Sexual Dysfunction in Iranian Men with Diabetes; a Systematic Review and Meta-analysis
Men's Health Journal,
Vol. 5 No. 1 (2021),
6 Dey 2021
,
Page e11
https://doi.org/10.22037/mhj.v5i1.34338
Abstract
Introduction: The typical sexual function involves the integrity and harmonious interaction of psychological, endocrine, vascular, and nervous systems. We aimed to determine the prevalence of sexual dysfunction (SD), more specifically erectile dysfunction in Iranian men with diabetes. Method: Using keywords including: “sexual function,” “erectile dysfunction,” “diabetes,” and “Iran”, an electronic search was done on national and international databases. All cross-sectional or baseline data in cohort studies were included. The prevalence of SD and its related risk factors were extracted and summarized. The random effect model was used for estimating the pooled prevalence. Results: Ultimately, 16 studies were included in the qualitative synthesis, amongst which 6 were included for quantitative synthesis. The pooled prevalence of SD across included studies was 50.7%. with a total sample size of 1513. Two main correlated factors with SD were advanced age and depression. Conclusion: Our analysis showed that more than half of the Iranian men with diabetes suffer from SD. Apart from advanced age, the most important attributes for comorbidity of diabetes and SD in these patients were found to be chronic uncontrolled high blood sugar and depression. More advanced epidemiological studies are needed to assess the temporality of the relationship between SD and its related comorbidities and to develop proper preventive programs.
Keywords:
- Diabetes
- Erectile dysfunction
- Iran
- Male
- Sexual dysfunction
How to Cite
Abedi, A. R., Aliakbari, F., Mirzababaei, M., Safian, F., & Shojaeefar, E. (2021). Sexual Dysfunction in Iranian Men with Diabetes; a Systematic Review and Meta-analysis . Men’s Health Journal, 5(1), e11. https://doi.org/10.22037/mhj.v5i1.34338
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23. Mofid, A., et al., Prevalence and risk factors of erectile dysfunction in Iranian diabetic men. Acta Medica Iranica, 2009: p. 309-314.
24. Ghodrati Mirkouhi, M. and S. Hadadi, Correlation between Self-Efficacy with Sleep Quality and Sexual Function Index in Patients with Type 2 Diabetes. Qom University of Medical Sciences Journal, 2018. 12(4): p. 31-41.
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27. Habibi, A., et al., Evaluation of erectile dysfunction and associated factors in type-II diabetic patients in Birjand, Iran in 2008-2009. 2011.
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31. Fedele, D., et al., Erectile dysfunction in diabetic subjects in Italy. Gruppo Italiano Studio Deficit Erettile nei Diabetici. Diabetes Care., 1998. 21(11): p. 1973-7.
32. Minami, H., et al., Physical activity and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study. Diabetes Investig. , 2018. 9(1): p. 193-198.
33. Cho, N.H., et al., Prevalence of erectile dysfunction in Korean men with Type 2 diabetes mellitus. Diabet Med. , 2006. 23(2): p. 198-203.
34. El-Sakka, A.I. and K.A. Tayeb, Erectile Dysfunction Risk Factors in Noninsulin Dependent Diabetic Saudi Patients. J Urol. , 2003. 169(3): p. 1043-7.
35. Dan, A., et al., Erectile dysfunction in patients with diabetes mellitus: Its magnitude, predictors and their bio-psycho-social interaction: A study from a developing country. J Psychiatr., 2014. 7(1): p. 58-65.
36. Shiferaw, W.S., T.Y. Akalu, and Y.A. Aynalem, Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis. Int J Endocrinol., 2020. 18: p. 5148370.
37. Safarinejad, M., Prevalence and risk factors for erectile dysfunction in a population-based study in Iran. International journal of impotence research, 2003. 15(4): p. 246-252.
38. Johannes, C.B., et al., Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol., 2000. 163: p. 460–463.
39. Kamenov, Z.A., Acomprehensive review of erectile dysfunction in men with diabetes. Exp Clin Endocrinol Diabetes 2015; 123: 141–158. 23 Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North Am, 2001. 28: p. 209–216.
40. Mekhtiev, T.V., Stress, anxiety, depression and erectile dysfunction in patients with diabetes mellitus Georgian Med News. , 2013. 220-221: p. 77-81.
41. Giuliano, F.A., et al., Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology 2004. 63: p. 1196–1201.
42. Ibrahim, A., et al., Erectile Dysfunction and Ischaemic Heart Disease Eur Cardiol. , 2018. 13(2): p. 98-103.
43. Mirzaei, M.R., M. Amini, and A. Aminorroaya, The prevalence of hypogonadism in diabetic men in Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 2012. 17(7): p. 602.
