Displaying publications 21 - 40 of 95 in total

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  1. Fulltext Oral health and erectile dysfunction
    Singh VP, Nettemu SK, Nettem S, Hosadurga R, Nayak SU
    J Hum Reprod Sci, 2017 Jul-Sep;10(3):162-166.
    PMID: 29142443 DOI: 10.4103/jhrs.JHRS_87_17
    Ample evidence strongly supports the fact that periodontal disease is a major risk factor for various systemic diseases namely cardio-vascular disease, diabetes mellitus, etc. Recently, investigators focussed on exploring the link between chronic periodontitis (CP) and erectile dysfunction (ED) by contributing to the endothelial dysfunction. Both the diseases share common risk factors. Various studies conducted in different parts of the world in recent years reported the evidence linking this relationship as well as improvement in ED with periodontal treatment. Systemic exposure to the periodontal pathogen and periodontal infection-induced systemic inflammation was thought to associate with these conditions. The objective of this review was to highlight the evidence of the link between CP and ED and the importance of oral health in preventing the systemic conditions.
    Matched MeSH terms: Erectile Dysfunction
  2. Fulltext A cross-sectional study of hypertensive outpatients to determine the necessity of asking about erectile dysfunction symptoms
    Sharifuddin N, Abdul Aziz AF, Sheikh Hamzah M, Abdul Rashid R, Zainuddin Z, Wan Puteh SE, et al.
    South African Family Practice, 2011;53:384-389.
    Background: Erectile dysfunction (ED) is common amongst hypertensive men. Hypertensive patients often attribute it to antihypertensive drugs, although conflicting evidence linking ED with antihypertensive medication exists. The objectives were to determine the prevalence and severity of ED, the type of treatment sought, and the risk factors for ED among hypertensive men.
    Method: A cross-sectional survey conducted over six months from June to November 2008 at University Kebangsaan, Malaysia Medical Centre, Kuala Lumpur. Inclusion criteria included hypertensive men above 30 years old, with essential hypertension for at least three months. We excluded diabetics, a history of pelvic surgery and known psychiatric illnesses. The International Index of Erectile Function-5 (IIEF-5) assessment was used with a standardised checklist. We analysed data using SPSS, to assess the prevalence and association of ED with selected variables.
    Results: Of the 200 participants screened, 35.5% perceived that they had ED. However, prevalence increased to 69% after screening using an IIEF-5 questionnaire. Forty-eight per cent were reported to have moderate-to severe ED. ED was significantly associated with age (p-value = 0.0001). No significant associations were found between ED and the duration of the hypertension (p-value = 0.505), hypertension control (p-value > 0.05), smoking status (p-value = 0.858) or number of antihypertensive medication taken (p-value > 0.05). Among perceived and proven ED patients, traditional medicines were mainly used for treatment (18.3% and 17.2% respectively).
    Conclusion: ED is a problem among hypertensive patients. It was associated with age but not with hypertension duration, control, number of antihypertensive drugs or smoking. Physicians should enquire about ED symptoms in hypertensive patients, as most of them resorted to self-treatment with traditional medicines. © SAAFP.
    Matched MeSH terms: Erectile Dysfunction
  3. Fulltext Premature ejaculation in urban malaysian population: the associations between erectile dysfunction(ED), anxiety and depression
    Shamini Arasalingam, Hatta Sidi, Ng Chong Guan, Srijit Das, Marhani Midin, Ramli Musa
    International Medical Journal Malaysia, 2016;15(1):89-96.
    MyJurnal
    Introduction: Both premature ejaculation(PE) and erectile dysfunction(ED) are prevalent sexual health disorders that have been inadequately investigated in Malaysia, a multiethnic and conservative nation.The objective of the study was to study the relationship between PE and ED, and other common mental health issues, i.e. anxiety and depression in Malaysian urban population.
    Methods: The diagnosis for PE was established by clinical diagnosis using DSM-5 and ISSM definition criteria for PE, whereas a diagnosis of ED was established by the International Index of Erectile Function (IIEF) questionnaire. Anxiety and depression levels were detected from the Hospital Anxiety and Depression Scale (HADS).
    Results: Based on DSM-V and ISSM clinical diagnosis for PE, the prevalence of PE was found to be 25%. Erectile dysfunction (p = 0.035, OR = 3.315, 95% CI 1.088, 10.103) and severe anxiety (p = 0.020, OR = 7.656, 95% CI 1.383, 42.396) significantly predicted presence of PE.
    Conclusion: There was a strong association between PE and ED and between PE and anxiety. Routine examination for PE in male patients should address the issue and the management of both ED and anxiety among PE patients, especially in an urban Malaysian clinical and medical care setting.
    Matched MeSH terms: Erectile Dysfunction
  4. Fulltext Co-morbid medical conditions and medical complications of prostate cancer in Southern Nigeria
    Sapira MK, Onwuchekwa AC, Onwuchekwa CR
    Med J Malaysia, 2012 Aug;67(4):412-6.
    PMID: 23082452
    BACKGROUND:
    Prostate cancer often co-exists with other diseases. It accounts for 11% of all cancers in Nigerian men, and it is the commonest cause of mortality due to cancer in elderly males in Nigeria.

