To explore the prevalence and risk factors of female sexual dysfunction (FSD) in Iran. A total of 2626 women aged 20-60 years old were interviewed by 41 female general practitioners and answered a self-administered questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders (OD). Criteria of sexual dysfunction followed classification by DSM-IV. The sexual function was evaluated by the Female Sexual Function Index (FSFI). The subjects were randomly identified from 28 counties of Iran. Data on medical history, toxic habits and current use of medication were also obtained. Of the women interviewed, 31.5% (759) reported FSD. The prevalence increased with age, from 26% in women aged 20-39 years to 39% in those 450 years (tested for trend Po0.001). Thirty-seven percent reported OD, 35% desire disorders (DD) and 30% arousal disorders (AD), all of which increased significantly with age. Pain disorders were reported by 26.7%, occurring most frequently in women aged 20-29 years. The educational level (P ¼ 0.01) and marriage age (o18 years) (P ¼ 0.04) were inversely correlated with the risk of DD, OD and AD. No significant differences were detected in smoking history (P ¼ 0.18), the presence of previous pelvic surgery (P ¼ 0.08) and contraception methods used (P ¼ 0.42). A history of psychological problems (P ¼ 0.04), married status (P ¼ 0.03), low physical activity (P ¼ 0.012), chronic disease (Po0.01), multiparity (Po0.05) menopause status (Pp0.01) and spousal erectile dysfunction (P ¼ 0.01) were significantly associated with FSD. This study provides a quantitative estimate of the prevalence and the main risk factors for FSD in Iranian women.
Coenzyme Q10 supplementation resulted in a statistically significant improvement in certain semen parameters. However, further studies are needed to draw a final conclusion and evaluate the effect of coenzyme Q10 supplementation on the pregnancy rate.
Effective medical treatments of infertile men with idiopathic oligoasthenoteratospermia (OAT) have yet to be determined. This study considered two major aims: (i) to measure the changes in semen parameters, omega-3 fatty acids (FA) compositions and anti-oxidant activity; (ii) to determine if the administration of omega-3 FA affect semen quality in infertile men with OAT. Two hundred thirty-eight infertile men with idiopathic OAT were randomised to eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), 1.84 g per day (EPAX 5500TG; Lysaker, Norway), or placebo for 32 weeks. The semen parameters were assessed according to WHO criteria, and the EPA and DHA concentrations were determined in red blood cells (RBCs), seminal plasma and sperm cells at baseline and 32-week treatment period. Of randomised subjects, 211 (88.7%) completed the full 32-week randomisation period. The anti-oxidant status of seminal plasma was also evaluated by measuring the superoxide dismutase (SOD) and catalase-like activity. In the total group of participants, all EPA and DHA levels in RBC, and seminal plasma, were statistically significantly correlated with those in spermatozoa (both P = 0.001). A significant improvement of sperm cell total count (from 38.7 ± 8.7 ' 10⁶ to 61.7 ± 11.2 ' 10⁶, P = 0.001) and sperm cell concentration (from 15.6 ± 4.1 ' 10⁶ per ml to 28.7 ± 4.4 ' 10⁶ per ml, P = 0.001) was observed in the omega-3 group. A significant positive correlation was found between the EPA and DHA in seminal plasma and the semen parameters. Seminal plasma EPA and DHA concentrations were positively correlated with seminal plasma SOD-like and catalase-like activity (both P = 0.001). In seminal plasma, both SOD-like and catalase-like activity were positively correlated with sperm count, sperm motility, and sperm morphology. Oligoasthenoteratospermic men with low levels of EPA and DHA may benefit from omega-3 FA supplementation. Further studies are warranted to shed more light on this important issue.
Effects of intensive exercise on hypothalamus-pituitary-testis (HPT) axis remain controversial. Our aim was to determine the effects of intensive, long-term treadmill running on reproductive hormones, HPT axis, and semen quality. A total of 286 subjects were randomly assigned to moderate-intensity exercise (w60% maximal oxygen uptake (VO 2max ); group 1, nZ143) and high-intensity exercise (w80% VO 2max ; group 2, nZ143) groups. The two groups exercised for 60 weeks in five sessions per week, each session lasting 120 min. This was followed by a 36-week low-intensity exercise recovery period. All subjects underwent routine semen analysis. Blood samples were drawn for the determination of the levels of the following hormones: LH, FSH, prolactin, testosterone (T), free testosterone (fT), inhibin B, and sex hormone-binding globulin (SHBG). The HPT axis was assessed using GnRH and human chorionic gonadotropin tests. After 24 weeks of exercise, the subjects exercising with high intensity demonstrated significantly declined semen parameters compared with those exercising with moderate intensity (PZ0 . 03). Serum T and fT began to decrease, and serum SHBG began to increase at the end of 12 weeks with both moderate-and high-intensity exercises. The serum LH and FSH concentrations decreased below the baseline level at 12 weeks in both groups (PZ0 . 07 in group 1 and 0 . 03 in group 2). Both groups had blunted LH and FSH responses to GnRH. These parameters improved to their pre-exercise level during the recovery period. Long-term strenuous treadmill exercises (overtraining syndrome) have a deleterious effect on reproduction.
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