Skip to main content
Top
Published in: International Urology and Nephrology 11/2018

01-11-2018 | Urology - Original Paper

Serum vitamin D level may be a novel potential risk factor for premature ejaculation: a comparative study

Authors: Alaa Mohamed Abd El aal, Sameh Fayek GamalEl Din, Laila Ahmed Rashed, Abd El Rahman Bakry Tawfik, Mohammed Said ElSheemy

Published in: International Urology and Nephrology | Issue 11/2018

Login to get access

Abstract

Purpose

To compare serum level of vitamin D [25(OH)D] in patients with life-long premature ejaculation (LPE) versus healthy controls.

Methods

Healthy married potent males were recruited from February 2017 to January 2018. Group A included 40 patients suffering from LPE who were compared versus 40 healthy controls (Group B). Participants suffering from hormonal disorders, obesity, neurological, psychological, or chronic diseases or taking medications that may affect ejaculatory function, serum level of vitamin D, or the accuracy of intra-vaginal ejaculation latency time (IELT) were excluded. LPE was self-reported by the patients with subsequent feelings of frustration and measured by premature ejaculation diagnostic tool (PEDT) and IELT using stopwatch handled by their partners. 25(OH)D was measured by obtaining 2 ml of venous blood. Statistical analysis was performed using Student t, Mann–Whitney, Chi square tests, logistic regression analysis, and Spearman correlation.

Results

Sixteen (20%) participants had vitamin D insufficiency/deficiency. All of them were in PE group. 25(OH)D correlated significantly with IELT (r2 = 0.349; p < 0.001) and PEDT (r2 = 0.425; p < 0.001). There was no statistically significant difference in age (p = 0.341), BMI (p = 1) or IIEF-5 (p = 0.408) in both groups. 25(OH)D was significantly lower in patients than controls (35.75 vs. 58.92 ng/ml, p < 0.001). ROC analysis revealed that the best cut-off value of 25(OH)D to detect patients suffering from LPE was 50.65 ng/ml with a sensitivity and specificity of 85% for both. 25(OH)D remained a significant risk factor for LPE in the logistic regression analysis (p < 0.001).

