Bang-Ping Jiann

Risk Factors for Individual Domains of Female Sexual Function

INTRODUCTION Female sexual function contains four major subtypes of desire, arousal, orgasm, and pain. Few studies used validated instruments to determine the dysfunction in these areas and assess their risk factors. AIM To assess the prevalence of and risk factors for individual components of sexual difficulty in women. METHODS A self-administered questionnaire containing the Female Sexual Function Index (FSFI) was given to 2,159 woman employees of two hospitals to assess their sexual function and its correlates. MAIN OUTCOME MEASURES The associations between female sexual difficulty in individual domains defined by the FSFI domain scores and potential risk factors assessed by simple questions. RESULTS Among the 1,580 respondents, 930 womens data were eligible for analysis with a mean age of 36.1 years (range 20-67). Of them, 43.8% had sexual difficulty in one or more domains, including low desire in 31.3%; low arousal, 18.2%; low lubrication, 4.8%; low orgasmic function, 10.4%; low satisfaction, 7.3%; and sexual pain, 10.5%. Compared with the younger women (20-49 years), the oldest age group (50-67 years) had a significantly higher prevalence in low desire, low arousal, and low lubrication, but not in the other domains. Based on multivariate logistic regression analyses, poor relationship with the partner and perception of partners sexual dysfunction were major risk factors for low desire, low arousal, low orgasmic function, and low satisfaction. Age and urge urinary incontinence were associated with low lubrication and sexual pain. Most comorbidities were not related to these difficulties, except diabetes being related to low desire. CONCLUSIONS Relationship factors had substantial impact on female sexual function in desire, arousal, orgasm, and satisfaction. On the other hand, womens lubrication problem and sexual pain were related predominantly with biological factors. These are initial results and future research is needed to confirm them.

Association of Glycemic Control with Risk of Erectile Dysfunction in Men with Type 2 Diabetes

INTRODUCTION Improvement in glycemic control is likely to reduce the risk of diabetic complication, while its effect on erectile dysfunction (ED) remains unclear. AIM The aim of this study was to evaluate the association of glycemic control with risk of ED in type 2 diabetics. METHODS A self-administered questionnaire containing Sexual Health Inventory for Men was obtained from 792 subjects with type 2 diabetes at our institution. Clinical data were obtained through chart review. MAIN OUTCOME MEASURES The contribution of glycemic control assessed by glycated hemoglobin (HbA(1c)) level as well as age, duration of diabetes, hypertension (HT), dyslipidemia, and cigarette smoking to risk of ED was evaluated. RESULTS Of 792 subjects, 83.6% reported having ED and 43.2% had severe ED. HbA(1c) level (%) adjusted for age and duration of diabetes was significantly associated with ED (OR 1.12, 95% CI: 1.01-1.25). None of HT, dyslipidemia, and cigarette smoking was a significant risk factor for ED after adjusted for age and duration of diabetes. HbA(1c) level, age, and duration of diabetes were significant independent risk factors for ED among the younger group (age < or = 60 years), and only age and duration of diabetes were independent risk factors among the older group (age > 60 years). For the risk of severe ED, compared with no and mild to moderate ED, HbA(1c) level, duration of diabetes, and HT were independent risk factors among the younger group, and only age was an independent factor among the older group. CONCLUSIONS Better glycemic control probably would reduce the prevalence of ED and its severity among the younger men with type 2 diabetes. For the older group, aging was the major determinant for ED risk among this population with type 2 diabetes.

Association of urinary incontinence and sexual function in women

To investigate the association between urinary incontinence and female sexual function in a non‐clinical population.

