Cardiovascular Aspects of Sexual Medicine

Jackson, Graham; Montorsi, Piero; Adams, Michael; Anis, Tarek; El‐Sakka, Ahmed I.; Miner, Martin; Vlachopoulos, Charalambos; Kim, Edward

doi:10.1111/j.1743-6109.2010.01779.x

Cited by 103 publications

(85 citation statements)

References 122 publications

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“…Low endogenous T levels correlate with an increased risk of adverse CVD events, and endothelial dysfunction and increased atherosclerosis are means by which male hypogonadism may contribute to an increased risk of death [Jackson et al 2010]. The potential that TD may be involved in the pathogenesis of CVD would create a notion that TRT would result in improved cardiovascular outcomes, yet no current evidence exists to support this claim.…”

Section: Risk Of Cardiovascular Morbidity and Mortalitymentioning

confidence: 99%

Adverse effects of testosterone replacement therapy: an update on the evidence and controversy

Grech

Breck

Heidelbaugh

2014

Therapeutic Advances in Drug Safety

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Testosterone replacement therapy (TRT) has been used in millions of men worldwide to treat diminished libido and erectile dysfunction, and to improve strength and physical function. The estimated likelihood of adverse effects of long-term TRT is still essentially unknown, as overall high-quality evidence based upon prospective randomized trials to recommend for or against its use in most men with testosterone deficiency (TD) is lacking. Evidence to suggest that TRT increases cardiovascular morbidity and mortality risks is poor, as results vary across study populations and their baseline comorbidities. While TRT may increase serum prostate-specific antigen levels in some men, it often remains within clinically acceptable ranges, and has not been shown to increase the risk of prostate cancer. Current literature supports that TRT does not substantially worsen lower urinary tract symptoms, and may actually improve symptoms in some men. Limited evidence suggests that TRT may initially worsen obstructive sleep apnea in some men, but that this is not a longstanding effect. TRT may result in erythrocytosis in some men, however long-term studies have not reported significant adverse events (e.g. cerebrovascular accident, vascular occlusive events, venous thromboembolisms). Future research will require dedicated focus on evaluation of large, multiethnic cohorts of men through prospective trials to better elucidate both risk and hazard ratios of TRT as it relates to cardiovascular disease, prostate cancer, lower urinary tract symptoms, obstructive sleep apnea, erythrocytosis, and other to-bedetermined theoretical risks in men both with and without cardiovascular risk equivalents.

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Section: Risk Of Cardiovascular Morbidity and Mortalitymentioning

confidence: 99%

Adverse effects of testosterone replacement therapy: an update on the evidence and controversy

Grech

Breck

Heidelbaugh

2014

Therapeutic Advances in Drug Safety

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“…The erection depends on the sexual stimulation that initiates the synthesis of NO and other endothelial factors that cause relaxation in the smooth muscles of the arteries carrying blood to the erectile tissues (8)(9)(10). For this reason, endothelial integrity plays an important role in penile erection physiology.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum Magnesium Levels in Patients with Erectile Dysfunction and Healthy Peers

Benli̇¹,

Çırakoğlu²,

Ayyıldız³

2018

JAREM

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Objective: Erectile dysfunction (ED) is a very common health problem among men that disrupts the quality of life. The aim of this study was to investigate whether serum magnesium levels in patients with ED are different from those in healthy individuals. Methods:The study accessed the data of 344 patients who applied to the urology clinic from 2014 to 2016. Patients were divided into two groups: patients with ED, Group 1 (n=155) and those without ED, Group 2 (control; n=189). Characteristics such as patients' age, additional diseases, and smoking habits were recorded and compared between the two groups along with laboratory parameters such as levels of serum magnesium, calcium, and inflammatory markers. Sexual situation was assessed with the SHIM-5 form.Results: Patients aged 63.15±8.90 years were included in Group 1 and those aged 61.63±8.01 years were included in Group 2 (p=0.101). There were no differences between the groups in terms of BMI and waist circumference (p>0.05). Serum magnesium levels were 1.94±0.20 and 2.00±0.17 mg/dl in groups 1 and 2, respectively (p=0.008). WBC value for inflammatory makers were 6.94±1.74 and 6.58±1.43 in groups 1 and 2, respectively (p=0.04).Conclusion: Our study found that serum magnesium values were reduced in ED patients than in the control group. Therefore, it may be beneficial to determine serum magnesium values in ED patients. Additionally, serum magnesium values may be used as markers for the early identification of patients at risk.

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“…Moreover, HF-induced reduction in exercise tolerance, side effects of HF medications and the coexistence of shared risk factors (Drory et al, 1998(Drory et al, , 2000Feldman et al, 2000) between HF and sexual dysfunction may further aggravate the sexual health of HF patients. In fact, ED and HF share several risk factors and pathogenetic mechanisms (Jackson et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction in heart failure patients: a critical reappraisal

et al. 2013

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SUMMARYHeart failure (HF) is a complex clinical syndrome with a constantly increasing incidence and prevalence in western countries. Total absence of sexual activity is registered in 30% of HF patients. Moreover, HF-induced reduction in exercise tolerance, side effects of HF medications and the coexistence of shared risk factors between HF and sexual dysfunction may further aggravate the sexual health of HF patients. The purpose of this review is to examine the pathophysiological mechanisms behind the association of erectile dysfunction (ED) and HF, the potential therapeutic approaches and the eventual indications for sexual activity in HF patients. Medline and Cochrane Library search was performed from January 1970 through October 2012 to retrieve relevant papers outlining the association between ED and HF. Many evidences have outlined a tight association between ED and HF pathophysiological standpoint. Shared risk factors, common pathogenic traits and epidemiologic association represent some of the links between these conditions. Erectile dysfunction has been recognized as an earlier predictor of cardiovascular events; moreover, HF itself may cause and/ or worsen ED because of its particular feature and co-morbidities. Furthermore, some cardiovascular drugs may contribute to impaired erectile function. In stable patients with stable HF, sexual activity is generally not contraindicated but it should be encouraged, as a form of moderate-intensity physical exertion. An effective treatment of ED in HF patients should be founded on the correction of reversible risk factors, on the choice of cardiovascular drugs with the lowest effect upon patient's erectile function, and on the use of phosphodiesterase-5-inhibitors. Physicians should be aware of the close relation between HF and ED and of the related clinical and therapeutic implications, in order to improve patients quality of life and clinical outcome.

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Cardiovascular Aspects of Sexual Medicine

Cited by 103 publications

References 122 publications

Adverse effects of testosterone replacement therapy: an update on the evidence and controversy

Adverse effects of testosterone replacement therapy: an update on the evidence and controversy

Comparison of Serum Magnesium Levels in Patients with Erectile Dysfunction and Healthy Peers

Erectile dysfunction in heart failure patients: a critical reappraisal

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