Conclusions

The current study showed that vitamin D has significant association with LPE and correlates significantly with IELT and PEDT.
Literature
1.
2.
go back to reference Rosen RC, Althof S (2008) Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences. J Sex Med 5(6):1296–1307PubMedCrossRef Rosen RC, Althof S (2008) Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences. J Sex Med 5(6):1296–1307PubMedCrossRef
3.
go back to reference Giuliano F, Clément P (2005) Physiology of ejaculation: emphasis on serotonergic control. Eur Urol 48(3):408–417PubMedCrossRef Giuliano F, Clément P (2005) Physiology of ejaculation: emphasis on serotonergic control. Eur Urol 48(3):408–417PubMedCrossRef
4.
go back to reference Waldinger MD (2014) Ejaculatio praecox, erectio praecox, and detumescentia praecox as symptoms of a hypertonic state in lifelong premature ejaculation: a new hypothesis. Pharmacol Biochem Behav 121:189–194PubMedCrossRef Waldinger MD (2014) Ejaculatio praecox, erectio praecox, and detumescentia praecox as symptoms of a hypertonic state in lifelong premature ejaculation: a new hypothesis. Pharmacol Biochem Behav 121:189–194PubMedCrossRef
6.
go back to reference Giuliano F (2007) 5-Hydroxytryptamine in premature ejaculation: opportunities for therapeutic intervention. Trends Neurosci 30(2):79–84PubMedCrossRef Giuliano F (2007) 5-Hydroxytryptamine in premature ejaculation: opportunities for therapeutic intervention. Trends Neurosci 30(2):79–84PubMedCrossRef
7.
go back to reference Waldinger MD, Olivier B (2004) Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Investig Drugs 5(7):743–747PubMed Waldinger MD, Olivier B (2004) Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Investig Drugs 5(7):743–747PubMed
8.
go back to reference Wrase J, Reimold M, Puls I, Kienast T, Heinz A (2006) Serotonergic dysfunction: brain imaging and behavioral correlates. Cogn Affect Behav Neurosci 6(1):53–61PubMedCrossRef Wrase J, Reimold M, Puls I, Kienast T, Heinz A (2006) Serotonergic dysfunction: brain imaging and behavioral correlates. Cogn Affect Behav Neurosci 6(1):53–61PubMedCrossRef
9.
go back to reference Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ (2005) Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 29(1):21–30PubMedCrossRef Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ (2005) Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat 29(1):21–30PubMedCrossRef
10.
go back to reference Patrick RP, Ames BN (2014) Vitamin D hormone regulates serotonin synthesis, part 1: relevance for autism. FASEB J 28(6):2398–2413PubMedCrossRef Patrick RP, Ames BN (2014) Vitamin D hormone regulates serotonin synthesis, part 1: relevance for autism. FASEB J 28(6):2398–2413PubMedCrossRef
11.
go back to reference Mirzahosseini S, Karabélyos C, Dobozy O, Csaba G (1996) Changes in sexual behavior of adult male and female rats neonatally treated with vitamin D3. Hum Exp Toxicol 15(7):573–576PubMedCrossRef Mirzahosseini S, Karabélyos C, Dobozy O, Csaba G (1996) Changes in sexual behavior of adult male and female rats neonatally treated with vitamin D3. Hum Exp Toxicol 15(7):573–576PubMedCrossRef
12.
go back to reference Shamloul R, Ghanem H, Abou-zeid A (2004) Validity of the Arabic version of the sexual health inventory for men among Egyptians. Int J Impot Res 16(5):452–455PubMedCrossRef Shamloul R, Ghanem H, Abou-zeid A (2004) Validity of the Arabic version of the sexual health inventory for men among Egyptians. Int J Impot Res 16(5):452–455PubMedCrossRef
13.
go back to reference Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11(6):319–326PubMedCrossRef Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11(6):319–326PubMedCrossRef
14.
go back to reference Serefoglu EC, McMahon CG, Waldinger MD et al (2014) An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med 2(2):41–59PubMedPubMedCentralCrossRef Serefoglu EC, McMahon CG, Waldinger MD et al (2014) An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med 2(2):41–59PubMedPubMedCentralCrossRef
15.
go back to reference Symonds T, Perelman MA, Althof S, Giuliano F et al (2007) Development and validation of a premature ejaculation diagnostic tool. Eur Urol 52(2):565–573PubMedCrossRef Symonds T, Perelman MA, Althof S, Giuliano F et al (2007) Development and validation of a premature ejaculation diagnostic tool. Eur Urol 52(2):565–573PubMedCrossRef
16.
go back to reference Althof SE (1998) Evidence based assessment of rapid ejaculation. Int J Impot Res 10(suppl 2):S74–S76. (discussion S77–S79)PubMed Althof SE (1998) Evidence based assessment of rapid ejaculation. Int J Impot Res 10(suppl 2):S74–S76. (discussion S77–S79)PubMed
17.
go back to reference Rosen RC, McMahon CG, Niederberger C, Broderick GA, Jamieson C, Gagnon DD (2007) Correlates to the clinical diagnosis of premature ejaculation: results from a large observational study of men and their partners. J Urol 177(3):1059–1064PubMedCrossRef Rosen RC, McMahon CG, Niederberger C, Broderick GA, Jamieson C, Gagnon DD (2007) Correlates to the clinical diagnosis of premature ejaculation: results from a large observational study of men and their partners. J Urol 177(3):1059–1064PubMedCrossRef
19.
