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The erection conundrum: risk factors for erectile dysfunction among middle-aged and elderly men in Lamongan, East Java, Indonesia



Abstract

Background: The most common sexual problem affecting the general population of men is Erectile Dysfunction (ED) with a global estimated number of over 100 million. It affects the biological, psychological, and social aspect of life which can cause frustration, depression, and anxiety. Unfortunately, the attention towards the disease in Indonesia is often overlooked as evidenced by the lack of studies regarding the prevalence and risk factors for the disease. This study aims to evaluate possible risk factors of Erectile Dysfunction among elderly males in Lamongan, East Java.

Methods: This is a quantitative study with an analytical observational design, performed using a case-control approach. Respondents consisted of male inpatients as well as outpatients aged 40 years or more in Ngimbang General Hospital evaluated using the International Index of Erectile Function (IIEF) questionnaire. The patient’s comorbid data are taken from the Medical Record to ensure proper diagnosis. The acquired data are then analysed using the ordinal logistic regression method.

Results: A total of 174 men were evaluated. There are 62 people with no ED (35.6%), 39 people with mild ED (22.4%), 35 people with mild to moderate ED (20.1%), 16 people with moderate ED (9.2%), and 22 people with severe ED (12.6%). Significant risk factors are older age (OR: 1.29; CI: 1.23-1.37), Diabetes (OR: 6.56; CI: 2.77-15.56), and hypertension (OR: 5.19; CI: 2.27-11.88) (all, p < 0.05); whereas dyslipidemia and smoking habit are insignificant (p>0.05).

Conclusion: Age, diabetes, and hypertension are significant risk factors for Erectile Dysfunction.

Keywords: erectile dysfunction risk factors elderly diabetes mellitus hypertension

