Objectives To assess erectile function in middle-aged and older men with asexuality status and further analyze their specific reasons for this condition. Subjects and Methods Men who had regular sexual intercourse attempts (sex frequency≥1 time per month) were classified into mild erectile dysfunction (ED), moderate to severe ED and non-ED according to International Index of Erectile Function-5, and men having no sexual intercourse attempts for at least 6 months were defined as having an asexuality status. The risk factors associated with ED were collected in a sample of 1,531 Chinese men aged 40 to 80 years, and the self-report reasons for asexuality were recorded in asexual cohort individually. Comparative analyses and multivariate regression models were conducted among these groups. Results The prevalence rates of ED and asexuality status were 49.9% and 37.2%. The asexuality status group had higher risk factors than the moderate to severe ED group in terms of old age (age≥65, adjusted odds ratio (OR) 17.69 versus (Vs.) 7.19), diabetes (crude OR: 2.40 Vs. 2.36) and hypertension (crude OR: 1.78 Vs. 1.72). The specific reasons for the asexuality status were “erectile difficulty” (52.9%), “do not care about sexuality” (53.5%)”, “no longer necessary to have sexuality at this age” (47.7%), “severe stress” (44.4%), “severe fatigue” (26.3%) and “masturbation” (26.9%). Conclusions Men with an asexual status suffer from higher risk factors for ED than men with moderate to severe ED. The majority of this asexual status could be attributed to a full ED, although the reasons for this transient asexuality also involved sexual attitudes and interests, sexual partners and masturbation.
References
[1]
Bogaert AF (2004) Asexuality: prevalence and associated factors in a national probability sample. J Sex Res 41: 279–287. doi: 10.1080/00224490409552235
[2]
Prause N, Graham CA (2007) Asexuality: classification and characterization. Arch Sex Behav 36: 341–356. doi: 10.1007/s10508-006-9142-3
[3]
Wei X, Zakus D, Liang H, Sun X (2005) The Shanghai case: A qualitative evaluation of community health reform in response to the challenge of population ageing. Int J Health Plann Manage 20: 269–286. doi: 10.1002/hpm.814
[4]
Araujo AB, Johannes CB, Feldman HA, Derby CA, McKinlay JB (2000) Relation between psychosocial risk factors and incident erectile dysfunction: prospective results from the Massachusetts Male Aging Study. American journal of epidemiology 152: 533–541. doi: 10.1093/aje/152.6.533
[5]
Perloff D, Grim C, Flack J, Frohlich E, Hill M, et al. (1993) Human blood pressure determination by sphygmomanometry. Circulation 88: 2460–2470. doi: 10.1161/01.cir.88.5.2460
[6]
WHO (2004) Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363: 157–163. doi: 10.1016/s0140-6736(03)15268-3
[7]
Ye Y, Bao Y, Hou X, Pan X, Wu H, et al. (2009) Identification of waist circumference cutoffs for abdominal obesity in the Chinese population: a 7.8-year follow-up study in the Shanghai urban area. International Journal of Obesity 33: 1058–1062. doi: 10.1038/ijo.2009.134
[8]
Nechuta SJ, Shu XO, Li HL, Yang G, Xiang YB, et al. (2010) Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study. PLoS medicine 7: e1000339. doi: 10.1371/journal.pmed.1000339
[9]
Khavari KA, Farber PD (1978) A profile instrument for the quantification and assessment of alcohol consumption. The Khavari Alcohol Test. J Stud Alcohol 39: 1525–1539.
[10]
Kleinman KP, Feldman HA, Johannes CB, Derby CA, McKinlay JB (2000) A new surrogate variable for erectile dysfunction status in the Massachusetts Male Aging Study. Journal of clinical epidemiology 53: 71–78. doi: 10.1016/s0895-4356(99)00150-x
[11]
Egan BM, Zhao Y, Axon RN (2010) US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA: the journal of the American Medical Association 303: 2043–2050. doi: 10.1001/jama.2010.650
[12]
Nickel JC, Downey J, Hunter D, Clark J (2001) Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index. The Journal of urology 165: 842–845. doi: 10.1097/00005392-200103000-00026
[13]
Myers GL, Cooper GR, Winn CL, Smith SJ (1989) The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. Clin Lab Med 9: 105–135.