    OBJECTIVE:
    To present co-morbid medical conditions and medical complications of prostate cancer in patients with the disease in Southern Nigeria.

    PATIENTS AND METHODS:
    The study was carried out prospectively (2002 to 2003) at University of Port Harcourt Teaching Hospital (UPTH), and Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi- both in Southern Nigeria. Using common proforma, patients who presented to the urology units of the two teaching hospitals were evaluated clinically and with relevant investigations for prostate cancer and other diseases. Those with histologically confirmed prostate cancer were included in this study. Data was also collected retrospectively by using the same proforma to obtain information from case files of 37 patients diagnosed with prostate cancer at UPTH. Data from the two institutions were collated and analysed.

    RESULTS:
    Of 189 cases analysed, 73.4% had significant medical co-morbid diseases/complications. These included anaemia (69.8%), urinary tract infection (56.1%), chronic renal failure (33.9%), hypertension (41.8%), diabetes mellitus (9.5%), paraplegia (9.5%), congestive cardiac failure (9.0%) and cerebrovascular disease (5.3%).

    CONCLUSION/RECOMMENDATIONS:
    These patients had high disease burden. Improved health education and well coordinated interdisciplinary team work are suggested in managing this malignancy.
    Matched MeSH terms: Erectile Dysfunction/complications
  5. Fulltext Surgical Techniques for Correction of Penile Paraffinoma
    Salauddin SA, Ghazali H
    Malays J Med Sci, 2019 Nov;26(6):137-142.
    PMID: 31908595 MyJurnal DOI: 10.21315/mjms2019.26.6.14
    Background: Penile augmentation using injection of a foreign body into penile skin was mainly performed by non-medical personnel. Majority of these patients end up with complication of an abnormal mass formation known as penile paraffinoma.

    Methods: We described three different surgical techniques for correction of penile paraffinoma based on our single-centre experience. Informed consents were obtained from patients whose photographs were taken during the operation step.

    Results: In general, three patients had simple excision biopsy with primary suturing, four patients underwent single stage excision of circumferential granuloma with bilateral scrotal skin flap reconstruction and one patient experienced dual stage procedure. Three of them were injected with paraffin, one with silicone and the remaining four were unable to identify the substance used. All patients successfully underwent the surgical procedure and four of them had minor post-operative surgical site infection and wound gapping.

    Conclusion: All patients recovered well and the mean International Index of Erectile Function (IIEF-5) score obtained was 24.25. In our experience, excision biopsy was adequate for focal mass and reconstructive surgery using bilateral scrotal flap was suitable for circumferential mass.

