, there are consistent-albeit transient-reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity [18]. Ramadan intermittent fasting might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level [19]. Remarkably, IF during early adult hood, and also during mid-life, was sufficient to extend lifespan, indicating a "memory" effect Hormesis is a phenomenon by which "low-level" toxic stress elicits response mechanisms that protect against similar but higher-level stresses associated with aging. ...
Research
keto-diet and Intermittent Fasting (IF) (মধ্যবর্তী উপবাস) work especially well together, especially for weight loss and stable energy. A single 24-hour fast increased growth hormone by 2000% in men and 1300% in women. IF related health improvements are lipid profiles, osteoarthritis, healing of thrombophlebitis, healing of refractory dermal ulcers and tolerance of elective surgery. IF improved the chemotherapeutic response to various drugs in cancer. Alternative day fasting can reduce obesity-associated changes in body composition, fasting insulin and glucose concentrations. Fasting in Ramadan (রমজানের অনশনব্রত) independent of anthropometric measures decreases IGF-1, IL-2, serum lipid. Fasted resistance exercise relies more heavily on fat metabolism than CHO. The cellular and molecular mechanisms by which IF improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair and autophagy. Fasting was found to modulate major pathways, which are dysregulated in obesity and may lead to skin cancer. Altering body composition in such a manner may be advantageous to the athlete for various biomechanical, aesthetic, and locomotive reasons. Fasting increase the sensitivity of tumor cell lines to cisplatin-induced cells resistant to any pharmacological treatment. Although several studies reported associations between breakfast skipping and fatigue at noon, worsens memory and higher BMI.
... Even with no advice on lifestyle changes, there are consistent-albeit transient-reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity [25] . Ramadan IF might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level [26] . Resistance training (weight lifting) in a fasted state affects the post-workout anabolic response to weight training more favorably than training after a fed-state, but only when a carbohydrate/protein/ leucine mixture was ingested following a heavy resistance training session [27] . ...
Article
Full-text available
keto-diet and Intermittent Fasting (IF) (মধ্যবর্তী উপবাস) work especially well together, especially for weight loss and stable energy. A single 24-hour fast increased growth hormone by 2000% in men and 1300% in women. IF related health improvements are lipid profiles, osteoarthritis, healing of thrombophlebitis, healing of refractory dermal ulcers and tolerance of elective surgery. IF improved the chemotherapeutic response to various drugs in cancer. Alternative day fasting can reduce obesity-associated changes in body composition, fasting insulin and glucose concentrations. Fasting in Ramadan (রমজানের অনশনব্রত) independent of anthropometric measures decreases IGF-1, IL-2, serum lipid. Fasted resistance exercise relies more heavily on fat metabolism than CHO. The cellular and molecular mechanisms by which IF improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair and autophagy. Fasting was found to modulate major pathways, which are dysregulated in obesity and may lead to skin cancer. Altering body composition in such a manner may be advantageous to the athlete for various biomechanical, aesthetic, and locomotive reasons. Fasting increase the sensitivity of tumor cell lines to cisplatin-induced cells resistant to any pharmacological treatment. Although several studies reported associations between breakfast skipping and fatigue at noon, worsens memory and higher BMI.
... Indeed, even with no exhortation on way of life changes, there are reliable but transient-decreases in weight and fat mass with the Ramadan quick, particularly in individuals with overweight or obesity [25]. Ramadan intermittent fasting may be related to decline in sexual want, recurrence of sexual intercourse and serum FSH level [26]. Resistance training (weight lifting) in a fasted state influences the post-exercise, anabolic response to weight training more positively than training after a nourished state, however, just when a starch/protein/leucine mixture was ingested following a substantial resistance training session [27]. ...
Preprint
IF related health improvements are lipid profiles, osteoarthritis, healing of thrombophlebitis, healing of refractory dermal ulcers and tolerance of elective surgery. IF improved the chemotherapeutic response to various drugs in cancer. Alternative day fasting can reduce obesity-associated changes in body composition, fasting insulin and glucose concentrations. Fasting in Ramadan independent of anthropometric measures decreases IGF-1, IL-2, serum lipid. Fasted resistance exercise relies more heavily on fat metabolism than CHO. The cellular and molecular mechanisms by which IF improves health and counteracts disease processes involve activation of adaptive cellular stress response signaling pathways that enhance mitochondrial health, DNA repair and autophagy.
