Abstract
BackgroundThe relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS).MethodsA representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression.ResultsControlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses.ConclusionA range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health.
Highlights
The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear
Association of lifestyle factors with male reproductive health disorders Waist Circumference When controlling for age only, men with a waist circumference of < 94 cm were significantly less likely to report erectile problems (ED) and perceived androgen deficiency while those with a large waist circumference (>102 cm) had a higher likelihood of erectile dysfunction (ED) compared to men in the medium waist circumference category but this did not reach statistical significance (Table 1)
Obesity was positively associated with ED and perceived symptoms of androgen deficiency (pAD) in age-adjusted analyses (Table 1) but in fully adjusted models obesity was not significantly associated with any reproductive health disorders (Figure 1)
Summary
The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. Most studies focus on ED as the predominant male reproductive health disorder, with evidence suggesting that lifestyle risk factors (such as obesity and sedentary lifestyles) for ED are similar to those for cardiovascular disease and diabetes [7,8]. These suggestions are based on observations that men with other such co-morbid conditions report significantly higher rates of ED [8]. The relationship between other reproductive health disorders and a range of behavioural and biomedical determinants is less clear
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