    Matched MeSH terms: Erectile Dysfunction
  6. Fulltext Health-Seeking Behavior for Erectile Dysfunction in Methadone Maintenance Treatment Patients
    Ramli FF, Shuid AN, Pakri Mohamed RM, Tg Abu Bakar Sidik TMI, Naina Mohamed I
    Int J Environ Res Public Health, 2019 11 01;16(21).
    PMID: 31683816 DOI: 10.3390/ijerph16214249
    Background: Erectile dysfunction (ED) is commonly associated with methadone usage. However, little data is known regarding the health-seeking behavior for ED in the methadone maintenance treatment (MMT) population. This study aimed to determine the health-seeking behavior of MMT patients with ED who perceived themselves as having ED. We aimed to assess the attitudes and health-seeking behavior, the effectiveness of the treatment and the factors associated with treatment-seeking behavior. Methods: This was an observational questionnaire-based study. Patients were first screened for ED (n = 154) using the International Index of Erectile Function-5 (IIEF-5). Fifty patients with ED were evaluated for health-seeking behavior for ED. Results: More than half of the patients who thought they had ED (78%) believed their sex life was affected. Most patients (48%) did not seek any information regarding ED. Education level (p = 0.017) and marital status (p = 0.008) were predictive factors of health-seeking behavior. Conclusions: The health-seeking rate among MMT patients with ED needs to be improved. Measures to increase awareness of ED in MMT patients should be taken to overcome the barrier to health-seeking behavior. Health practitioners should take action to screen ED in this population to increase the detection rate and offer appropriate management according to the patients' needs.
    Matched MeSH terms: Erectile Dysfunction
  7. Autophagy, a critical element in the aging male reproductive disorders and prostate cancer: a therapeutic point of view
    Raee P, Tan SC, Najafi S, Zandsalimi F, Low TY, Aghamiri S, et al.
    Reprod Biol Endocrinol, 2023 Sep 26;21(1):88.
    PMID: 37749573 DOI: 10.1186/s12958-023-01134-1
    Autophagy is a highly conserved, lysosome-dependent biological mechanism involved in the degradation and recycling of cellular components. There is growing evidence that autophagy is related to male reproductive biology, particularly spermatogenic and endocrinologic processes closely associated with male sexual and reproductive health. In recent decades, problems such as decreasing sperm count, erectile dysfunction, and infertility have worsened. In addition, reproductive health is closely related to overall health and comorbidity in aging men. In this review, we will outline the role of autophagy as a new player in aging male reproductive dysfunction and prostate cancer. We first provide an overview of the mechanisms of autophagy and its role in regulating male reproductive cells. We then focus on the link between autophagy and aging-related diseases. This is followed by a discussion of therapeutic strategies targeting autophagy before we end with limitations of current studies and suggestions for future developments in the field.
    Matched MeSH terms: Erectile Dysfunction*
  8. Prevalence of sexual problems and its association with social, psychological and physical factors among men in a Malaysian population: a cross-sectional study
    Quek KF, Sallam AA, Ng CH, Chua CB
    J Sex Med, 2008 Jan;5(1):70-6.
    PMID: 17362280 DOI: 10.1111/j.1743-6109.2006.00423.x
    INTRODUCTION: Sexual problems are common in the general population. Studies have shown that most of these sexual problems are related to their social lives, medical illnesses, and psychological status. Among the sexual problems in men, premature ejaculation (PE) is one of the most frequent, yet it is the least well-understood of the sexual dysfunctions of men.
    AIM: To determine the prevalence of sexual problem particularly PE and erectile dysfunction (ED) among people living in urban areas and to investigate the characteristics associated with these sexual problems in a Malaysian population.
    MAIN OUTCOME MEASURE: The PE which is defined as an intravaginal ejaculation latency time less than 2 minutes was assessed in the ED and non-ED group.
    METHODS: The Hospital Anxiety and Depression scale is used as a measure of the psychological status [30]. The ED status was assessed using the International Index of Erectile Function questionnaire.
    RESULTS: The prevalence of self-reported sexual problems for ED and PE were 41.6% and 22.3%, respectively. In those subjects with ED, 33.5% reported to have PE. Of the total of 430 subjects, anxiety was present in 8.1%, while depression was 5.3%. The prevalence of PE accounted for 25% anxiety and 14.6% for depression respectively in the population. EDs were associated with diabetes and hypertension (OR [95% CI]: 5.33 [2.33, 10.16], 3.40 [1.76, 6.57], P < 0.05), respectively, while factors associated with PE were anxiety and depression (OR [95% CI]: 1.29 [0.68, 2.45], 1.39 [0.69, 2.78]), respectively.