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Objective: To determine whether Ramadan month-long daily fasting affects semen analysis parameters. Methods: this retrospective cohort study was conducted in tertiary academic medical center. Medical records of 97 Muslim patients who were admitted to the IVF unit from May 2011-May 2021 were reviewed. Only men who provided at least one semen sample during Ramadan period (Ramadan month +70 days after) and one sample not during Ramadan were included. Semen characteristics of each patient were independently compared to himself. Results: The post-gradient semen analysis indicated significantly lower progressive sperm motility (mean 30.01±20.46 vs. 38.12±25.13 (p<0.001). The decrease in the progressive moility remained significant among patients with non-male factor indications (p<0.001). In the non-male factor indication group, the difference in the progressive moility of the post-gradient semen analysis between the 2 samples was not statistically significant (p=0.4). There were no significant differences between semen parameters before centrifuging. The incidence of asthenospermia (progressive sperm motility <32%) as an absolute parameter was higher after centrifuging the semen sample during the Ramadan period (p=0.04). Conclusions: Semen samples collected during Ramadan period was associated with lower progressive moility and reduced semen volume compared to semen samples from the same men outside of the Ramadan period. A possible effect of these altered semen parameters on fertility should be investigated further.
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Background: Erectile dysfunction (ED) is recognized as one of the complications of diabetes mellitus (DM). To date, a wide gap of knowledge is present on the efficacy of pharmacological treatments of DM on erectile function (EF), acting not only through metabolic control. Similarly, the effects of different diet regimens on ED are still debated. Objectives: we aimed to explore the effects of diet and antihyperglycemic drugs, considering both old and novel therapeutic approaches, on EF. Materials/methods: we performed a systematic review, following the PRISMA guidelines. The research was made on studies reporting ED assessment in subjects with diabetes and the relationship with diet and antihyperglycemic drugs. Results: Mediterranean diet resulted effective in most studies for the protection of EF. Furthermore, antihyperglycemic drugs seem to show overall a protective role on EF. Discussion/conclusion: Although encouraging results are present for all classes of antihyperglycemic drugs, several studies are needed in humans, mainly on acarbose, pioglitazone, dipeptidyl-peptidase-4 (DPP-4) inhibitors, and sodium-glucose cotransporter-2 (SGLT2) inhibitors. This article is protected by copyright. All rights reserved.
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Worship is practised by all Muslims worldwide, and even every Muslim can see that every worship will keep his practiser from sinning. Yet there is no question that some of these religious groups are engaged in inhumane acts by rendering their sexual pleasure perpetrators to children. Most paedophiles in Malaysia are figures of religious authority and give the religious teachings themselves a negative image. The problem is, does not the worship conducted, preclude the practitioner from sinning? To this end, this article aims to describe the philosophy of Sufism in worship, specifically Islamic foundations, as a study of paedophilia issues in care. Through implementing qualitative approaches, this article found that theories of Imam al-Ghazali (d. 1111) and Said Hawwa (d. 1989) were able to incorporate the Sufism meaning and observance in worship, while at the same time rendering the Islamic cornerstone a significant influence on the way of life of a believer.
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Background: As circulating testosterone may be suppressed in the post-prandial state, it has been recommended that measurements are carried out with the patient fasted. Objectives: In this regard, we assessed the effect of fasting/non-fasting status on total testosterone (T) levels in men. Materials and Methods: Data was collected in a single UK Hospital in men with two serum T requests taken within a 6-month period of each other and sampled at a time of day ≤2 hours apart. Three groups were established, with T levels compared via sign-rank test in men with both a fasting and non-fasting sample (Group 1; n=69), and in men with paired non-fasting (Group 2; n=126) and paired fasting (Group 3; n=18) samples. The differences in T levels between the paired samples was compared between the three groups using the rank-sum test and also via multiple regression analysis with the groups factorised. Results: Median (IQR) age did not vary significantly between Groups 1, 2 and 3 at 49 (38–56), 51.5 (42–60) and 51.5 (40–59) years, respectively. No significant difference (p=0.89) was found between the T levels in Group 1 with non-fasting (median (IQR) T = 11.1 (9.3–13.6) nmol/L) versus fasting samples T = 10.8 (8.9–14.1) nmol/L). Paired T levels did not significantly differ in each of the other two groups (2 and 3). There was no significant association between the differences in paired T levels between the three groups, even when the model was adjusted for age and time, with Group 1 (as reference) versus Group 2 (p=0.79) and versus Group 3 (p=0.63). Discussion: We found no significant differences between fasting and non-fasting T levels. A definitive confirmatory study is required to determine whether fasting status is necessary to diagnose hypogonadism. Conclusion: Non-requirement of fasting status when checking testosterone levels would remove a major hurdle in the diagnosis of hypogonadism.
