Men's Sexual Health Research Articles

Exploring First Sexual Intercourse, Sexual Orientation, and Sexual Health in Men

ABSTRACT In this study the characteristics of the sexual debut of men who have sex with men (MSM) and men who have sex with women (MSW) age 35 or younger (N = 1,201) were compared with one another. We investigated whether these characteristics were associated with sexual health and behavior, and to what extent. Compared to MSW, MSM tended to be older when they had their first sexual intercourse; their first sex partner was older, they felt less ready, and they experienced more pain. We also found that they reported a higher number of lifetime sexual partners and less condom use compared to MSW. Similarities were also ascertained, such as the fact that individuals from both groups do not differ significantly regarding how they experienced their first sexual intercourse emotionally. Many differences between these groups should not always be seen as problematic, whereas others still indicate a need for targeted interventions.

Psychobiological Protective Factors Modifying the Association Between Age and Sexual Health in Men: Findings From the Men's Health 40+ Study.

Sexual health severely decreases with age. For males older than 40 years, erectile dysfunction (ED) is the most common sexual disorder. Although physical and psychological risk factors for ED have been identified, protective factors are yet to be determined. To date, no study has examined endocrine and psychosocial factors in parallel with regard to their modifying effect on the age-related increase in ED. Two hundred and seventy-one self-reporting healthy men aged between 40 and 75 years provided both psychometric data on sexual function and a set of potential psychosocial protective factors, and saliva samples for the analysis of steroid hormones and proinflammatory cytokines. Around 35% of the participants reported at least a mild form of ED. Direct associations with ED were identified for perceived general health, emotional support, relationship quality, intimacy motivation but not for steroid hormones or proinflammatory markers. Moderation analyses for the association between age and ED revealed positive effects for testosterone (T), dehydroepiandrosterone (DHEA), perceived general health, emotional support, intimacy motivation, and a negative effect for interleukin-6 (all p < .05; f2 > .17). Group differences between older men with and without ED emerged for T, DHEA, and psychometric measures such as perceived general health, emotional support, satisfaction with life, and intimacy motivation (all p < .05; d > .3). Both psychosocial and endocrine parameters moderated the association between age and sexual health. Perceived general health, emotional support, intimacy motivation, and relationship quality emerged as psychosocial protective factors against ED. Higher T and DHEA and lower interleukin-6 levels also buffered against an age-related increase in ED.

SEXUAL HEALTH OF MEN IN GERMANY – THE THIRD MEN´S HEALTH REPORT

In a critical review of the First [1] and the Second Men&lsquo;s Health Report [2] published by the Men&lsquo;s Health Foundation Berlin, the Report of the Robert Koch-Institute &bdquo;Health Status of Men in Germany&rdquo; [3] and the Men&lsquo;s Health Report of the European Union: &ldquo;The Men&lsquo;s State of Health&rdquo; [4] has shown that the sexuality of men as a relevant topic was excluded.&nbsp; In a Survey [5] conducted by Global Action on Men&lsquo;s Health (GAMH) and Sanofi&nbsp;in 2015, with 16,000 adult men and women in 8 countries (including Germany), the question of the relevance of sexuality for life quality was raised. The result was that sex is ranked fi rst, at least in the younger age groups. &nbsp;For this reason, it seemed to the Men&acute;s health Foun-dation as the editor to take up the issue of sexuality of men for the Third German Men&acute;s Health Report. &nbsp;In order to cover the diverse facets of male sexu-ality despite poor &bdquo;offi&nbsp;cial&ldquo; data, the German Men&acute;s Health Foundation cooperated with the Institute for Applied Sexual Science at the University of Applied Sciences in Merseburg, Germany. &nbsp;The interlinking of social sciences with the medical perspective in the fi eld &bdquo;Sexual health of men&ldquo; was the key to the successful approach of the topic &ldquo;sexual health of men&rdquo; [6]. &nbsp;The report includes 31 articles written by 40 ex-perts. Offi cial data, which is a criterion for a health report, could only be used marginally. Figures result predominantly from scientifi c and literature research.

Unzip the Truth: Results from the Fort Peck Men's Sexual Health Intervention and Evaluation Study

ABSTRACTAmerican Indian (AI) men experience sexual and reproductive health disparities including sexually transmitted infections, unplanned pregnancy, absent fatherhood, and intimate relationship violence. Using a case-control study within a community-based participatory research framework, we investigated the effectiveness of a sexual and reproductive health peer led education intervention model for AI men, ages 18–24. Intervention results demonstrated the greatest impact on attitudes regarding contraceptives, commitment in relationships, and consistency of condom use. Our study provides insights into how to access education and influence sexual risk behaviors among a diverse group of hard to reach young adult males.