Patterns and Their Correlates of Seeking Treatment for Erectile Dysfunction in Type 2 Diabetic Patients

INTRODUCTION Diabetic patients are at high risk of having erectile dysfunction (ED), but their doctors rarely pay attention to this association. AIM To evaluate the treatment-seeking patterns and their correlates for ED in type 2 diabetic patients. METHODS A questionnaire containing Sexual Health Inventory for Men and questions inquiring treatment-seeking patterns was mailed or given to 4,040 subjects who had visited our endocrinology outpatient department for diabetes during January 2004 to May 2006. MAIN OUTCOME MEASURES The prevalence of being bothered and having interest in treatment, and the percentage having sought treatment in regard to ED and their correlates with age and ED severity. RESULTS Of the subjects with questionnaire completed, 83.9% (708/844) had ED. Among the subjects with different severity of ED, the moderate group had the highest percentages regarding prevalence of being bothered (89.4%), having interest in treatment (78.5%), and having sought treatment (46.2%). Of all the subjects, only 14.2% had ever visited Western physicians, whereas embarrassment and misinformation about ED treatment were the leading reasons for never doing so. Over half (56.6%) of those with ED wished to discuss ED problem with their doctors, and of them 90.4% wished the doctors to initiate to broach this issue. CONCLUSIONS The prevalence of ED and the concerns about it were high in these diabetic patients. ED severity was the major determinant of their treatment-seeking decision, whereas only few of them had ever sought professional help. Routine screening of ED in diabetic patients is recommended.

The Impact of Illicit Use of Amphetamine on Male Sexual Functions.

INTRODUCTION Data concerning the impact of amphetamine on male sexual functions are limited, although amphetamine has been used as an aphrodisiac. AIMS This cross-sectional study was to assess the impact of illicit use of amphetamine on male sexual functions. METHODS Male illicit drug users in a Drug Abstention and Treatment Center were recruited to complete a self-administered questionnaire, and data were compared with age-matched controls. MAIN OUTCOME MEASURES The International Index of Erectile Function (IIEF) and global assessment questions were used to assess sexual functions. RESULTS Of 1,159 amphetamine mono-illicit drug users, the mean age was 31.9 ± 7.5 (18-57) years, and mean duration of drug use was 30.7 ± 52.2 (median 9, range 0.1-252) months. Half of them reported that drug use had no impact on their sexual functions. The other half reported drug impacts as reduced erectile rigidity and sexual life satisfaction, enhanced orgasmic intensity, and prolonged ejaculation latency time more often than the opposite effects, while they reported enhanced or reduced effect equally on sexual desire. Dosing frequency of amphetamine was associated with its impact on sexual functions, but duration of its use had little association with that. Compared with 211 age-matched controls, the amphetamine mono-illicit drug users had lower IIEF scores in the domains of erectile function, orgasmic function, and overall satisfaction, but there are no significant differences in intercourse satisfaction and sexual desire scores. The prevalence of erectile dysfunction (ED) was significantly higher in the drug users than in the controls (29.3% vs. 11.9%). The odds ratio of ED for amphetamine use was 2.1 (95% confidence interval 1.2-3.6) after adjustment for other risk factors. CONCLUSIONS The impact of illicit use of amphetamine on male sexual functions varied among users, and their ED prevalence was higher than the controls.

Using the International Index of Erectile Function‐5 to Assess Erectile Function in Epidemiological Studies

2) and low testosterone (T) levels (defined by serum total T level < 12.1 nmol/L) with an odds ratio (OR) of 84 (95% confidence interval [CI] 16–436) and 680 (95% CI 108–4,260), respectively. Public health programs may benefit for applying these data in preventing obesity among young men. However, the strong correlations between ED and obesity and low serum T levels are not consistent with other relevant studies. Most observational studies in elderly men did not find a significant correlation between ED and serum T levels. In a study on healthy young men (ages 20–40 years), the ability to maintain penile erection during sexual intercourse did not significantly decrease when mean serum total T level was as low as 1.9 nmol/L in experimentally hypogonadal state [2]. Relative risk of obesity for ED was reported to be <3 in most observational studies. A study in 1,181 younger Danish men (ages 20–45 years), the OR of obesity for ED was 2.74 (95% CI 1.1–6.8) [3]. It seems necessary to scrutinize the methodology of Chao et al.’s study. The original diagnostic evaluation of the IIEF-5 was based only on men who reported having attempted sexual intercourse in the 4-week period before filling out the questionnaire [4]. Men who had no sexual activity during the reference period are suitable to answer the IIEF-5 only when they had clinically diagnosed ED or were involved in a stable relationship [4]. In Chao et al.’s report, stable relationship was not required for eligibility of the subjects, and only the subjects who had never had sexual intercourse were excluded [1]. In a survey using International Index of Erectile

