ABSTRACT
Background: Sexual dysfunction has been traditionally attributed to psychogenic origins and managed bymental health professionals and urologists. However, advances in pathophysiology research point to avascular origin of the problem in the majority of patients, possibly due to atherosclerotic lesions in the genitalarteries that result in decreased blood flow. During management of Hypertension; even the highly skilledphysicians fail to raise the question of sexual dysfunction as they have never been accustomed to do it intheir routine practice.Aim: The study has two aims- (i) to evaluate sexual dysfunctions in male patients of Hypertension and (ii)comparison of sexual dysfunctions and other variables between case and control group.Methodology: Consecutive 200 Hypertensive patients were included in the study. Individuals withcomparable age served as a control group. Detailed socio-demographic variables, substance history andtreatment history for hypertension obtained using a semi-structured Performa. Subject’s sexual dysfunctionswere assessed by ASEX (Arizona Sexual Experience Scale), IIEF (International Index of ErectileDysfunction), PEDT ( Premature ejaculation diagnostic tools).Result: Of the 200 hypertensive patients, 74(37%) participants reported erectile dysfunction, 16(8%)participants reported premature ejaculation, while among 200 normotensive participants, only 8(4%)reported erectile dysfunction, 15(7.5%) reported premature ejaculation. Of the hypertensive participantsstudied, 23% had severe, 8% had moderate, 6% had mild erectile dysfunction. Frequency of erectiledysfunction increase with advancing age.Conclusion: The present study has revealed that erectile dysfunction was a major problem, with a higherprevalence among hypertensive men than normotensive men. Age was considered statistically significantpredictors of erectile dysfunction.Keywords: Sexual dysfunctions, International Index of Erectile dysfunction, Arizona sexual experiencescale, Premature ejaculation diagnostic tools, hypertension
ABSTRACT
Objective@#To explore the factors influencing the sexual function of the male patients with obstructive sleep apnea (OSA).@*METHODS@#Using Arizona Sexual Experience Scale (ASEX) and Epworth Sleepiness Scale (ESS), we conducted a questionnaire investigation among 81 male patients with OSA aged 40.5 ± 8.6 years and 35 healthy volunteers aged 38.8 ± 10 years. According to the sex drive (SD) score in ASEX, we divided the OSA patients into an SD reduction group (SD score = 4, n = 32) and a non-SD reduction group (SD score <4, n = 49), compared the clinical data and polysomnographic (PSG) indexes, and analyzed the factors influencing SD by evaluating the association of the PSG indexes with the SD score.@*RESULTS@#The OSA patients scored significantly higher than the healthy controls in ESS (8 ± 5 vs 5 ± 4, P <0.05) and ASEX (15 ± 4 vs 10 ± 2, P <0.05), and so did the patients of the SD reduction group than those of the non-SD reduction group in ESS (9 ± 5 vs 6 ± 5, P <0.05) and saturation impair time below 90% (SIT90) (41.01 ± 26.95 vs 21.87 ± 19.03, P <0.05). Multivariate regression analysis revealed that the SD score was significantly correlated with age (β = 0.25, P <0.001) and SIT90 (β = 0.4, P <0.001) in the OSA patients.@*CONCLUSIONS@#OSA affects various aspects of the sexual function, particularly SD, of the patient. The duration of hypoxia and age of the patient are independent risk factors for SD reduction, which can be considered as a main clinical symptom of OSA.
Subject(s)
Adult , Humans , Male , Age Factors , Case-Control Studies , Hypoxia , Libido , Physiology , Risk Factors , Sleep Apnea, Obstructive , Surveys and Questionnaires , Time FactorsABSTRACT
Background: Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) have the potential to produce delayed ejaculation in men, delayed orgasm or anorgasmia in women and decreased libido that is independent of the gender. The occurrence of medication-associated sexual dysfunction increases the likelihood of medication non-compliance (or non-adherence) in patients, which may contribute to untreated depression and/or disease relapse. Materials & Methods: 60 patients with diagnosis of Depressive episode (in remission at the time of study), divided into 2 groups of 30 patients taking Duloxetine and the remaining 30 patients taking Escitalopram, were recruited on consecutive basis from the patients attending Psychiatry OPD of Lady Hardinge Medical College (LHMC). Each subject was rated on Arizona Sexual Experience Scale (ASEX) and the results obtained were statistically analyzed. Results: In the present study the average ASEX score obtained in the Escitalopram group (12.63) was found to be more than that in Duloxetine group (12.36), though this difference was not found to be statistically significant. Conclusions: These results illustrate that antidepressant-induced sexual dysfunction is reported frequently by patients taking SSRIs or SNRIs. Our study did not find any significant difference between escitalopram and duloxetine with respect to their sexual dysfunction profile but in view of the limitations of our study there is need for further research in this domain of psychopharmacology.