44. Ziaei-Rad, M., M. Vahdaninia, and A. Montazeri, Sexual dysfunctions in patients with diabetes: a study from Iran. Reproductive Biology and Endocrinology, 2010. 8(1): p. 1-8.
45. Shiri, R., M. Ansari, and K.F. Hassani, Association between comorbidity and erectile dysfunction in patients with diabetes. International journal of impotence research, 2006. 18(4): p. 348-353.
46. Sharifi, F., et al., Independent predictors of erectile dysfunction in type 2 Diabetes mellitus: Is it true what they say about risk factors? ISRN endocrinology, 2012. 2012.
47. Rahimi, M., et al., Factors Associated with Sexual Function and Sexual Satisfaction in Male Patients with Diabetes Type 2. Journal of Mazandaran University of Medical Sciences, 2018. 28(164): p. 164-169.
48. Torkamani, Z.J., et al., Relationship between sexual function and type 2 diabetes in infertile men referred to Royan institute.
49. Bahar, A., et al., Sexual dysfunction in men with type II diabetes. Caspian Journal of Internal Medicine, 2020. 11(3): p. 295.
2. Biswas, A., et al., Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 2015. 162(2): p. 123-132.
3. Lee, I.-M., et al., Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The lancet, 2012. 380(9838): p. 219-229.
4. Organization, W.H., Measuring sexual health: Conceptual and practical considerations and related indicators. 2010, World Health Organization.
5. Rush Jr, A.J., M.B. First, and D. Blacker, Handbook of psychiatric measures. 2009: American Psychiatric Pub.
6. Atlantis, E. and T. Sullivan, Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. The journal of sexual medicine, 2012. 9(6): p. 1497-1507.
7. Nappi, R.E., et al., Female sexual dysfunction (FSD): Prevalence and impact on quality of life (QoL). Maturitas, 2016. 94: p. 87-91.
8. Fallahi, M., et al., Evaluation of sexual function in men with diabetes mellitus type 2-Yazd Diabetes Research Center. Iranian Journal of Diabetes and Obesity, 2014. 6(3): p. 136-141.
9. Hatzimouratidis, K., et al., Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European urology, 2010. 57(5): p. 804-814.
10. Lewis, R.W., et al., Definitions/epidemiology/risk factors for sexual dysfunction. The journal of sexual medicine, 2010. 7(4): p. 1598-1607.
11. Aytac, I., J. McKinlay, and R. Krane, The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU international, 1999. 84: p. 50-56.
12. Beutel, M., W. Weidner, and E. Brähler, Epidemiology of sexual dysfunction in the male population. Andrologia, 2006. 38(4): p. 115-121.
13. Gupta, B.P., et al., The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Archives of Internal Medicine, 2011. 171(20): p. 1797-1803.
14. McAninch, J.W. and T.F. Lue, Smith & Tanagho's general urology. 2013: McGraw-Hill Medical New York.
15. Meneilly, G.S. and D. Tessier, Diabetes in elderly adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2001. 56(1): p. M5-M13.
16. Tong, P.C., et al., Association of testosterone, insulin-like growth factor-I, and C-reactive protein with metabolic syndrome in Chinese middle-aged men with a family history of type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism, 2005. 90(12): p. 6418-6423.
17. Hidalgo-Tamola, J. and K. Chitaley, Type 2 diabetes mellitus and erectile dysfunction. The Journal of Sexual Medicine, 2009. 6(4): p. 916-926.
18. Isidro, M.L., Sexual dysfunction in men with type 2 diabetes. Postgraduate medical journal, 2012. 88(1037): p. 152-159.
19. Kamenov, Z., A comprehensive review of erectile dysfunction in men with diabetes. Experimental and Clinical Endocrinology & Diabetes, 2015. 123(03): p. 141-158.
20. Parazzini, F., et al., Diabetes, cardiovascular diseases and risk of erectile dysfunction: a brief narrative review of the literature. Archivio Italiano di Urologia e Andrologia, 2009. 81(1): p. 24-31.
21. Awad, H., et al., Erectile function in men with diabetes type 2: correlation with glycemic control. International journal of impotence research, 2010. 22(1): p. 36-39.
22. Furukawa, S., et al., Depressive symptoms and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: the Dogo Study. International Journal of Impotence Research, 2017. 29(2): p. 57-60.
23. Mofid, A., et al., Prevalence and risk factors of erectile dysfunction in Iranian diabetic men. Acta Medica Iranica, 2009: p. 309-314.