Efficacy and safety of tadalafil 5 mg once-daily in Asian men with both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction: A phase 3, randomized, double-blind, parallel, placebo- and tamsulosin-controlled s

To evaluate the efficacy and safety of tadalafil in Asian men with both lower urinary tract symptoms associated with benign prostatic hyperplasia and erectile dysfunction.

Effect of Alcohol Consumption on the Risk of Erectile Dysfunction

Alcohol consumption is a common behavior in social circumstances worldwide. Epidemiological studies have suggested that moderate alcohol consumption reduces cardiovascular morbidity and mortality. The cardiovascular protective effects of alcohol may be attributed to its antioxidant, vasorelaxant, and antithrombotic properties, elevation of high-density lipoprotein or increase of nitric oxide production. Erectile dysfunction (ED) is a harbinger of cardiovascular diseases. Most epidemiological studies have also found that alcohol consumption, like its relationship with coronary artery disease, is related to ED in a J-shaped manner, with moderate consumption conferring the highest protection and higher consumption less benefits. In epidemio-logical studies, it is difficult to distinguish the ethanol effects from those of associated confounding factors. Meanwhile, long-term alcohol users, especially in those with alcohol liver disease, are highly associated with ED. More research is needed to investigate the true effects of alcohol consumption on cardiovascular diseases or ED.

Association of Areca Nut Chewing With Risk of Erectile Dysfunction

Introduction Areca nut chewing has been shown to increase the risk of cardiovascular disease, but its association with erectile dysfunction (ED) has not been investigated. Aim To investigate the association between areca nut chewing and risk of ED. Methods Consecutive men at public health centers for oral malignancy screening or health checkup were invited to complete a questionnaire. Main Outcome Measure The Sexual Health Inventory for Men (SHIM). Results Of the 2,652 respondents, 1,038 (mean age = 43.8 ± 11.1 years) were eligible for the areca nut chewing group and 1,090 non-areca nut chewers were selected as the age-matched control group. In the areca nut group, the mean duration of chewing was 13.2 ± 9.6 years, 61.7% consumed more than 10 portions per day, and 76.2% used it with betel leaf, 16.7% used it with betel inflorescence, and 7.1% used it with betel leaf and inflorescence. Smoking, alcohol drinking, obesity, hypertension, and diabetes were more predominant in areca nut chewers compared with controls. ED defined by self-report and by SHIM score was more prevalent in areca nut chewers than in controls (13.7% vs 9.8% and 48.7% vs 43.3%, respectively; P < .05 for the two comparisons). Areca nut use with betel inflorescence was associated with a higher risk of ED (odds ratio = 2.25, 95% confidence interval = 1.55–3.28) with a dose-dependent effect, whereas using it with betel leaf was not (odds ratio = 1.00, 95% confidence interval = 0.79–1.26) after adjustment of possible confounders. Conclusion Areca nut chewing with betel inflorescence was associated with an increased risk of ED. These findings warrant further studies. Huang Y-J, Jiann B-P. Association of Areca Nut Chewing With Risk of Erectile Dysfunction. Sex Med 2017;5:e163–e168.

Does hair dye use really increase the risk of prostate cancer

Recently, Shu-Yu Tai et al. reported that personal hair dye use increased risk of prostate cancer with a dose-response effect. Although hair dyes were identified as carcinogenic in animals and increased risk of some cancers among hairdressers, the existing epidemiological data did not support that personal hair dye use increased risk of cancers, even for bladder cancer. Given that Tai et al.’s report of a potential hazard of personal hair dye use on risk of prostate cancer was particular, the methodology of the study was scrutinized and some flaws were found including the issue of external validity.