1.Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan
Akira TSUJIMURA ; Shinichiro FUKUHARA ; Koji CHIBA ; Tsuyoshi YOSHIZAWA ; Hikaru TOMOE ; Masato SHIRAI ; Kazunori KIMURA ; Eiji KIKUCHI ; Eri MAEDA ; Yoshikazu SATO ; Atsushi NAGAI ; Koichi NAGAO ; Haruaki SASAKI ;
The World Journal of Men's Health 2025;43(1):239-248
Purpose:
Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.
Materials and Methods:
Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.
Results:
Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.
Conclusions
The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.
2.Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan
Akira TSUJIMURA ; Shinichiro FUKUHARA ; Koji CHIBA ; Tsuyoshi YOSHIZAWA ; Hikaru TOMOE ; Masato SHIRAI ; Kazunori KIMURA ; Eiji KIKUCHI ; Eri MAEDA ; Yoshikazu SATO ; Atsushi NAGAI ; Koichi NAGAO ; Haruaki SASAKI ;
The World Journal of Men's Health 2025;43(1):239-248
Purpose:
Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.
Materials and Methods:
Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.
Results:
Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.
Conclusions
The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.
3.Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan
Akira TSUJIMURA ; Shinichiro FUKUHARA ; Koji CHIBA ; Tsuyoshi YOSHIZAWA ; Hikaru TOMOE ; Masato SHIRAI ; Kazunori KIMURA ; Eiji KIKUCHI ; Eri MAEDA ; Yoshikazu SATO ; Atsushi NAGAI ; Koichi NAGAO ; Haruaki SASAKI ;
The World Journal of Men's Health 2025;43(1):239-248
Purpose:
Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.
Materials and Methods:
Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.
Results:
Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.
Conclusions
The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.
4.Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan
Akira TSUJIMURA ; Shinichiro FUKUHARA ; Koji CHIBA ; Tsuyoshi YOSHIZAWA ; Hikaru TOMOE ; Masato SHIRAI ; Kazunori KIMURA ; Eiji KIKUCHI ; Eri MAEDA ; Yoshikazu SATO ; Atsushi NAGAI ; Koichi NAGAO ; Haruaki SASAKI ;
The World Journal of Men's Health 2025;43(1):239-248
Purpose:
Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.
Materials and Methods:
Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.
Results:
Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.
Conclusions
The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.
6.Erectile Function and Sexual Activity Are Declining in the Younger Generation: Results from a National Survey in Japan
Akira TSUJIMURA ; Shinichiro FUKUHARA ; Koji CHIBA ; Tsuyoshi YOSHIZAWA ; Hikaru TOMOE ; Masato SHIRAI ; Kazunori KIMURA ; Eiji KIKUCHI ; Eri MAEDA ; Yoshikazu SATO ; Atsushi NAGAI ; Koichi NAGAO ; Haruaki SASAKI ;
The World Journal of Men's Health 2025;43(1):239-248
Purpose:
Twenty five years have passed since the first national survey on erectile dysfunction (ED) in Japan. The Japanese Society for Sexual Medicine conducted a nationwide survey on the actual status of sexual function targeting men over 20 years old in Japan using validated questionnaires commonly used in clinical practice.
Materials and Methods:
Japanese men aged 20 to 79 years participated in our online epidemiological study on sexual dysfunction. Erectile status was assessed by direct questioning and specific questionnaires. Risk factors and frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were assessed. The prevalence of these risk factors was compared between men with and without ED. Prevalence and frequencies were calculated for each 5-year age group. Main outcomes were the prevalence and number of patients with ED and simultaneous evaluation of age-related variations.
Results:
Direct questioning of the men revealed that 13.0% felt troubled by ED. Although 81.0% of them had at least some ED symptoms based on a Sexual Health Inventory For Men score of ≤21, the prevalence of men with ED by Erection Hardness Score (EHS), the most appropriate questionnaire for Japanese with low sexual activity, was 30.9%, indicating that 14,012,596 men have ED. Most risk factors were related with ED, whereas frequencies of sexual intercourse, masturbation, nocturnal erections, and feeling sexual desire were affected by aging. However, the low frequency of these factors in the young generation was surprising.
