Exposure to environmental or occupational substances may affect penile erectile function, and it would add to a growing list of pathogenic risk factors associated with erectile dysfunction. Several lines of evidence gained by clinical epidemiologic and biomedical investigations lend support to this viewpoint. Some environmental toxicants, including smoke, lead, organic solvents, and pesticides, are potential hazards, whose effects on the nervous and hormonal systems have been proposed as the leading mechanisms by which environmental toxicants adversely impact erectile function. A synthesis of current data suggests a possible association between environmental exposure and erectile dysfunction, but evidence is not yet sufficient to support a direct causal link for the time being. More studies are needed to identify specific environmental agents that may harm erectile function and to define their exact action mechanisms in this regard.
Animals ; Environmental Exposure ; Environmental Pollutants ; Erectile Dysfunction ; chemically induced ; Humans ; Male ; Rats

The cyclic nucleotide (cGMP) signalling pathway mediates the smooth-muscle relaxing effects of nitric oxide necessary for normal erectile function. Down-regulation of this pathway is the pathophysiological pivot of many forms of erectile dysfunction (ED) and leads to the development of some chronic diseases, such as hypertension and type 2 diabetes mellitus. Therefore, selective inhibition of the enzyme that catalyses the degradation of cGMP promotes erectile responses to sexual stimulation. Recently, a new phosphodiesterase type 5 (PDE-5) inhibitor tadalafil has emerged, which has a prolonged half-life. Here is a review of recent studies on the safety of tadalafil in the treatment of ED.
Back Pain ; chemically induced ; Carbolines ; adverse effects ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Headache ; chemically induced ; Humans ; Male ; Phosphodiesterase Inhibitors ; adverse effects ; therapeutic use ; Tadalafil

OBJECTIVETo compare the incidences of sexual dysfunction induced by mirtazapine and SSRI in the treatment of patients with depression.

METHODSUsing key-word retrieval from the compact disks of the Chinese biological medicine (CBM) data base, we analyzed the rates of sexual dysfunction from the published clinical control trials on depression treated with mirtazapine and SSRI by applying the fixed effects model (FEM) of evidence-based medicine (EBM).

RESULTSAmong 1108 cases in 14 studies, there were 5 cases of mirtazapine-induced and 106 cases of SSRI-induced sexual dysfunction, accounting for 0.90% and 19.2% respectively, OR = 0.07 (95% CI: 0.04-0.14), Z = 8.03, P < 0.01.

CONCLUSIONSSRI is far more likely to induce sexual dysfunction than mirtazapine in the treatment of depression.

Antidepressive Agents, Tricyclic ; adverse effects ; Depressive Disorder ; drug therapy ; Erectile Dysfunction ; chemically induced ; Humans ; Male ; Mianserin ; adverse effects ; analogs & derivatives ; Serotonin Uptake Inhibitors ; adverse effects

OBJECTIVETo observe the effects of nicotine on endogenous carbon monoxide (CO) concentration and nitric oxide synthase (NOS) activity in the corpus cavernosum of adult male rats, and explore the possible mechanism of cigarette smoking affecting erectile dysfunction.

METHODSForty adult male rats were equally divided into three treatment groups to receive subcutaneous injection of nicotine at 0.5 mg/kg pre d for 1, 2 and 3 months, and a control group to receive saline only. After treatment, the corpus cavernosum was harvested for detection of CO concentration by modified two-wavelength spectrophotometry and NOS activity by improved Griess measurement.

RESULTSCO concentration and NOS activity were decreased by 9.05 and 13.37%, respectively, after 1 month of nicotine injection (P < 0.01), 16.47 and 22.5% after 2 months (P < 0.01), and 22.99 and 31.74% after 3 months (P < 0.01), as compared with (13.664 +/- 0.404) umol/mg prot and (9.721 +/- 0.470) U/mg prot in the control group.

CONCLUSIONNicotine can reduce endogenous CO concentration and NOS activity in the corpus cavernosum of adult male rats, which suggests the involvement of endogenous CO and NOS in the pathophysiological process of smoking-induced erectile dysfunction .