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This narrative review presents an overview of present knowledge on fertility and reproductive hormones changes in aging men, the factors driving and modulating these changes, their clinical consequences, and benefits and risks of testosterone (T) therapy. Aging is accompanied by moderate decline of gamete quality and fertility. Population mean levels show mild total T decline, SHBG increase, steeper free T decline, and moderate LH increase with important contribution of comorbidities (e.g. obesity) to these changes. Sexual symptoms and lower hematocrit are associated with low T and partly responsive to T therapy. Relationship of serum T with body composition and metabolic health is bidirectional; limited beneficial effects of T therapy on body composition have only marginal effects on metabolic health and physical function. Skeletal changes are associated primarily with estradiol and SHBG. Cognitive decline is not consistently linked to low T and not improved by T therapy. Although limited evidence links moderate androgen decline with depressive symptoms, T therapy has small beneficial effects on mood, depressive symptoms and vitality in elderly with low T. Not optimal T (and/or DHT) has been associated with increased risk of stroke, but not of ischemic heart disease, whereas association with mortality probably reflects that low T is a marker of poor health. Globally, neither severity of clinical consequences attributable to low T, nor nature and magnitude of beneficial treatment effects justify the concept of some broadly applied ‘T replacement therapy’ in older men with low T. Moreover, long-term safety of T therapy is not established.
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Background: Ramadan involves one month of fasting from sunrise to sunset. In this meta-analysis, we aimed to determine the effect of Ramadan fasting on weight and body composition. Methods: In May 2018, we searched six databases for publications that measured weight and body composition before and after Ramadan, and that did not attempt to influence physical activity or diet. Results: Data were collected from 70 publications (90 comparison groups, 2947 participants). There was a significant positive correlation between starting body mass index and weight lost during the fasting period. Consistently, there was a significant reduction in fat percentage between pre-Ramadan and post-Ramadan in people with overweight or obesity (−1.46 (95% confidence interval: −2.57 to −0.35) %, p = 0.010), but not in those of normal weight (−0.41 (−1.45 to 0.63) %, p = 0.436). Loss of fat-free mass was also significant between pre-Ramadan and post-Ramadan, but was about 30% less than loss of absolute fat mass. At 2–5 weeks after the end of Ramadan, there was a return towards, or to, pre-Ramadan measurements in weight and body composition. Conclusions: Even with no advice on lifestyle changes, there are consistent—albeit transient—reductions in weight and fat mass with the Ramadan fast, especially in people with overweight or obesity.
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Muslims must refrain from eating, drinking, smoking, and sexual relations from sunrise to sunset during the month of Ramadan. Serum concentrations of melatonin, steroid hormones (cortisol, testosterone), pituitary hormones (prolactin, LH, FSH, GH, TSH) and thyroid hormones (free thyroxin and free triiodothyronine) were documented around the clock at six 4-hourly intervals before Ramadan began and on the twenty-third day of Ramadan (daytime fasting). Time series were analysed with repeated measures ANOVA. Statistically significant differences were found in some variables: the nocturnal peak of melatonin was diminished and may have been delayed; there was a shift in the onset of cortisol and testosterone secretion; the evening peak of prolactin was enhanced, FSH and GH rhythmic patterns were affected little or not at all by Ramadan fasting and only the serum TSH rhythm was blunted over the test time span. These data show that daytime fasting, modifications in sleep schedule and psychological and social habits during Ramadan induce changes in the rhythmic pattern of a number of hormonal variables.