    CONCLUSION: Prevalence of ED is associated with medical symptoms such as diabetes and hypertension and a rise in the prevalence of age while psychological distress such as anxiety and depression also contribute to a higher PE rate.
    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/epidemiology*; Erectile Dysfunction/psychology
  9. Fulltext The performance properties of the International Index of Erectile Function (IIEF-15) in assessing erectile dysfunction in patients with lower urinary tract symptoms
    Quek KF, Low WY, Razack AH, Chua CB, Loh CS, Dublin N
    Med J Malaysia, 2002 Dec;57(4):445-53.
    PMID: 12733169
    To validate the International Index of Erectile Function (IIEF-15) in Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Sensitivity to change was expressed as the effect size index. Internal consistency was excellent (Cronbach's alpha value = 0.75 to 0.90) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant (ICC = 0.75 and above) and a high degree of sensitivity and specificity was observed. The IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
    Matched MeSH terms: Erectile Dysfunction/complications*; Erectile Dysfunction/diagnosis*
  10. Fulltext The sensitivity of the Malay version of Brief Manual of Sexual Function Inventory in assessing erectile dysfunction secondary to benign prostatic hyperplasia
    Quek KF, Low WY, Razack AH, Chua CB, Loh CS
    Med J Malaysia, 2003 Aug;58(3):356-64.
    PMID: 14750375
    This study aimed to assess the sensitivity of the Malay version of the Brief Manual Sexual Function Inventory (BMSFI) on patients with and without urinary symptoms in Malaysian population. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability and validity was evaluated by using the test-retest method while internal consistency was assessed by Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in patients who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 11 items and 5 domains (Cronbach's alpha value = 0.67 and higher and 0.73 and higher respectively). Test-retest correlation coefficient for the 11 items scores was highly significant. Intraclass correlation coefficient was high (ICC = 0.68 and above). The sensitivity and specificity showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across 3 domains in the treatment corresponds cohort but not in the control group. The Mal-BMSFI is a suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/etiology*
  11. Fulltext Reliability and validity of the Malay version of the International Index of Erectile Function (IIEF-15) in the Malaysian population
    Quek KF, Low WY, Razack AH, Chua CB, Loh CS
    Int J Impot Res, 2002 Aug;14(4):310-5.
    PMID: 12152122
    The objective of this study was to validate the Malay version of the International Index of Erectile Function (IIEF-15) in patients with lower urinary tract symptoms. Reliability and validity was assessed by using the test-retest while Cronbach's alpha was used to assess internal consistency. Effect size 5was evaluated to assess the sensitivity to change in the pre-transurethral resection of the prostate (TURP) vs post-TURP. Internal consistency was excellent. A high degree of internal consistency was observed for each of the 15 items and five domains (Cronbach's alpha value=0.56 and higher and 0.74 and higher, respectively). Test-retest correlation coefficient for the 15 items and domains scores showed no significant changes. Intraclass correlation coefficient for 15 items and domains were high (ICC=0.59 and above). It can be concluded that the Mal-IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
    Matched MeSH terms: Erectile Dysfunction/diagnosis*
  12. Fulltext Serotonin reuptake inhibitor citalopram inhibits GnRH synthesis and spermatogenesis in the male zebrafish
    Prasad P, Ogawa S, Parhar IS
    Biol Reprod, 2015 Oct;93(4):102.
    PMID: 26157069 DOI: 10.1095/biolreprod.115.129965
