Erectile dysfunction can be an early warning sign of broader health problems. That's the suggestion of a new retrospective analysis of European men, which found that erectile dysfunction and other sexual symptoms were associated with an increased risk of death, regardless of testosterone levels. Similar studies have shown links between mortality and sexual dysfunction, or between mortality and testosterone level, but the current study is unique, said Leen Antonio, MD, PhD, assistant professor of endocrinology at Katholieke Universiteit Leuven (Belgium), in a presentation during the Endocrine Society annual meeting, which was presented online this year. The actual meeting, scheduled for March 28 and 31 in San Francisco, was canceled due to COVID-19 concerns.
"It is the first time that we have brought the two together in the same group of people, and we can say that it is primarily sexual symptoms that predict the risk of mortality, regardless of the testosterone levels of these men," said Dr. Antonio. it's a statement. interview. "We can consider sexual symptoms as a marker of overall adverse health status. It is like a warning sign that you are at risk for more serious problems," added Dr. Antonio.
Dr. Antonio advised doctors to assess blood pressure and cholesterol levels in men who have sexual dysfunction and to advise lifestyle changes, such as physical activity and weight control. "These may be beneficial for sexual symptoms and for overall health and risk of cardiovascular disease in the future."
Although the study was unable to identify a reason for the relationship between sexual dysfunction and mortality, Dr. Antonio hypothesized that the narrow artery of the penis may be more likely to experience noticeable effects in the early stages of atherosclerosis, earlier for clinical effects to occur in the coronary artery. Michael Blaha, MD, professor of medicine and director of clinical research at the Ciccarone Center for Heart Disease Prevention at Johns Hopkins University, Baltimore, who studied erectile dysfunction (ED) and its association with cardiovascular disease, said that the study is Additional Evidence that ED is an important and independent risk factor for cardiovascular disease and other health risks. He would like to see a move toward establishing men's health clinics, where risk factors can be identified and mitigated through lifestyle changes and therapies. "There must be a complete rethink of how we approach the entire group of patients presenting with erectile dysfunction to various specialists," he said in an interview, noting that middle-aged men often present to ED specialists. after years of not having any contact with the health system. In that group, ED can be an early warning signal that could trigger broader interventions.
"This points to the need for more men's health clinics that focus on early detection of risk factors and treating erectile dysfunction and other risk factors in a more comprehensive way," said Dr. Blaha, who was not associated with the study. Dr. Antonio and his colleagues studied 1,913 men living in the community, who participated in the European Study on Male Aging. Baseline information on sexual function and testosterone levels was collected between 2003 and 2005. The men were between 40 and 79 years old at the start of the study, and "due to the wide age range at the start of the study, age was used as a time scale, instead of years since inclusion is adjusted for age, "the researchers explained. During a mean follow-up of 12.4 years, 25.3% of the participants died. The body mass index was higher in the men who died (p = 0.002), but there were no significant differences in smoking. Both groups had similar levels of total testosterone, but free testosterone was lower in the deceased population (270 pmol / L vs. 312 pmol / L; P <.001), while luteinizing hormone levels were higher (7.8 units / L vs. 5.7 units / L; P <.001). The lowest quartile of free testosterone level was associated with an increased risk of mortality (risk ratio, 1.43; P = .021), while the highest quartile of follicle-stimulating hormone was associated with an increased risk of mortality ( HR, 1.38; P = .036). There was no association between the risk of mortality and total testosterone or estradiol.
Men who reported three sexual symptoms at the start of the study had a higher risk of mortality than those who did not report symptoms (HR, 1.77; P < .001). There was an association between mortality risk and ED (HR, 1.40;P= .001) and poor morning erections (HR, 1.30;P= .012), but not low libido. The associations were not affected after adjustment for total testosterone or free testosterone. Among men with normal total testosterone (>12 nmol / L), sexual symptoms were associated with an increased risk of mortality (HR, 1.51; P = .003), and the same was true for men with total testosterone levels of less than 8 nmol, compared to men with normal total testosterone who reported no sexual symptoms (HR, 1.92; P = .035).
The European Study on Male Aging received the support of the European Union. Dr. Antonio has no relevant financial disclosures. Dr. Blaha received grants from Amgen and is on advisory boards for Amgen and other pharmaceutical companies. Dr. Antonio and her team's research will be published in a special supplemental issue of the Journal of the Endocrine Society. In addition to a series of press conferences from March 30 to 31, the society will organize ENDO Online 2020 from June 8 to 22, which will present programming for doctors and researchers.
SOURCE: Antonio L et al. ENDO 2020, Summary OR02-06.
This article originally appeared on MDedge.com.
. (tagsToTranslate) erectile dysfunction (t) impotence (t) atherosclerosis (t) lipids (t) lipid management (t) Europe (t) European (t) sexual disorder (t) sexual dysfunction (t) cardiovascular disease (t) cvd (cardiovascular disease) (t) cv (t) cardiovascular (t) Endocrine Society
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