title: Weaker masturbatory erection may be a sign of early cardiovascular risk associated with erectile dysfunction in young men without sexual intercourse.
abstract: BACKGROUND
  Although increasing evidences emphasize the importance of early cardiovascular evaluation in men with erectile dysfunction (ED) of unexplained aetiology, impaired masturbation-induced erections in young men are usually overlooked and habitually presumed to be psychological origin.
  
  
  OBJECTIVE
  To evaluate the young men presenting weaker masturbatory erection with no sexual intercourse (WME-NS) and verify if this cohort have early cardiovascular risks associated with ED.
  
  
  METHODS
  Male subjects aged 18-40 years with WME-NS were screened by analyzing detailed sexual intercourse and masturbatory history. The age-matched ED and non-ED population were identified by using International Index of Erectile Function-5 (IIEF-5). All subjects with acute and/or chronic diseases (including diagnosed hypertension and diabetes) and long-term pharmacotherapy were excluded. Nocturnal penile tumescence and rigidity (NPTR), systemic vascular parameters and biochemical indicators related to metabolism were assessed.
  
  
  METHODS
  Comparison analysis and logistic regression analysis were conducted among WME-NS, ED and non-ED population.
  
  
  RESULTS
  In total, 78 WME-NS cases (mean 28.99 ± 5.92 years), 179 ED cases (mean 30.69 ± 5.21 years) and 43 non-ED cases (mean 28.65 ± 4.30 years) were screened for analysis. Compared with non-ED group, WME-NS group had higher prevalence of early ED risk factors including endothelial dysfunction, insulin resistance, high level of glycosylated serum protein and abnormal NPTR. Multivariable-adjusted logistic regression analysis showed endothelia dysfunction (odds ratio: 8.83 vs. 17.11, both P < 0.001) was the independent risk factor for both WME-NS and ED.
  
  
  CONCLUSIONS
  Weaker masturbatory erection may be a sign of early cardiovascular risk associated with ED in young men without sexual intercourse. More studies are warranted to elucidate the clinical benefits by targeting these formulated strategies.
authors.affiliation: Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Andrology, Shanghai, China.
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Huang
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.forename: Feng-Juan
authors.initials: FJ
authors.lastname: Yao
authors.forename: Sheng-Fu
authors.initials: SF
authors.lastname: Chen
authors.forename: Bin
authors.initials: B
authors.lastname: Ouyang
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Deng
authors.forename: Yi-Ran
authors.initials: YR
authors.lastname: Huang
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D003075:Coitus / Q000502:physiology; D007172:Erectile Dysfunction / Q000209:etiology* / Q000503:physiopathology; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008418:Masturbation / Q000503:physiopathology*; D010410:Penile Erection / Q000502:physiology; D012307:Risk Factors; D055815:Young Adult; D000093422:Glycated Serum Proteins
chemical_list: D001798:Blood Proteins; D006023:Glycoproteins; D000093422:Glycated Serum Proteins
keywords: Cardiovascular Risk; Early Cardiovascular Evaluation; Erectile Dysfunction; No Sexual Intercourse; Weaker Masturbatory Erection; Young Men