    Selective serotonin reuptake inhibitors (SSRIs) are widely used antidepressants for the treatment of depression. However, SSRIs cause sexual side effects such as anorgasmia, erectile dysfunction, and diminished libido that are thought to be mediated through the serotonin (5-hydroxytryptamine, 5-HT) system. In vertebrates, gonadotropin-releasing hormone (GnRH) neurons play an important role in the control of reproduction. To elucidate the neuroendocrine mechanisms of SSRI-induced reproductive failure, we examined the neuronal association between 5-HT and GnRH (GnRH2 and GnRH3) systems in the male zebrafish. Double-label immunofluorescence and confocal laser microscopy followed by three-dimensional construction analysis showed close associations between 5-HT fibers with GnRH3 fibers and preoptic-GnRH3 cell bodies, but there was no association with GnRH2 cell bodies and fibers. Quantitative real-time PCR showed that short-term treatment (2 wk) with low to medium doses (4 and 40 μg/L, respectively) of citalopram significantly decreased mRNA levels of gnrh3, gonadotropins (lhb and fshb) and 5-HT-related genes (tph2 and sert) in the male zebrafish. In addition, short-term citalopram treatment significantly decreased the fluorescence density of 5-HT and GnRH3 fibers compared with controls. Short-term treatment with low, medium, and high (100 μg/L) citalopram doses had no effects on the profiles of different stages of spermatogenesis, while long-term (1 mo) citalopram treatment with medium and high doses significantly inhibited the different stages of spermatogenesis. These results show morphological and functional associations between the 5-HT and the hypophysiotropic GnHR3 system, which involve SSRI-induced reproductive failures.
    Matched MeSH terms: Erectile Dysfunction
  13. [Can western medicine resolve psychological problems in ethnic regions outside Europe? 2 cases from the region of Borneo-Sarawak]
    Pilz A, Wiesnagrotzki S, Leixnering W
    Wien Med Wochenschr, 1983 Jul 31;133(13-14):355-9.
    PMID: 6636792
    The case histories of two patients healed by animist treatment in the Iban tradition are reviewed by two psychiatrists. Both psychiatrists point to the difficulties in the evaluation of the background of the disease and of the mechanisms of its treatment by people not aware of the cultural and sociological aspects of eastern civilisation. The diagnostic classification of both patients by means of western medicine and the possible treatment of their disease are discussed. The failure of western medicine to understand the psychiatrical aspects of animist religions in the pathogenesis of diseases raises the question whether western medicine will be able to cope with the health problems of Iban (and other animists) sufficiently when their animist tradition will be replaced by western civilisation.
    Matched MeSH terms: Erectile Dysfunction/psychology; Erectile Dysfunction/therapy*
  14. Factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and non-smoking schizophrenia men
    Ong KY, Muhd Ramli ER, Che Ismail H
    Mental Health and Substance Use: Dual Diagnosis, 2014;7:370-80.
    DOI: 10.1080/17523281.2014.940370
    Cigarette-smoking in schizophrenia and its associations with sexual functioning have been relatively under-examined. The study purpose was to determine the factors associated with sexual dysfunction among schizophrenia men with nicotine dependency and those non-smokers. A retrospective study was conducted in a local hospital in Malaysia over a two-year period from 2011 to 2012. There were 54 schizophrenia men with nicotine dependency and 57 non-smokers. Sexual functioning was assessed using the Malay version of the International Index of Erectile Function-15. Logistic regression analysis was employed. All the 111 schizophrenia men had at least one sexual dysfunction domain. For the group with nicotine dependency, Positive and Negative Syndrome Scale (PANSS)-positive was positively associated with the ability to achieve orgasm and ejaculation. However, age of schizophrenia onset was negatively associated with the confidence to attain and keep an erection. For the non-smoker group, married status and duration of schizophrenia were positively associated with the ability to attain erection and overall sex life satisfaction, respectively, while age of schizophrenia onset was negatively associated with the ability to attain erection and erectile sustainability during intercourse. Among the domains, only orgasmic dysfunction was significantly associated with PANSS-positive, i.e. higher PANSS-positive score was a protective factor for orgasmic dysfunction (odds ratio = 0.37; 95% confidence interval: 0.17, 0.80; p =.012). Schizophrenia men may apparently attempt to treat their orgasmic impairment due to effect from antipsychotics through smoking cigarettes. Sexual impairment among the non-smokers may be attributed mostly to relationship issues with their partner. © 2014 Taylor & Francis.
    Matched MeSH terms: Erectile Dysfunction
  15. Fulltext Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia
    Nordin RB, Soni T, Kaur A, Loh KP, Miranda S
    Singapore Med J, 2019 Jan;60(1):40-47.
    PMID: 29774359 DOI: 10.11622/smedj.2018049
    INTRODUCTION: Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia.