[14]
Krieger DT (1975) Rhythms of ACTH and corticosteroid secretion in health and disease, and their experimental modification. Journal of steroid biochemistry 6: 785–791. doi: 10.1016/0022-4731(75)90068-0
[15]
Brambilla DJ, McKinlay SM, McKinlay JB, Weiss SR, Johannes CB, et al. (1996) Does collecting repeated blood samples from each subject improve the precision of estimated steroid hormone levels? Journal of clinical epidemiology 49: 345–350. doi: 10.1016/0895-4356(95)00569-2
[16]
Longcope C, Franz C, Morello C, Baker R, Johnston CC (1986) Steroid and gonadotropin levels in women during the peri-menopausal years. Maturitas 8: 189–196. doi: 10.1016/0378-5122(86)90025-3
[17]
Fernandez-Sanchez C, McNeil CJ, Rawson K, Nilsson O, Leung HY, et al. (2005) One-step immunostrip test for the simultaneous detection of free and total prostate specific antigen in serum. J Immunol Methods 307: 1–12. doi: 10.1016/j.jim.2005.08.014
[18]
Marumo K, Nakashima J, Murai M (2001) Age-related prevalence of erectile dysfunction in Japan: assessment by the International Index of Erectile Function. Int J Urol 8: 53–59. doi: 10.1046/j.1442-2042.2001.00258.x
[19]
Malavige LS, Levy JC (2009) Erectile dysfunction in diabetes mellitus. J Sex Med 6: 1232–1247. doi: 10.1111/j.1743-6109.2008.01168.x
Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, et al. (2007) A study of sexuality and health among older adults in the United States. N Engl J Med 357: 762–774. doi: 10.1056/nejmoa067423
[22]
Prins J, Blanker MH, Bohnen AM, Thomas S, Bosch JL (2002) Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res 14: 422–432. doi: 10.1038/sj.ijir.3900905
[23]
Martins FG, Abdo CH (2010) Erectile dysfunction and correlated factors in Brazilian men aged 18–40 years. J Sex Med 7: 2166–2173. doi: 10.1111/j.1743-6109.2009.01542.x
[24]
Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, et al. (2013) One patient out of four with newly diagnosed erectile dysfunction is a young man–worrisome picture from the everyday clinical practice. J Sex Med 10: 1833–1841. doi: 10.1111/jsm.12179
[25]
Lee JC, Benard F, Carrier S, Talwar V, Defoy I (2011) Do men with mild erectile dysfunction have the same risk factors as the general erectile dysfunction clinical trial population? BJU Int 107: 956–960. doi: 10.1111/j.1464-410x.2010.09691.x
[26]
Li D, Jiang X, Zhang X, Yi L, Zhu X, et al. (2012) Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China. Urology 79: 601–606. doi: 10.1016/j.urology.2011.11.035
[27]
Rhoden E, Teloken C, Sogari P, Vargas Souto C, Correspondence C (2002) The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. International journal of impotence research 14: 245–250. doi: 10.1038/sj.ijir.3900859
[28]
La Vignera S, Condorelli RA, Vicari E, Calogero AE (2012) Statins and erectile dysfunction: a critical summary of current evidence. J Androl 33: 552–558. doi: 10.2164/jandrol.111.015230
[29]
Esposito K, Ciotola M, Giugliano F, Maiorino MI, Autorino R, et al. (2009) Effects of intensive lifestyle changes on erectile dysfunction in men. J Sex Med 6: 243–250. doi: 10.1111/j.1743-6109.2008.01030.x
[30]
Meldrum DR, Gambone JC, Morris MA, Esposito K, Giugliano D, et al. (2012) Lifestyle and metabolic approaches to maximizing erectile and vascular health. Int J Impot Res 24: 61–68. doi: 10.1038/ijir.2011.51
[31]
Smith NJ, Sak SC, Baldo O, Eardley I (2007) The prevalence of newly diagnosed hyperlipidaemia in men with erectile dysfunction. BJU Int 100: 357–361. doi: 10.1111/j.1464-410x.2007.06988.x
[32]
Hall SA, Kupelian V, Rosen RC, Travison TG, Link CL, et al. (2009) Is hyperlipidemia or its treatment associated with erectile dysfunction?: Results from the Boston Area Community Health (BACH) Survey. J Sex Med 6: 1402–1413. doi: 10.1111/j.1743-6109.2008.01207.x
[33]
Nicolosi A, Moreira ED Jr, Shirai M, Bin Mohd Tambi MI, Glasser DB (2003) Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction. Urology 61: 201–206. doi: 10.1016/s0090-4295(02)02102-7
[34]
Nicolosi A, Glasser DB, Kim SC, Marumo K, Laumann EO (2005) Sexual behaviour and dysfunction and help-seeking patterns in adults aged 40–80 years in the urban population of Asian countries. BJU Int 95: 609–614. doi: 10.1111/j.1464-410x.2005.05348.x
[35]
Wong SYS, Leung JCS, Woo J (2008) Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in Southern China. The journal of sexual medicine 6: 74–80. doi: 10.1111/j.1743-6109.2008.01034.x
[36]
Kim JH, Lau JTF, Cheuk KK (2009) Sexlessness among married Chinese adults in Hong Kong: Prevalence and associated factors. The journal of sexual medicine 6: 2997–3007. doi: 10.1111/j.1743-6109.2009.01367.x
[37]
Brody S (2010) The relative health benefits of different sexual activities. J Sex Med 7: 1336–1361. doi: 10.1111/j.1743-6109.2009.01677.x
[38]
Corona G, Mannucci E, Lotti F, Boddi V, Jannini EA, et al. (2009) Impairment of couple relationship in male patients with sexual dysfunction is associated with overt hypogonadism. J Sex Med 6: 2591–2600. doi: 10.1111/j.1743-6109.2009.01352.x
[39]
Brotto LA, Knudson G, Inskip J, Rhodes K, Erskine Y (2010) Asexuality: a mixed-methods approach. Arch Sex Behav 39: 599–618. doi: 10.1007/s10508-008-9434-x
[40]
Corona G, Lee DM, Forti G, O’Connor DB, Maggi M, et al. (2010) Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med 7: 1362–1380. doi: 10.1111/j.1743-6109.2009.01601.x
[41]
Bassil N (2011) Late-onset hypogonadism. Med Clin North Am 95: 507–523. doi: 10.1016/j.mcna.2011.03.001
[42]
Mikhail N (2006) Does testosterone have a role in erectile function? Am J Med 119: 373–382. doi: 10.1016/j.amjmed.2005.07.042