Psychobiological resilience factors modifying the association between age and sexual health in men

Psychobiological resilience factors modifying the association between age and sexual health in men

Impact of Testosterone Solution 2% on Ejaculatory Dysfunction in Hypogonadal Men

IntroductionHypogonadism is defined as decreased testosterone levels in men. Hypogonadism can be accompanied by erectile, orgasmic, and ejaculatory dysfunction. AimsTo evaluate whether treatment with testosterone solution 2% (testosterone) could improve ejaculatory function in a cohort of hypogonadal men. MethodsSexually active, hypogonadal men at least 18 years old (total testosterone < 300 ng/dL) were randomized to receive testosterone or placebo for 12 weeks. Main Outcome MeasuresEffects of testosterone on primary outcomes were evaluated using the International Index of Erectile Function (IIEF) and the Men's Sexual Health Questionnaire, Ejaculatory Dysfunction, Short Form (MSHQ-EjD-SF) questionnaires. Treatment differences were calculated using analysis of covariance. ResultsIn total, 715 men (mean age = 55 years) were randomized to placebo (n = 357) or testosterone (n = 358). Most sexually active men who reported IIEF scores had some degree of erectile dysfunction (IIEF erectile function score < 26). Although ejaculatory function score (MSHQ-EjD-SF) improved in the testosterone group compared with placebo (P < .001), improvement on the “bother” item did not reach statistical significance. Treatment-related adverse events in the testosterone group affecting at least 1% of patients were increased hematocrit, upper respiratory tract infection, arthralgia, burning sensation, fatigue, increased prostate-specific antigen, erythema, and cough. Few patients in either treatment group developed at least one adverse event leading to discontinuation (testosterone = 1.98% vs placebo = 3.09%; P = .475). ConclusionHypogonadal men receiving testosterone solution 2% therapy experience significantly greater improvement in ejaculatory function, compared with placebo, as assessed by the MSHQ-EjD-SF. However, improvement in “bother” was not statistically different between the two groups. Testosterone therapy was generally well tolerated.

The Impact of HIV Pre-exposure Prophylaxis (PrEP) Use on the Sexual Health of Men Who Have Sex with Men: A Qualitative Study in Seattle, WA

ABSTRACTThis study explores the impacts of HIV pre-exposure prophylaxis (PrEP) use on the sexual health of men who have sex with men (MSM). The authors conducted in-depth interviews with MSM who use PrEP (n = 14). Data was analyzed using interpretative phenomenological analysis. PrEP use reduced fear and shame associated with sex and facilitated greater sexual satisfaction and intimacy. Although participants generally viewed PrEP as empowering and beneficial, they also experienced PrEP-related stigma. The authors’ analysis emphasizes the importance of understanding the reasons MSM use PrEP and highlights opportunities for reducing harm and fostering sexual health among MSM who are using or considering PrEP.

Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study.

With survival rates higher than 80%, the number of survivors from pediatric cancer continues to increase. Late effects resulting from cancer and cancer therapy are being characterized, but little information exists on sexual health for men who have survived childhood cancer. To assess erectile dysfunction (ED) in men who survived childhood and adolescent cancers and to identify potential risk factors for ED. In total, 1,622 men and 271 eligible brothers in the Childhood Cancer Survivor Study cohort completed the Male Health Questionnaire, which provided information on sexual practices and sexual function. Combined with demographic, cancer, and treatment information from medical record abstraction, results of the Male Health Questionnaire were analyzed using multivariable modeling. The International Index of Erectile Function was used to identify ED in subjects. International Index of Erectile Function. Survivors (mean age= 37.4 years, SD= 7.3 years) reported significantly lower sexual activity in the year before the survey than the brothers (mean age= 38.8 years, SD= 8.5 years) without cancer. ED was reported by 12.3% (95% CI= 10.4-14.3) of survivors and 4.2% (95% CI= 2.0-7.9) of brothers. Survivors showed significantly higher relative risk (RR) for ED (RR= 2.63, 95% CI= 1.40-4.97). In addition to older age, survivors who were exposed to higher-dose (≥10 Gy) testicular radiation (RR= 3.55, 95% CI= 1.53-8.24), hadsurgery on the spinal cord or nerves (RR= 2.87, 95% CI= 1.36-6.05), prostate surgery (RR= 6.56, 95% CI= 3.84-11.20), or pelvic surgery (RR= 2.28, 95% CI= 1.04-4.98) were at higher risk for ED. Men who have survived childhood cancer have a greater than 2.6-fold increased risk for ED and certain cancer-specific treatments are associated with increased risk. Attention to sexual health, with its physical and emotional implications, and opportunities for early detection and intervention in these individuals could be important.