Animals ; Carbon Monoxide ; metabolism ; Erectile Dysfunction ; chemically induced ; Male ; Nicotine ; toxicity ; Nitric Oxide Synthase ; metabolism ; Penis ; metabolism ; Rats ; Smoking ; adverse effects

alpha1-adrenoceptor antagonists are first-line agents for the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia, while their adverse effects on sexual function are reported frequently in recent years, especially the induction of ejaculatory dysfunction. This review presents the distribution of alpha 1-adrenoceptors in the male genital system and the relationship of alpha1-adrenoceptors with ejaculatory function. It also highlights the interesting phenomenon of ejaculatory dysfunction related to these drugs and its possible mechanism, with the intention to provide some essential clues for further research on this problem as well as some references to safer use of these drugs in clinical settings.
Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-Antagonists ; adverse effects ; pharmacology ; Ejaculation ; physiology ; Erectile Dysfunction ; chemically induced ; physiopathology ; Humans ; Male ; Receptors, Adrenergic, alpha-1 ; physiology

OBJECTIVETo establish a rat model of diabetic erectile dysfunction (ED) with streptozotocin (STZ) injection.

METHODSThirty male rats were randomized equally into 5 groups (control group and STZ 40 mg/kg, 60 mg/kg, 80 mg/kg, and 100 mg/kg groups). All the rats were examined at 4 days and 1, 2, and 3 weeks after STZ injection for fasting blood glucose, erectile frequency induced by apomorpHine (APO) and body weight changes.

RESULTSSignificant difference occurred in the fasting food glucose among the groups at different time points (P=0.001), and also in APO-induced erectile frequency, fasting blood glucose and body weight between the groups with STZ injection at different doses (P<0.001, P=0.045 and P<0.001, respectively). No significant difference was found in induced erectile frequency and body weight between different time points (P=0.306 and P=0.628).

CONCLUSIONThe optimal dose of STZ for establishing diabetic ED model is 60 mg/kg, and two weeks after the injection can be the optimal time for evaluating model establishment by means of APO-induced penis erection.

Animals ; Apomorphine ; Diabetes Mellitus, Experimental ; chemically induced ; complications ; Disease Models, Animal ; Erectile Dysfunction ; etiology ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Streptozocin

Objective: To explore the relationship between male sexual function and daily exposure to bisphenol A (BPA) at a reproductive center in Taiyuan. Methods: Male patients who were seeking treatment of infertility due to problems caused by either of the spouse were selected from the Shanxi reproductive center between September 2014 and April 2015. Information on general characteristics, sexual function and fasting venous blood samples were collected. Total scores of sexual function were evaluated by Delphi expert scoring method. Levels of serum BPA were measured by high-performance liquid chromatography. Data was analyzed by Spearman rank correlation, rank sum test, multivariate logistic regression analysis and χ(2) trend test. Relationship between BPA and sexual function was presented as OR and corresponding 95%CI. Results: Among the 353 participants, 45.0% was defined as sexual dysfunction with low sexual desire (47.3%) as the major reason. BPA was detected in all the 353 patients, with a range of concentration as 0.38-21.93 ng/ml and an average as 5.79 ng/ml. Results from the Spearman rank correlation analysis revealed significant negative correlations between serum BPA and sexual function, sexual desire, erectile ability and ejaculation intensity, while serum BPA was positively correlated with premature ejaculation. According to the four percentile of BPA concentration (ng/ml), the subjects were divided into four groups. Compared with the low concentration group (0.38-3.79 ng/ml), the risk of sexual dysfunction significantly increased in the groups with higher BPA levels. Particularly, in the highest BPA group (8.68-21.93 ng/ml), more obvious effects were seen on sexual dysfunction (OR=1.55, 95%CI:1.00-3.23), reduced sexual desire (OR=4.75, 95%CI: 2.44-9.22), reduced erection ability (OR=2.40, 95%CI: 1.18-4.88), reduced ejaculation intensity (OR=2.53, 95%CI: 1.25-5.16) and premature ejaculation (OR=1.95, 95%CI: 1.02-3.72). Conclusion: Low sexual desire appeared as the main type of male sexual dysfunction, the exposure to higher levels of BPA in daily life might lead to male sexual dysfunction.
Benzhydryl Compounds/toxicity* ; Ejaculation/drug effects* ; Environmental Exposure/adverse effects* ; Erectile Dysfunction/chemically induced* ; Humans ; Male ; Occupational Exposure/adverse effects* ; Phenols/toxicity*

OBJECTIVETo investigate the effect of elastic fiber alterations in the tunica albuginea of the penis on erectile function of diabetic rats.