    METHODS: We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale.

    RESULTS: The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114).

    CONCLUSION: ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.

    Matched MeSH terms: Erectile Dysfunction/diagnosis*; Erectile Dysfunction/epidemiology*
  16. Fulltext Clinical correlates of erectile dysfunction among male patients on methadone maintenance therapy (MMT) in Kuala Lumpur
    Nik Ruzyanei, N.J., Noormazita, M., Azlin, B., Normala, I., Hazli, Z., Abdul Aziz, S., et al.
    Malaysian Journal of Medicine and Health Sciences, 2012;8(1):27-35.
    MyJurnal
    Sexual dysfunction is common but not often assessed in the routine clinical care among males on opiate substitute treatment.
    Objective: To determine the association between clinical variables and erectile dysfunction (ED) among men on methadone maintenance therapy (MMT).
    Methods: A cross-sectional study involving 108 participants who attended the Drug Clinic, Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for DSM-IV Axis-I Disorder (SCID-I), Beck Depression Inventory (BDI) and International Index of Erectile Function-15 (IIEF-15).
    Results: Concurrent heroin abuse was significantly associated with presence of ED (p=0.024). Treatment factors including methadone dose and duration of methadone treatment were not significantly associated with ED.
    Conclusion: Education on sexual dysfunction as a potential adverse effect and its association with illicit heroin use should be considered in the doctor-patient consultation to encourage treatment adherence and abstinence from heroin.
    Study site: Drug Clinic, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Erectile Dysfunction
  17. Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy
    Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, et al.
    J Sex Med, 2013 Aug;10(8):2069-76.
    PMID: 23445463 DOI: 10.1111/jsm.12105
    INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits.
    AIM:To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population.
    MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI).
    METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables.
    RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED.
    CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.
    KEYWORDS: Erectile Dysfunction; Methadone Therapy; Opiate Dependence
    Study site: outpatient clinic for opiate substitution therapy, Hospital Kuala Lumpur (HKL), Malaysia
    Matched MeSH terms: Erectile Dysfunction/epidemiology*
  18. A population study of the association between sexual function, sexual satisfaction and depressive symptoms in men
    Nicolosi A, Moreira ED, Villa M, Glasser DB
    J Affect Disord, 2004 Oct 15;82(2):235-43.
    PMID: 15488252 DOI: 10.1016/j.jad.2003.12.008
    BACKGROUND:
    Depression and erectile dysfunction (ED) have a complex and bi-directional relationship. We examined the relationships between erectile dysfunction and depressive symptoms or diagnosed depression, sexual activity and sexual satisfaction.

    METHODS:
    A population survey of men aged 40-70 years was carried out in Brazil, Italy, Japan and Malaysia in 1997-1998. A questionnaire was used to collect life style, sexual behaviors and medical data. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. ED was classified as moderate or complete if the men reported they were "sometimes" or "never" able to achieve and maintain an erection satisfactory for sexual intercourse. Only men with a sexual partner and not taking psychoactive drugs were considered.