Motivators and barriers for HIV testing among men who have sex with men in Sweden.

To explore motivators and barriers to HIV testing and to assess the factors associated with testing among men who have sex with men. Previous research has considered fear, worries and structural barriers as hindrances to HIV testing among men who have sex with men. However, few studies have included assessments of actual HIV testing when exploring barriers or motivators for such testing. The design of the study was a stratified cross-sectional online survey (n=2373). Factor analysis was conducted to analyse the barriers and motivators for HIV testing. Logistic regression analysis was conducted to assess predictors for HIV testing. Many men who have sex with men test for HIV regularly, and specific reasons for testing were having unprotected sex or starting/ending a relationship. A lack of awareness and a perception of being at low risk for exposure were common reasons for never being tested. Fear and anxiety as well as barriers related to the use of test services remain important hindrances for testing. Predictors associated with having been tested within the past 12months were: younger age (15-25years old compared with 47+); knowledge on where to take an HIV test on short notice as well as having talked with a counsellor, having received condoms for free, or having had unprotected anal intercourse with casual partners within the last 12months. Easily accessible test services offering testing and counselling on short notice should be available for all men who have sex with men. Outreach activities, distribution of free condoms and testing at venues where men who have sex with men meet are important prevention add-ons that can contribute to increased awareness about HIV and testing. Test services must ensure confidentiality and health care professionals who meet men who have sex with men for testing need competency with regards to men who have sex with men sexual health needs.

Men who have sex with men in Great Britain: comparing methods and estimates from probability and convenience sample surveys

ObjectiveTo examine sociodemographic and behavioural differences between men who have sex with men (MSM) participating in recent UK convenience surveys and a national probability sample survey.MethodsWe compared 148 MSM aged...

Core principles of sexual health treatments in cancer for men.

The considerable prevalence of sexual health problems in men after cancer treatment coupled with the severity of impact and challenges to successful intervention make sexual dysfunction one of the most substantial health-related quality of life burdens in all of cancer survivorship. Surgeries, radiation therapies, and nontreatment (e.g., active surveillance) variously result in physical disfigurement, pain, and disruptions in physiological, psychological, and relational functioning. Although biomedical and psychological interventions have independently shown benefit, long-term, effective treatment for sexual dysfunction remains elusive. Recognizing the complex nature of men's sexual health in an oncology setting, there is a trend toward the adoption of a biopsychosocial orientation that emphasizes the active participation of the partner, and a broad-spectrum medical, psychological, and social approach. Intervention research to date provides good insight into the potential active ingredients of successful sexual rehabilitation programming. Combining a biopsychosocial approach with these active intervention elements forecasts an optimistic future for men's sexual rehabilitation programming within oncology. However, significant gaps remain in our understanding of patient experience and appropriate sexual health intervention for gay men and men of diverse race and culture.

P-235 YI Sexual Dysfunction Assessment in Inflammatory Bowel Disease Patients

Inflammatory Bowel Disease (IBD) is a term used for diseases such as the Crohn's Disease (CD) and Ulcerative colitis (UC), both characterized by a chronic intestinal inflammation. IBD can change the patients' quality of life and sexuality. Sexuality is an important factor concerning personal satisfaction and quality of life in general. Few professionals touch on this subject during clinical practice. It's up to nursing care the patient's reception and the opening of a wider communication channel between patients and the professionals. The objectives of this study were to study the prevalence of sexual dysfunction in IBD patients and presenting the importance of this subject's approach by the nurse. It was an observational study with 99 IBD outpatients; 118 controls were paired by gender and age. The Crohn's Disease Activity Index (CDAI) was used to assess the clinical activity of CD patients. Mayo score was used to assess the clinical activity of UC patients. The Inflammatory Bowel Disease Questionnaire (IBDQ) was used to measure the healthy related quality of life. The hospital anxiety and depression scale (HADS) was used to measure anxiety and depression. The women's sexual response assessment was done through the Female Sexual Function Index (FSFI) and men's sexual health was done with the International Index of Erectile Function (IIFE). The mean age was 38.89 ± 10.15 years; 57% were women; 73% were in a consensual relationship; 8% were smokers; 97% heterosexual. 57% presented CD, 36% in clinic activity; 43% had UC, 16% in clinic activity; 42% undergone biological therapy. 2% were ostomates and 31% presented perianal disease. Regarding quality of life and psychological aspects, 65% presented an excellent/good quality of life; 48% were anxious (P = 0.0963); 24% were depressed (P = 0.2353) and 90% presented high self-esteem (P = 0.3137), with no statistic difference when compared to control group. Regarding sexual factors, 13% of the patients presented dyspareunia, 5% of the men reported use of medication to facilitate erection (P = 1.0), 28% presented medium to moderate erectile dysfunction (P = 0.1122), 81% were satisfied with their sexual life (P = 0.5625). 93% of the women presented sexual dysfunction (P = 0.6990), 73% reported having vaginal lubrication during the sex act (P = 0.3083), 80% were satisfied with their sexual life (P = 0.2601) and 29% were in sexual abstinence (P = 0.6843). There was sexual dysfunction prevalence on this target population, with no difference between the patients and the control group. Nurses have an important role during the whole assistance, since they can clarify doubts and contribute to education, comprehension regarding the disease, adherence to the treatment, improving the relationship between the medical team and the patients and their families, leading to treatment acceptance, evolving into a good and accompanied life quality.

