title: Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS).
abstract: BACKGROUND
  The 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).
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Controlling 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.
  
  
  CONCLUSIONS
  A 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.
authors.affiliation: Andrology Australia, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia. carol.holden@med.monash.edu.au
authors.forename: Carol A
authors.initials: CA
authors.lastname: Holden
authors.forename: Robert I
authors.initials: RI
authors.lastname: McLachlan
authors.forename: Marian
authors.initials: M
authors.lastname: Pitts
authors.forename: Robert
authors.initials: R
authors.lastname: Cumming
authors.forename: Gary
authors.initials: G
authors.lastname: Wittert
authors.forename: Johnathon P
authors.initials: JP
authors.lastname: Ehsani
authors.forename: David M
authors.initials: DM
authors.lastname: de Kretser
authors.forename: David J
authors.initials: DJ
authors.lastname: Handelsman
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000150:complications; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D011469:Prostatic Diseases / Q000453:epidemiology* / Q000209:etiology; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D013689:Telephone; D014555:Urination Disorders / Q000453:epidemiology* / Q000209:etiology