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During Ramadan, Muslims abstain from food, drink and sex from sunrise to sunset. The aim of the study is to explore the effect of fasting on sex life and dysfunctions compared to the non-Ramadan period. The tool was a hetero-questionnaire drafted by the authors. The criteria of sexual dysfunction were those of DSM IV classification. Data were collected one week before Ramadan (W–1), then the first (W1) and the fourth week during Ramadan (W4). One hundred and thirteen persons were included (58% women). Mean age was 34.41±7.33 years, 72.6% were married. The frequency of sexual intercourse was 2 to 3 times per week for 56% before Ramadan whereas it was 29% to the fourth week of this month. Sixteen per cent did not have sexual intercourse during Ramadan whereas 100% of the sample had sexual intercourse on at least one occasion the month before. Statistically significant results (p
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The timing of food and liquid intake depends on the times of sunset and sunrise during the month of Ramadan. The current body of knowledge presents contradicting results as to the effect of Ramadan fasting on body mass, body composition and metabolic changes. The main objective of the present investigation was to gain additional information and scientific data in conformity with the philosophical background of Islam to allow optimisation of the daily training and dietary regimen in relation to the mental and physical performance of football players. The four teams, along with their coaches and trainers, attended a residential training camp at training centre 3 weeks before the start of Ramadan and throughout the study. Energy intake was relatively stable in the fasting group, but there was a small, albeit significant, decrease of approximately 0.7 kg in body mass. Water intake increased on average by 1.3 l/day in line with the greater energy intake in the non-fasting group in Ramadan. Daily sodium intake fell during Ramadan in the fasting players but increased slightly in the non-fasting group. Fasting players trained on average 11 h after their last food and drink, and reported that they felt slightly less ready to train during the Ramadan fast. None of the assessed performance variables was negatively affected by fasting while nearly all variables showed significant improvement at the third test session, indicating a training effect. Heart rate measurements in one training session during the third week of Ramadan appeared to suggest that the training load during training was marginally greater for the fasting than for the non-fasting players. However, the overall exercise load measures indicated that there was no biologically significant difference between the fasting and non-fasting groups. In the present study, biochemical, nutritional, subjective well-being and performance variables were not adversely affected in young male football players who followed Ramadan fasting in a controlled training camp environment. Physical performance generally improved, but match performance was not measured. We recommend that players should ensure adequate sleep and good nutrition during Ramadan to preserve football performance and general health.
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To develop a brief, reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction. Relevant domains of sexual function across various cultures were identified via a literature search of existing questionnaires and interviews of male patients with erectile dysfunction and of their partners. An initial questionnaire was administered to patients with erectile dysfunction, with results reviewed by an international panel of experts. Following linguistic validation in 10 languages, the final 15-item questionnaire, the international index of Erectile Function (IIEF), was examined for sensitivity, specificity, reliability (internal consistency and test-retest repeatability), and construct (concurrent, convergent, and discriminant) validity. A principal components analysis identified five factors (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) with eigenvalues greater than 1.0. A high degree of internal consistency was observed for each of the five domains and for the total scale (Cronbach's alpha values of 0.73 and higher and 0.91 and higher, respectively) in the populations studied. Test-retest repeatability correlation coefficients for the five domain scores were highly significant. The IIEF demonstrated adequate construct validity, and all five domains showed a high degree of sensitivity and specificity to the effects of treatment. Significant (P values = 0.0001) changes between baseline and post-treatment scores were observed across all five domains in the treatment responder cohort, but not in the treatment nonresponder cohort. The IIEF addresses the relevant domains of male sexual function (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction), is psychometrically sound, and has been linguistically validated in 10 languages. This questionnaire is readily self-administered in research or clinical settings. The IIEF demonstrates the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.
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To evaluate the effect of body mass on the hormonal and semen profiles of subfertile men with oligozoospemia, sperm concentration and reproductive hormone levels were compared in two body mass index (BMI) groups: underweight or normal weight patients (BMI = 25 kg/m2) vs. overweight or obese patients (BMI > 25 kg/m2). The mean BMI was 27 +/- 4.6 kg/m2. The testosterone/estradiol ratio was significantly reduced in the high BMI group as compared to the low BMI group (17 +/- 4 vs. 12 +/- 3; p < 0.05). A similar difference was found in the sperm concentration (11.2 +/- 3.16 x 10(6)/ml vs. 8.1 +/- 2.6 x 10(6)/ml). A nonsignificant difference was found in the LH/FSH ratio (1.41 +/- 0.64 vs. 1.63 +/- 0.72). We concluded that obesity and the consequent estrogen excess decrease the sperm concentration by influencing the hypothalamo-pituitary system.