A Perspective on the Evolving Landscape in Male Reproductive Medicine.

Men's health and aging are emerging as important areas of research opportunity because of advances in reproductive biology and the recognition of men's health as a unique and important aspect of public health. A perspective of the evolving landscape in male reproductive medicine. Remarkable discoveries in reproductive biology have greatly advanced the treatment of erectile dysfunction, androgen deficiency, infertility, hormone sensitive cancers, and prostate diseases. Although the off-label use of testosterone in middle-aged and older men has grown, the management of androgen deficiency syndromes remains suboptimal. There is a pressing need for wider adoption of accurate testosterone assays and harmonized reference ranges and large randomized trials of testosterone's efficacy and cardiovascular and prostate safety. The transformation in idealized body image towards greater muscularity has contributed to increasing prevalence of body image disorders and the use of muscle building drugs in men. Therapeutic options for fertility regulation in men remain limited, the pathophysiologic basis of infertility in a vast majority of infertile men remains unknown, and assisted reproductive technologies remain inaccessible to many infertile men. Much of the dogma on testosterone's binding to its binding proteins remains inaccurate, and the role of free and albumin-bound testosterone poorly understood. The reproductive health of cancer survivors and the availability of wider contraceptive choices for men are other areas of unmet need. Suboptimal care of transgender persons has framed transgender medicine as an important healthcare disparities issue. Transformative changes in societal attitudes towards men's sexual health, body image, and gender identity, and in the economics of reproductive healthcare services, offer extraordinary opportunities for translational science that is patient focused, mechanism based, and integrated with healthcare.

A Urologist's Guide to Ingredients Found in Top-Selling Nutraceuticals for Men's Sexual Health.

Use of supplements is common among men seeking urologic evaluation for sexual health matters. With a dizzying array of formulations available and little regulation on the dosage, purity, or ingredients found in these products, the health effects of nutraceuticals are often confusing to patients and medical practitioners alike. In this review, we set out to concisely summarize the data on ingredients found within the top-selling nutraceutical agents marketed for men's sexual health in order to provide a clinical guide for urologists. We used sales data from the most popular retail provider of men's health supplements to identify the top-selling products marketed toward improvement of men's sexual health. We summarized the available information related to the ingredients, dosage, cost, and mechanism of action for these substances and performed an extensive literature search to identify and review the current evidence available for each of the most common ingredients found in these nutraceuticals. The top-selling nutraceuticals marked for men's sexual health contain a blend of multiple supplements (up to 33 in one formulation identified), the most common being ginseng, tribulus, zinc, horny goat weed, B complex vitamins/trace minerals, fenugreek, L-arginine, maca, DHEA, ginkgo, and yohimbine. The currently available medical literature evaluating the efficacy of these substances is generally of low quality. Despite the dearth of evidence supporting nutraceutical agents in the men's health arena, these substances are still commonly used by patients. As these products can affect the health and well-being of men presenting to a urology clinic, a familiarity with commonly used agents can help the urologist appropriately counsel their patients.

A minority stress--emotion regulation model of sexual compulsivity among highly sexually active gay and bisexual men.