Conclusions
The EHS-based assessment revealed a prevalence of ED of 30.9%, which affected approximately 14 million men, and that the sexual desire, erection stiffness, orgasms, and satisfaction were lower than expected in young Japanese men, especially those aged 20 to 24 years, although those factors tended to worsen with aging. We believe that these findings actually reveal the current sexual status of men in Japan.
7.Effect of Aging on Thermoregulatory and Cardiovascular Changes during Bathing in the Elderly
Chihiro MIWA ; Hiroya SHIMASAKI ; Masayasu MIZUTANI ; Yasunori MORI ; Kazunori MAEDA ; Takeshi NAKAMURA ; Akira DEGUCHI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2022;():2351-
Background: Aging affects thermoregulation and can potentially cause cardiovascular changes during bathing in the elderly, possibly leading to accidents and, in worst cases, drowning. However, adequate data on this subject are lacking. Therefore, the purpose of this study was to clarify the effect of aging on thermoregulatory and cardiovascular changes during bathing in the older versus younger adults the relationship between body temperature and thermoregulatory and cardiovascular changes. Methods: Ten young (mean age: 20.4 years) and 10 elderly (mean age: 69.7 years) participants were asked to bathe for 15 min using water at 41°C. Tympanic temperature (Tty), skin blood flow (SkBF), sweating rate (SR), blood pressure, heart rate (HR), and double product (DP) were measured. In addition, we measured subjective psychological changes during bathing. Results: The results showed significant changes in SkBF, SR, and HR in the young participants rather than in the elderly participants. However, in the elderly participants, significant change was noted in systolic blood pressure (SBP). Conclusion: These results demonstrate changes in thermal adaptation and SBP owing to structural and functional progression due to aging.
8.Are Saunas Beneficial or Harmful for Autosomal Dominant Polycystic Kidney Disease? Examination with Model Mouse
Yoshihiro IWASHITA ; Kousuke WATARU ; Akira MAEDA ; Kazuki SUGIMOTO ; Syouko YAMADA ; Junichi IIYAMA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2022;85(2):37-47
Background: Heat shock proteins (Hsps), expression of which are induced by thermal treatment, function in the protection of kidneys by suppressing apoptosis and maintaining renal tubular viability. Moreover, recently, it has been indicated that the expression of Hsps can be a therapeutic target for autosomal dominant polycystic kidney disease (ADPKD). We investigated the effect of dry sauna therapy on ADPKD model mice. Methods and Results: The mice (male DBA/2FG-pcy mice) were categorized into three groups: controls, TS: pcy mice subjected to prolonged sauna with administered water containing 4% sucrose, SW: pcy mice administered water containing 4% sucrose. The TS group was subjected to sauna sessions twice a week for four weeks. The TS group attained and were maintained at rectal temperatures of approximately 39.0°C, until they were carefully removed from the far infrared-ray device. After 4 weeks of sauna treatment, creatinine and blood-urea-nitrogen (BUN) levels determined by an enzymatic method. The heat shock protein (HSP) or cell growth and size related proteins were analyzed by western blotting. The TS group exhibited marginally higher creatinine and BUN levels than did the control and SW groups, however, the differences were not significant. However, cyst enlargement in the TS group reduced significantly compared to that of the control group. HSP90 expression was slightly decreased in the TS and SW groups relative to the control group (p < 0.01 or p < 0.001, vs. control), as was Erk expression, which is linked to cyst development and proliferation (p < 0.05, TS vs. control). Hsp27 expression and phosphorylation level in the SW group were comparable with that of the control group. However, the TS group had increased levels of Hsp27 and phosphorylation (NS). The expression of pro-caspase-3 in the TS group was marginally lower than that in the control group. However, the activity of caspase-3 in all groups showed no differences. Conclusion: The findings of this study indicated that 4 weeks of sauna treatment could cause transient dehydration and related renal dysfunction and led to the risk of stimulating cyst growth by increased Hsp27 expression. Moreover, we concluded that prevention of dehydration and cyst growth could be suppressed by taking an appropriate amount of water directly after sauna treatment.