go back to reference Wang TT, Tavera-Mendoza LE, Laperriere D et al (2005) Large-scale in silico and microarray-based identification of direct 1,25-dihydroxyvitamin D3 target genes. Mol Endocrinol 19(11):2685–2695PubMedCrossRef Wang TT, Tavera-Mendoza LE, Laperriere D et al (2005) Large-scale in silico and microarray-based identification of direct 1,25-dihydroxyvitamin D3 target genes. Mol Endocrinol 19(11):2685–2695PubMedCrossRef
20.
go back to reference McCann JC, Ames BN (2008) Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB J 22(4):982–1001PubMedCrossRef McCann JC, Ames BN (2008) Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB J 22(4):982–1001PubMedCrossRef
21.
go back to reference Ginde AA, Liu MC, Camargo CA Jr (2009) Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 169(6):626–632PubMedPubMedCentralCrossRef Ginde AA, Liu MC, Camargo CA Jr (2009) Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med 169(6):626–632PubMedPubMedCentralCrossRef
22.
go back to reference Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87(4):1080S–1086SPubMedCrossRef Holick MF, Chen TC (2008) Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 87(4):1080S–1086SPubMedCrossRef
23.
go back to reference Walther DJ, Bader M (2003) A unique central tryptophan hydroxylase isoform. Biochem Pharmacol 66(9):1673–1680PubMedCrossRef Walther DJ, Bader M (2003) A unique central tryptophan hydroxylase isoform. Biochem Pharmacol 66(9):1673–1680PubMedCrossRef
24.
go back to reference Gutknecht L, Kriegebaum C, Waider J, Schmitt A, Lesch KP (2009) Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice. Eur Neuropsychopharmacol 19(4):266–282PubMedCrossRef Gutknecht L, Kriegebaum C, Waider J, Schmitt A, Lesch KP (2009) Spatio-temporal expression of tryptophan hydroxylase isoforms in murine and human brain: convergent data from Tph2 knockout mice. Eur Neuropsychopharmacol 19(4):266–282PubMedCrossRef
25.
go back to reference Leon-Ponte M, Ahern GP, O’Connell PJ (2007) Serotonin provides an accessory signal to enhance T-cell activation by signaling through the 5-HT7 receptor. Blood 109(8):3139–3146PubMedPubMedCentralCrossRef Leon-Ponte M, Ahern GP, O’Connell PJ (2007) Serotonin provides an accessory signal to enhance T-cell activation by signaling through the 5-HT7 receptor. Blood 109(8):3139–3146PubMedPubMedCentralCrossRef
26.
go back to reference Haussler MR, Jurutka PW, Mizwicki M, Norman AW (2011) Vitamin D receptor (VDR)-mediated actions of 1α,25(OH)2vitamin D3: genomic and non-genomic mechanisms. Best Pract Res Clin Endocrinol Metab 25(4):543–559PubMedCrossRef Haussler MR, Jurutka PW, Mizwicki M, Norman AW (2011) Vitamin D receptor (VDR)-mediated actions of 1α,25(OH)2vitamin D3: genomic and non-genomic mechanisms. Best Pract Res Clin Endocrinol Metab 25(4):543–559PubMedCrossRef
27.
go back to reference Turunen MM, Dunlop TW, Carlberg C, Vaisanen S (2007) Selective use of multiple vitamin D response elements underlies the 1 alpha,25-dihydroxyvitamin D3-mediated negative regulation of the human CYP27B1 gene. Nucleic Acids Res 35(8):2734–2747PubMedPubMedCentralCrossRef Turunen MM, Dunlop TW, Carlberg C, Vaisanen S (2007) Selective use of multiple vitamin D response elements underlies the 1 alpha,25-dihydroxyvitamin D3-mediated negative regulation of the human CYP27B1 gene. Nucleic Acids Res 35(8):2734–2747PubMedPubMedCentralCrossRef
28.
go back to reference Kaneko I, Sabir MS, Dussik CM et al (2015) 1,25-Dihydroxyvitamin D regulates expression of the tryptophan hydroxylase 2 and leptin genes: implication for behavioral influences of vitamin D. FASEB J 29(9):4023–4035PubMedCrossRef Kaneko I, Sabir MS, Dussik CM et al (2015) 1,25-Dihydroxyvitamin D regulates expression of the tryptophan hydroxylase 2 and leptin genes: implication for behavioral influences of vitamin D. FASEB J 29(9):4023–4035PubMedCrossRef
29.
go back to reference Corona G, Jannini EA, Mannucci E et al (2008) Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med 5(8):1991–1998PubMedCrossRef Corona G, Jannini EA, Mannucci E et al (2008) Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med 5(8):1991–1998PubMedCrossRef
30.
go back to reference El Tayeb IM, EL-Saghier EOA, Cheta S, Sabbah NA, Raafat N (2013) Assessment of Vitamin D status among senior executive managers in large scale industries in the 10th of Ramadan city, Egypt. IOSR-JDMS 12(6):77–83CrossRef El Tayeb IM, EL-Saghier EOA, Cheta S, Sabbah NA, Raafat N (2013) Assessment of Vitamin D status among senior executive managers in large scale industries in the 10th of Ramadan city, Egypt. IOSR-JDMS 12(6):77–83CrossRef
31.
go back to reference Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135(2):317–322PubMedCrossRef Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135(2):317–322PubMedCrossRef
Metadata
Title
Serum vitamin D level may be a novel potential risk factor for premature ejaculation: a comparative study
Authors
Alaa Mohamed Abd El aal
Sameh Fayek GamalEl Din
Laila Ahmed Rashed
Abd El Rahman Bakry Tawfik
Mohammed Said ElSheemy
Publication date
01-11-2018
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 11/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-018-1975-x

Other articles of this Issue 11/2018

International Urology and Nephrology 11/2018 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.