Sexual compulsivity represents a significant public health concern among gay and bisexual men, given its co-occurrence with other mental health problems and HIV infection. The purpose of this study was to examine a model of sexual compulsivity based on minority stress theory and emotion regulation models of mental health among gay and bisexual men. Gay and bisexual men in New York City reporting at least nine past-90-day sexual partners (n = 374) completed measures of distal minority stressors (i.e., boyhood gender nonconformity and peer rejection, adulthood perceived discrimination), hypothesized proximal minority stress mediators (i.e., rejection sensitivity, internalized homonegativity), hypothesized universal mediators (i.e., emotion dysregulation, depression, and anxiety), and sexual compulsivity. The hypothesized model fit the data well (RMSEA = 0.05, CFI = 0.98, TLI = 0.95, SRMR = 0.03). Distal minority stress processes (e.g., adulthood discrimination) were generally found to confer risk for both proximal minority stressors (e.g., internalized homonegativity) and emotion dysregulation. Proximal minority stressors and emotion dysregulation, in turn, generally predicted sexual compulsivity both directly and indirectly through anxiety and depression. The final model suggests that gay-specific (e.g., internalized homonegativity) and universal (e.g., emotion dysregulation) processes represent potential treatment targets to attenuate the impact of minority stress on gay and bisexual men's sexual health. Tests of interventions that address these targets to treat sexual compulsivity among gay and bisexual men represent a promising future research endeavor.

Developing Federal Clinical Care Recommendations for Men.

U.S. men experience substantial sexual and reproductive health needs across the life span. A significant barrier for providers in serving men in family planning, primary care, and sexually transmitted disease clinics has been the lack of standards for men's sexual and reproductive health care. The goal of this synthesis paper is to describe the development of clinical recommendations for the delivery of family planning services for men that were developed and published by CDC and the U.S. Office of Population Affairs. This paper is intended to describe the process used from 2011 to 2014 to develop the recommendations for the delivery of comprehensive reproductive healthcare services to men, and the rationale underpinning them.

EDUCATIONAL NEEDS OF ADULT MEN REGARDING SEXUAL AND REPRODUCTIVE HEALTH IN AHVAZ, IRAN

Background: Men’s sexual and reproductive health is one of the most important public health issues. However, less attention has been paid to this matter, compared to women’s health issues. The aim of this study was to evaluate the educational needs of men regarding sexual and reproductive health in Ahvaz, Iran. Methods:This descriptive study was performed on 1,068 adult men (aged 20-60 years), selected via random cluster sampling in Ahvaz city in 2014. In order to determine the educational needs of men regarding sexual and reproductive health, a questionnaire consisting of three major sections (i.e., demographic data, sexual and reproductive health needs, and men’s attitudes) was designed. The validity of the questionnaire was determined by content and face validity. Its reliability was assessed by internal consistency (α=85%) and test-retest. For data analysis, descriptive statistics, t-test and ANOVA were performed, using SPSS version 19. Results: The majority of men (75.1%) had poor knowledge and a moderate attitude (67.3%) towards sexual and reproductive health. The three most important educational needs of men regarding sexual and reproductive health were cancers of male reproductive system (83.8%), sexually transmitted diseases (STD)/HIV (77.4%) and religious attitudes toward sex (77%), respectively. Friends were the most important source of information in all aspects of sexual and reproductive health, while men preferred to receive information from a male physician or counselor. According to the results, men were dissatisfied with the amount of information they received about sexual and reproductive health. Conclusion: Based on the findings, men felt the need for sexual and reproductive health education; these needs were influenced by social and demographic factors, except marital status. If health policymakers pay attention to these educational needs, it is possible to implement suitable programs for improving men's sexual health and knowledge.

The experience of implementing Smoking cessation to improve sexual health in men

The experience of implementing Smoking cessation to improve sexual health in men

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health.

PurposeThere is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men.Materials and MethodsA total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed.ResultsBy use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction.ConclusionsOur data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.

'He said he had been out doing the traffic': general practitioner perceptions of sexually transmitted infection and HIV testing strategies for men

Sexual health is an important component of primary care, and optimal sexually transmitted infection (STI) and HIV testing by doctors could help improve sexual health outcomes for men. Currently, little is known about general practitioners' (GPs') assessment of STI and HIV risk, particularly in relation to male patients, and the degree to which current advice can be translated into consistent testing protocols. The aim of the study was to explore STI and HIV testing strategies for men in general practice and opportunities and barriers to more optimal testing. This study used a qualitative, multiple-case methodology, incorporating 17 distinct GP cases, drawing on in-depth, semi-structured interviews, and using thematic analysis. The following themes were identified: sexual health consultations by men in general practice are usually initiated by the patient; GPs appear to have a consistent rationale for their risk assessments in terms of STI testing; the nature of the doctor's interaction with men influences the quality of sexual health services utilisation; optimal sexual health consultations require sufficient time and a recognition of the 'delicacy' of the consultation content for both patient and health practitioner. The stratified testing strategies undertaken by GPs appeared appropriate given the risk profiles of their patients. Constraints to optimal sexual health consultations were identified, including inadequate consultation time, male utilisation of GP consultations, and challenges in discussing sexual health topics within the consultation. Prioritising men's sexual health as a topic in CME may be helpful.