9.Effect of Aging on Thermoregulatory and Cardiovascular Changes during Bathing in the Elderly
Chihiro MIWA ; Hiroya SHIMASAKI ; Masayasu MIZUTANI ; Yasunori MORI ; Kazunori MAEDA ; Takeshi NAKAMURA ; Akira DEGUCHI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2022;85(2):48-58
Background: Aging affects thermoregulation and can potentially cause cardiovascular changes during bathing in the elderly, possibly leading to accidents and, in worst cases, drowning. However, adequate data on this subject are lacking. Therefore, the purpose of this study was to clarify the effect of aging on thermoregulatory and cardiovascular changes during bathing in the older versus younger adults the relationship between body temperature and thermoregulatory and cardiovascular changes. Methods: Ten young (mean age: 20.4 years) and 10 elderly (mean age: 69.7 years) participants were asked to bathe for 15 min using water at 41°C. Tympanic temperature (Tty), skin blood flow (SkBF), sweating rate (SR), blood pressure, heart rate (HR), and double product (DP) were measured. In addition, we measured subjective psychological changes during bathing. Results: The results showed significant changes in SkBF, SR, and HR in the young participants rather than in the elderly participants. However, in the elderly participants, significant change was noted in systolic blood pressure (SBP). Conclusion: These results demonstrate changes in thermal adaptation and SBP owing to structural and functional progression due to aging.
10.Are Saunas Beneficial or Harmful for Autosomal Dominant Polycystic Kidney Disease? Examination with Model Mouse
Yoshihiro IWASHITA ; Kousuke WATARU ; Akira MAEDA ; Kazuki SUGIMOTO ; Syouko YAMADA ; Junichi IIYAMA
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2021;():2345-
Background: Heat shock proteins (Hsps), expression of which are induced by thermal treatment, function in the protection of kidneys by suppressing apoptosis and maintaining renal tubular viability. Moreover, recently, it has been indicated that the expression of Hsps can be a therapeutic target for autosomal dominant polycystic kidney disease (ADPKD). We investigated the effect of dry sauna therapy on ADPKD model mice. Methods and Results: The mice (male DBA/2FG-pcy mice) were categorized into three groups: controls, TS: pcy mice subjected to prolonged sauna with administered water containing 4% sucrose, SW: pcy mice administered water containing 4% sucrose. The TS group was subjected to sauna sessions twice a week for four weeks. The TS group attained and were maintained at rectal temperatures of approximately 39.0°C, until they were carefully removed from the far infrared-ray device. After 4 weeks of sauna treatment, creatinine and blood-urea-nitrogen (BUN) levels determined by an enzymatic method. The heat shock protein (HSP) or cell growth and size related proteins were analyzed by western blotting. The TS group exhibited marginally higher creatinine and BUN levels than did the control and SW groups, however, the differences were not significant. However, cyst enlargement in the TS group reduced significantly compared to that of the control group. HSP90 expression was slightly decreased in the TS and SW groups relative to the control group (p < 0.01 or p < 0.001, vs. control), as was Erk expression, which is linked to cyst development and proliferation (p < 0.05, TS vs. control). Hsp27 expression and phosphorylation level in the SW group were comparable with that of the control group. However, the TS group had increased levels of Hsp27 and phosphorylation (NS). The expression of pro-caspase-3 in the TS group was marginally lower than that in the control group. However, the activity of caspase-3 in all groups showed no differences. Conclusion: The findings of this study indicated that 4 weeks of sauna treatment could cause transient dehydration and related renal dysfunction and led to the risk of stimulating cyst growth by increased Hsp27 expression. Moreover, we concluded that prevention of dehydration and cyst growth could be suppressed by taking an appropriate amount of water directly after sauna treatment.


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