    RESULTS:
    Diagnosed depression was reported by 2.0% of the men, depressive symptoms by 21.0%. The prevalence of moderate or complete ED was 17.8%. Sexual satisfaction related to the frequency of sexual intercourse and inversely related to depressive symptoms. Depressive symptoms were positively associated with being single (odds ratio [OR] 1.7), widowed, separated or divorced (OR 2.2), moderate or complete ED (1.8), heart disease (1.6) and smoking (1.6), and negatively associated with age, physical activity and frequency of sexual intercourse.

    LIMITATIONS:
    Cross-sectional studies cannot establish a temporal cause-effect relationship. However, the confirmation of known associations reassures about the validity of the original findings.

    CONCLUSIONS:
    The findings suggest that depressive symptoms are linked to ED by the mediation of decreased sexual activity and the dissatisfaction generated by the inability to have a healthy sexual life.
    Matched MeSH terms: Erectile Dysfunction/diagnosis; Erectile Dysfunction/epidemiology*; Erectile Dysfunction/psychology
  19. Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction
    Nicolosi A, Moreira ED, Shirai M, Bin Mohd Tambi MI, Glasser DB
    Urology, 2003 Jan;61(1):201-6.
    PMID: 12559296 DOI: 10.1016/s0090-4295(02)02102-7
    OBJECTIVES:
    To measure the prevalence of erectile dysfunction (ED) in community-based populations in Brazil, Italy, Japan, and Malaysia and to study its association with the demographic characteristics, medical conditions, and health-related behavior.

    METHODS:
    In each country, a random sample of approximately 600 men aged 40 to 70 years was interviewed using a standardized questionnaire. All the data were self-reported. ED was assessed by the participants' "ability to attain and maintain an erection satisfactory for sexual intercourse," and the men were classified as not having ED if they answered "always" and as having mild, moderate, or complete ED if they answered "usually," "sometimes," or "never," respectively.

    RESULTS:
    The age-adjusted prevalence of moderate or complete ED was 34% in Japan, 22% in Malaysia, 17% in Italy, and 15% in Brazil. The overall age-specific prevalence of moderate or complete ED was 9% for men aged 40 to 44 years, 12% for 45 to 49 years, 18% for 50 to 54 years, 29% for 55 to 59 years, 38% for 60 to 64 years, and 54% for those 65 to 70 years. The increased risk of ED was associated with diabetes, heart disease, lower urinary tract symptoms, heavy smoking, and depression and increased by 10% per year of age. It was inversely associated with education, physical activity, and alcohol drinking.

    CONCLUSIONS:
    ED is an international problem, the prevalence and severity of which increases with age. Despite national variations in prevalence, uniform associations were found between ED and medical conditions and lifestyle habits.
    Matched MeSH terms: Erectile Dysfunction/diagnosis; Erectile Dysfunction/epidemiology*
  20. Fulltext Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study
    Nicolosi A, Glasser DB, Moreira ED, Villa M, Erectile Dysfunction Epidemiology Cross National Study Group
    Int J Impot Res, 2003 Aug;15(4):253-7.
    PMID: 12934052 DOI: 10.1038/sj.ijir.3901010
    We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia about medical history, lifestyle habits and sexual behavior. Men were classified as having moderate or complete erectile dysfunction (ED) if they reported to be sometimes or never able to achieve and maintain an erection satisfactory for sexual intercourse, respectively. There were 1335 men with no diagnosis of cardiovascular or prostate diseases, diabetes, ulcer or depression, nor taking hormones. The prevalence of ED was 16.1%. ED was associated with age (the risk increased 8% per y), moderate (odds ratio (OR)=2.2) or severe (OR=4.9) lower urinary tract symptoms and smoking (OR=2.3 for >30 cigarettes/day). It was inversely associated with physical activity (OR=0.5) and higher educational levels. Between the ages of 40 and 70 y, almost one in six 'healthy' men is affected by ED. Further research should look at preclinical disease stages and genetic factors.
    Matched MeSH terms: Erectile Dysfunction/complications; Erectile Dysfunction/epidemiology*; Erectile Dysfunction/physiopathology
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