24. Ghodrati Mirkouhi, M. and S. Hadadi, Correlation between Self-Efficacy with Sleep Quality and Sexual Function Index in Patients with Type 2 Diabetes. Qom University of Medical Sciences Journal, 2018. 12(4): p. 31-41.
25. Malavige, L.S. and J.C. Levy, Erectile dysfunction in diabetes mellitus. The journal of sexual medicine, 2009. 6(5): p. 1232-1247.
26. Penson, D.F., et al., Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients?: Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (EXCEED) database. Diabetes care, 2003. 26(4): p. 1093-1099.
27. Habibi, A., et al., Evaluation of erectile dysfunction and associated factors in type-II diabetic patients in Birjand, Iran in 2008-2009. 2011.
28. Lo, C.K.-L., D. Mertz, and M. Loeb, Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC medical research methodology, 2014. 14(1): p. 1-5.
29. Ayta, I.A., J.B. McKinlay, and R.J. Krane, The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999. 84: p. 50–56.
30. Shlomai, G., et al., Type 2 diabetes mellitus and cancer: the role of pharmacotherapy J Clin Oncol, 2016. 34: p. 4261–4269.
31. Fedele, D., et al., Erectile dysfunction in diabetic subjects in Italy. Gruppo Italiano Studio Deficit Erettile nei Diabetici. Diabetes Care., 1998. 21(11): p. 1973-7.
32. Minami, H., et al., Physical activity and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study. Diabetes Investig. , 2018. 9(1): p. 193-198.
33. Cho, N.H., et al., Prevalence of erectile dysfunction in Korean men with Type 2 diabetes mellitus. Diabet Med. , 2006. 23(2): p. 198-203.
34. El-Sakka, A.I. and K.A. Tayeb, Erectile Dysfunction Risk Factors in Noninsulin Dependent Diabetic Saudi Patients. J Urol. , 2003. 169(3): p. 1043-7.
35. Dan, A., et al., Erectile dysfunction in patients with diabetes mellitus: Its magnitude, predictors and their bio-psycho-social interaction: A study from a developing country. J Psychiatr., 2014. 7(1): p. 58-65.
36. Shiferaw, W.S., T.Y. Akalu, and Y.A. Aynalem, Prevalence of Erectile Dysfunction in Patients with Diabetes Mellitus and Its Association with Body Mass Index and Glycated Hemoglobin in Africa: A Systematic Review and Meta-Analysis. Int J Endocrinol., 2020. 18: p. 5148370.
37. Safarinejad, M., Prevalence and risk factors for erectile dysfunction in a population-based study in Iran. International journal of impotence research, 2003. 15(4): p. 246-252.
38. Johannes, C.B., et al., Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol., 2000. 163: p. 460–463.
39. Kamenov, Z.A., Acomprehensive review of erectile dysfunction in men with diabetes. Exp Clin Endocrinol Diabetes 2015; 123: 141–158. 23 Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North Am, 2001. 28: p. 209–216.
40. Mekhtiev, T.V., Stress, anxiety, depression and erectile dysfunction in patients with diabetes mellitus Georgian Med News. , 2013. 220-221: p. 77-81.
41. Giuliano, F.A., et al., Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology 2004. 63: p. 1196–1201.
42. Ibrahim, A., et al., Erectile Dysfunction and Ischaemic Heart Disease Eur Cardiol. , 2018. 13(2): p. 98-103.
43. Mirzaei, M.R., M. Amini, and A. Aminorroaya, The prevalence of hypogonadism in diabetic men in Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 2012. 17(7): p. 602.
44. Ziaei-Rad, M., M. Vahdaninia, and A. Montazeri, Sexual dysfunctions in patients with diabetes: a study from Iran. Reproductive Biology and Endocrinology, 2010. 8(1): p. 1-8.
45. Shiri, R., M. Ansari, and K.F. Hassani, Association between comorbidity and erectile dysfunction in patients with diabetes. International journal of impotence research, 2006. 18(4): p. 348-353.
46. Sharifi, F., et al., Independent predictors of erectile dysfunction in type 2 Diabetes mellitus: Is it true what they say about risk factors? ISRN endocrinology, 2012. 2012.
47. Rahimi, M., et al., Factors Associated with Sexual Function and Sexual Satisfaction in Male Patients with Diabetes Type 2. Journal of Mazandaran University of Medical Sciences, 2018. 28(164): p. 164-169.
48. Torkamani, Z.J., et al., Relationship between sexual function and type 2 diabetes in infertile men referred to Royan institute.
49. Bahar, A., et al., Sexual dysfunction in men with type II diabetes. Caspian Journal of Internal Medicine, 2020. 11(3): p. 295.
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