Relationship between hyperuricemia with deposition and sexual dysfunction in males and females

Abstract

Purpose The association between gout, the most common crystal arthropathy, and sexual dysfunctions has often been investigated by studies in the last decades. Despite the presence of shared risk factors and comorbidities and the possible effects on sexual health of long-term gout complications, awareness of this association is severely lacking and the pathogenetic mechanisms have only partially been identified. In the present review, we aimed to investigate the current evidence regarding the potential mechanisms linking sexual dysfunctions and gout. Methods A comprehensive literature search within PubMed was performed to provide a summary of currently available evidence regarding the association between gout and sexual dysfunctions. Results Gout and sexual dysfunctions share several risk factors, including diabesity, chronic kidney disease, hypertension, metabolic syndrome, and peripheral vascular disease. Gout flares triggered by intense inflammatory responses feature severe pain and disability, resulting in worse sexual function, and some, but not all, treatments can also impair sexual health. Long-term gout complications can result in persistent pain and disability due to joint deformity, fractures, or nerve compression, with negative bearing on sexual function. The presence of low-grade inflammation impairs both sex steroids synthesis and endothelial function, further advancing sexual dysfunctions. The psychological burden of gout is another issue negatively affecting sexual health. Conclusions According to currently available evidence, several biological and psychological mechanisms link sexual dysfunctions and gout. Addressing risk factors and providing adequate treatment could potentially have beneficial effects on both conditions. Appropriate clinical evaluation and multidisciplinary approach are recommended to improve patient care.

The Independent Value of Neutrophil to Lymphocyte Ratio in Gouty Arthritis: A Narrative Review

“…The common complications of GA include cardiovascular diseases, 38,39 diabetes, 40 renal function impairment, 41 sexual dysfunction, 42 and ophthalmic diseases. 43 Recent studies have found that NLR may be able to predict the risk and outcome of GA comorbidities.…”

Causal association between erectile dysfunction with urate levels and gout: a two-sample Mendelian randomization study

“…During hyperuricemia or gout attacks, UA crystals accumulate in blood vessels and the joints to trigger in ammation responses. Then this in ammation response can contribute to the occurrence of ED 41 .…”

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction

“…Having gout there is a 20% increased risk of developing ED, even after adjusting for possible confounders, including comorbidities. Considering that hyperuricemia is the underlying condition favoring gout development and that hyperuricemia is associated with endothelial dysfunction and CVD [ 74 ], it is obvious that known or even unknown comorbidities might favor ED development [ 75 ]. Finally, the couple, being in a stable relationship, may have a positive “anti-inflammatory” role in modifying incorrect lifestyles leading to gout and to other metabolic risk factors producing ED [ 76 ].…”