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- O'Connor, Daryl B, et al.
(författare)
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Assessment of sexual health in aging men in Europe: Development and validation of the European Male Ageing Study sexual function questionnaire
- 2008
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 5:6, s. 1374-1385
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Assessment of male sexual dysfunction has been the focus of substantial scientific effort. Less research has focused on the development of instruments for the measurement of sexual functioning in aging men. Aim. The aims of this study were: (i) to characterize the psychometric properties of a new brief, reliable, and valid measure of male sexual functioning for use in a large population survey of middle-aged and elderly European men; and (ii) specifically, to determine whether the new instrument, the European Male Ageing Study-sexual function questionnaire (EMAS-SFQ), discriminates between men with high and low levels of circulating testosterone (T) (total T, free T, and bioavailable T). Method. One thousand six hundred men aged 40-79 years completed the self-administered EMAS-SFQ, the Beck depression inventory, and provided a blood sample for assessment of sex hormones. Eighty-five men aged 35-74 years completed the EMAS-SFQ twice, 2 weeks apart to examine the test-retest reliability of the instrument. Main Outcome Measures. Scores on the EMAS-SFQ in relation to age and T levels. Results. Principal component analysis showed that the EMAS-SFQ had four distinct domains (overall sexual functioning [OSF], masturbation, sexual functioning-related distress, and change in sexual functioning). The instrument demonstrated excellent internal and test-retest reliability, as well as convergent, divergent, and discriminant validity. Men with the lowest levels of total, free, and bioavailable T reported lower OSF scores compared to men with the highest T levels. Conclusion. The EMAS-SFQ is a valid and reproducible instrument, sensitive to age and T levels. It should be suitable for the assessment of sexual health in population samples of men in epidemiological studies of aging.
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| 3. |
- Wu, Frederick C W, et al.
(författare)
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Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: The European Male Aging Study
- 2008
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 93:7, s. 2737-2745
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT The cause of declining testosterone (T) in aging men and their relationships with risk factors are unclear. OBJECTIVE To investigate the relationships between lifestyle and health with reproductive hormones in aging men. DESIGN Baseline cross-sectional survey on 3200 community - dwelling men aged 40 - 79 yr from a prospective cohort study in 8 European countries. RESULTS Four predictors were associated with distinct modes of altered function:- Age: lower free T (FT) (-3.12 pmol/L/ yr, p<0.001) with raised luteinizing hormone (LH) suggesting impaired testicular function. Obesity: lower total T (TT) (-2.32 nmol/L) and FT (-17.60 pmol/L) for BMI >/=25 - <30 kg/m(2) and lower TT (-5.09 nmol/L,) and FT (-53.72 pmol/L) for BMI >/=30 kg/m(2) (p <0.001 - 0.01, referent: BMI <25 kg/m(2)) with unchanged/decreased LH, indicating hypothalamus/pituitary dysfunction. Co-morbidity: lower TT (-0.80 nmol/L, p <0.01) with unchanged LH in younger men but higher LH in older men. Smoking: higher sex hormone binding globulin (SHBG) (5.96 nmol/L, p <0.001) and LH (0.77 U/L, p <0.01) with increased TT (1.31 nmol/L, p<0.001) but not FT, compatible with a resetting of T-LH negative feedback due to elevated SHBG. CONCLUSIONS Complex multiple alterations in the hypothalamic-pituitary-testicular axis function exist in ageing men against a background of progressive age-related testicular impairment. These changes are differentially linked to specific risk factors. Some risk factors operate independently of but others interact with age, in contributing to the T decline. These potentially modifiable risk factors suggest possible preventative measures to maintain T during in aging men.
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