METHODSStreptozotocin (STZ) injection was adopted to produce rat models of diabetes mellitus and erectile dysfunction. Forty rats were randomized equally into two groups according to the time after streptozotocin (STZ) injection, namely 4 week group and 7 week group. Each group was further divided into 4 subgroups, including a control group (n=5, without STZ injection), diabetic with erectile dysfunction group (DM and ED group), diabetic without erectile dysfunction group (DM group) and group with neither diabetes mellitus or erectile dysfunction after STZ injection (None group). Victoria blue/Ponceau red staining and color image analysis were used to observe the content of the elastic fibers in the tunica albuginea, which was quantified by means of integrated optical density (IOD) readings.

RESULTSignificant difference in the IOD was observed between different groups (F=10.433, P<0.001). The content of elastic fibers in the tunica albuginea was the lowest in DM and ED group among the 4 groups (P<0.05), and there was no significant difference between 7-week and 4 week groups (F=0.685, P=0.415), nor was any interaction observed (F=0.905, P=0.452).

CONCLUSIONSDecreased elastic fibers in the tunica albuginea can result from diabetes mellitus. Elastic fibers in the tunica albuginea play an important role in the course of erection, and erectile dysfunction may result from decreased elastic fiber content.

Animals ; Diabetes Mellitus, Experimental ; chemically induced ; complications ; physiopathology ; Elastic Tissue ; metabolism ; Erectile Dysfunction ; complications ; metabolism ; physiopathology ; Male ; Penis ; metabolism ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Time Factors

PURPOSE: Androgen replacement therapy has been shown to be safe and effective for most patients with testosterone deficiency. Male partners of infertile couples often report significantly poorer sexual activity and complain androgen deficiency symptoms. We report herein an adverse effect on fertility caused by misusage of androgen replacement therapy in infertile men with hypogonadal symptoms. MATERIALS AND METHODS: The study population consisted of 8 male patients referred from a local clinic for azoospermia or severe oligozoospermia between January 2008 and July 2011. After detailed evaluation at our andrology clinic, all patients were diagnosed with iatrogenic hypogonadism associated with external androgen replacement. We evaluated changes in semen parameters and serum hormone level, and fertility status. RESULTS: All patients had received multiple testosterone undecanoate (NebidoR) injections at local clinic due to androgen deficiency symptoms combined with lower serum testosterone level. The median duration of androgen replacement therapy prior to the development of azoospermia was 8 months (range: 4-12 months). After withdrawal of androgen therapy, sperm concentration and serum follicle-stimulating hormone level returned to normal range at a median 8.5 months (range: 7-10 months). CONCLUSION: Misusage of external androgen replacement therapy in infertile men with poor sexual function can cause temporary spermatogenic dysfunction, thus aggravating infertility.
Adult ; Androgens/administration & dosage/adverse effects/*therapeutic use ; Azoospermia/*drug therapy ; Erectile Dysfunction/drug therapy ; Humans ; Hypogonadism/*drug therapy ; Infertility, Male/*chemically induced/drug therapy ; Male ; Oligospermia/*drug therapy ; Testosterone/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use

AIMTo investigate the effect of substituting beta-blockers with nebivolol on the erectile function of patients suffering from essential hypertension.

METHODSForty-four young and middle-aged men (31-65 years) with essential hypertension visited our outpatient clinic and took beta-blocker treatment (atenolol, metoprolol or bisoprolol) for more than 6 months. All the patients completed a questionnaire regarding erectile function (International Index for Erectile Function). Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire.

RESULTSTwenty-nine out of the 44 (65.9%) patients who took beta-blockers (atenolol, metoprolol or bisoprolol) had exhibited erectile dysfunction (ED). Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 (69%) patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized.

CONCLUSIONNebivolol seems to have a beneficial effect on ED (possibly due to increased nitric oxide availability); however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol.

Adrenergic beta-Antagonists ; adverse effects ; therapeutic use ; Adult ; Aged ; Antihypertensive Agents ; adverse effects ; Benzopyrans ; therapeutic use ; Erectile Dysfunction ; chemically induced ; drug therapy ; Ethanolamines ; therapeutic use ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Nebivolol ; Surveys and Questionnaires