References

  1. Selvin E, Burnett A, Platz E. Prevalence and Risk Factors for Erectile Dysfunction in the US. The American Journal of Medicine. 2007;120(2):151-157.
  2. Esposito K, Maiorino M, Bellastella G. Lifestyle modifications and erectile dysfunction: what can be expected?. Asian Journal of Andrology. 2015;17(1):5.
  3. Yafi F, Jenkins L, Albersen M, Corona G, Isidori A, Goldfarb S et al. Erectile dysfunction. Nature Reviews Disease Primers. 2016;2(1).
  4. De Berardis G, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, Kaplan S et al. Erectile Dysfunction and Quality of Life in Type 2 Diabetic Patients: A serious problem too often overlooked. Diabetes Care. 2002;25(2):284-291.
  5. Pagano M, De Fazio A, Levy A, RoyChoudhury A, Stahl P. Age, Body Mass Index, and Frequency of Sexual Activity are Independent Predictors of Testosterone Deficiency in Men With Erectile Dysfunction. Urology. 2016;90:112-118.
  6. Esposito K, Maiorino M, Bellastella G. Diabetes and sexual dysfunction: current perspectives. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2014;:95.
  7. Turek S, Hastings S, Sun J, King G, Keenan H. Sexual Dysfunction as a Marker of Cardiovascular Disease in Males With 50 or More Years of Type 1 Diabetes. Diabetes Care. 2013;36(10):3222-3226.
  8. Shindel A. Erectile Dysfunction and Risk of Cardiovascular Disease: Meta-Analysis of Prospective Cohort Studies. Yearbook of Urology. 2012;2012:114-115.
  9. 10. Nicolosi A, Laumann E, Glasser D, Moreira E, Paik A, Gingell C. Sexual behavior and sexual dysfunctions after age 40: The global study of sexual attitudes and behaviors. Urology. 2004;64(5):991-997.
  10. Lewis R, Fugl-Meyer K, Corona G, Hayes R, Laumann E, Moreira E et al. ORIGINAL ARTICLES: Definitions/Epidemiology/Risk Factors for Sexual Dysfunction. The Journal of Sexual Medicine. 2010;7(4):1598-1607.
  11. Morales A. Erectile dysfunction and its neuroendocrine correlates: towards an integral perspective. The Aging Male. 2002;5(4):239-241.
  12. Traish A. Androgens Play a Pivotal Role in Maintaining Penile Tissue Architecture and Erection: A Review. Journal of Andrology. 2008;30(4):363-369.
  13. Guay A. Testosterone and erectile physiology. The Aging Male. 2006;9(4):201-206.
  14. Aversa A, Isidori A, De Martino M, Caprio M, Fabbrini E, Rocchietti-March M et al. Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clinical Endocrinology. 2000;53(4):517-522.
  15. Corona G, Maggi M. The role of testosterone in erectile dysfunction. Nature Reviews Urology. 2009;7(1):46-56.
  16. Cho N, Ahn C, Park J, Ahn T, Lee H, Park T et al. Prevalence of erectile dysfunction in Korean men with Type 2 diabetes mellitus. Diabetic Medicine. 2006;23(2):198-203.
  17. Chitaley K, Webb R. Microtubule depolymerization facilitates contraction of vascular smooth muscle via increased activation of RhoA/Rho-kinase. Medical Hypotheses. 2001;56(3):381-385.
  18. Kamenov Z. A Comprehensive Review of Erectile Dysfunction in Men with Diabetes. Experimental and Clinical Endocrinology & Diabetes. 2014;123(03):141-158.
  19. Tesfaye S, Selvarajah D. The Eurodiab study: What has this taught us about diabetic peripheral neuropathy?. Current Diabetes Reports. 2009;9(6):432-434.
  20. Viigimaa M. Management of erectile dysfunction in hypertension: Tips and tricks. World Journal of Cardiology. 2014;6(9):908.
  21. Behr-Roussel D, Gorny D, Mevel K, Compagnie S, Kern P, Sivan V et al. Erectile dysfunction: an early marker for hypertension? A longitudinal study in spontaneously hypertensive rats. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2005;288(1):R276-R283.
  22. Cordero A, Bertomeu-Martínez V, Mazón P, Fácila L, González-Juanatey J. Erectile Dysfunction May Improve by Blood Pressure Control in Patients with High-Risk Hypertension. Postgraduate Medicine. 2010;122(6):51-56.
  23. Kostis J, Dobrzynski J. The Effect of Statins on Erectile Dysfunction: A Metaâ€Analysis of Randomized Trials. The Journal of Sexual Medicine. 2014;11(7):1626-1635.
  24. Nikoobakht M, Nasseh H, Pourkasmaee M. The relationship between lipid profile and erectile dysfunction. Int J Impot Res 2005;17:523–6.
  25. Hall S, Kupelian V, Rosen R, Travison T, Link C, Miner M et al. Is Hyperlipidemia or Its Treatment Associated with Erectile Dysfunction?: Results from the Boston Area Community Health (BACH) Survey. The Journal of Sexual Medicine. 2009;6(5):1402-1413.
  26. Azadzoi K, Tejada I. Hypercholesterolemia Impairs Endothelium-Dependent Relaxation of Rabbit Corpus Cavernosum Smooth Muscle. Journal of Urology. 1991;146(1):238-240.
  27. Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004;171:2341–5.
  28. Giuliano FA, Leriche A, Jaudinot EO, Solesse de Gendre A. Prevalence of erectile dysfunction among 7,689 patients with diabetes or hypertension, or both. Urology 2004;64:1196–201.
  29. Gratzke C, Angulo J, Chitaley K, Dai Y, Kim N, Paick J et al. Anatomy, Physiology, and Pathophysiology of Erectile Dysfunction. The Journal of Sexual Medicine. 2010;7(1):445-475.

How to Cite

Kloping, Y. P., Himawan, B., & Balti, D. R. (2019). The erection conundrum: risk factors for erectile dysfunction among middle-aged and elderly men in Lamongan, East Java, Indonesia. Bali Medical Journal, 8(3), 793–797. https://doi.org/10.15562/bmj.v8i3.1614
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Yudhistira Pradnyan Kloping
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Budi Himawan
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Dimas Rio Balti
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