Ƙarƙwarar Maɗaukaki tsakanin Ma'aikata Na Farko da Tsofaffi (2014)

Kira: Huang YP, Chen B, Ping P, Wang HX, Hu K, et al. (2014) Haɓakawa tsakanin maza da mata da maza. Koma KASHE 9 (3): e92794. Doi: 10.1371 / journal.pone.0092794

edita: Alice YW Chang, Kaohsiung Chang Gung Memorial Hospital, Taiwan

An samu: Oktoba 30, 2013; An karɓa: Fabrairu 26, 2014; Buga: Maris 25, 2014

Copyright: © 2014 Huang et al. Wannan labari ne mai budewa da aka rarraba a ƙarƙashin sharuɗan Ƙirƙar Lasisi na Creative Commons, wanda ya ba da izinin amfani mara kyau, rarraba, da kuma haifuwa a kowane matsakaici, idan aka ba da mawallafin asali da asali.

Kudade: Wannan nazarin ne aka ba da kyautar daga asusun kimiyya na kasa da kasa na kasar Sin (A'a. 81270741). Hukumar Kimiyya da Fasaha ta Municipal Project na Shanghai (A'a. 08411951700). Masu ba da tallafin ba su da wani tasiri a cikin zane-zane, tattara bayanai da bincike, yanke shawarar buga, ko shirye-shiryen rubutun.

Gudanar da bukatun: Masu marubuta sun bayyana cewa babu wani abun da ya dace.

Gabatarwa

Tare da ci gaban al'umma da kuma tsarin tsufa, likita da kuma ayyuka da suka danganci aikin jima'i suna karuwa, kuma tsofaffi da tsofaffi yawanci ne yawan mutane masu yawa a yawancin nazarin binciken da magance matsalolin jima'i. Cutar da aka yi amfani da shi na Erectile (ED) ita ce matsalar jima'i da ta shafi yawancin nazari a duk faɗin duniya, duk da haka akwai iyakanceccen bayani game da matsayi na yau da kullum wanda zai iya bambanta da ED a yanayi na jiki da na jiki. Yayinda yake tsayayya da yanayin da ke faruwa a cikin 2-3% na maza kuma ba a bayyana shi a matsayin rashin lafiya ba. [1], [2], matsakaicin matsakaicin matsayi na iya zama matsayi na wucin gadi ko kuma marar iyaka a cikin tsofaffi da tsofaffi waɗanda ke da jima'i kafin yin jima'i amma sun kasance a cikin wani mataki na rudani zuwa ga jima'i. Sau da yawa, masu sana'a na kiwon lafiya sunyi la'akari da matsayin matsayin mutumtaka da alaka da halayen halayen mutum, addini, masu yin jima'i da har ma da liwadi, kuma sun kasa yin la'akari da waɗannan mutane, wanda aka bayyana cewa ba tare da jima'i ba, ta hanyar amfani da Yarjejeniya Ta Duniya. na Functile Function (IIEF) don ƙayyade ED. Kamar yadda babu shawarwari masu dacewa domin kimanta matsayi na yau da kullum, yadda za a tabbatar da gaskiyar aikin da aka gano da kuma gano wasu dalilan dalilai na yin amfani da layi a wannan rukuni na da muhimmancin gaske. Amma a yau, babu cikakken, wakilin da kuma bayanan jama'a na samuwa don taimaka wa likitoci su fahimci matsayi na ma'amala. Shanghai ta dauki gubar a cikin tsarin tsufa kuma ta zama wuri na farko tare da tsarin tsofaffi a kasar Sin. Yawan mutane a kan 65 za su kai kimanin miliyan hudu a shekarar 2025, sannan kuma su kasance 29% na yawan yawan jama'a [3]. Saboda haka za a iya ganin tsofaffi mazauna birnin Shanghai a matsayin wakilin kasa, kuma yawancin maza na iya kasancewa mafi kyawun samfurin nazarin ilimin jima'i. Manufar wannan nazari na babban ɗalibin jama'a shine tabbatar da aikin da ba a yi ba a tsakanin tsofaffi da tsofaffi tare da matsayi na matsakaici ta hanyar kwatanta matsayi na asali tare da ED da ba ED kamar yadda aka bayyana a asibiti, kuma a cikin yanayin zamantakewa -diddigar, yanayin asibiti da kuma salon rayuwa kuma ƙara nazarin wasu dalilai na dalilai na ma'amala.

Kaya da matakai

Nazarin Yawan

Wannan binciken ya bincika jima'i da matsayin kiwon lafiya a cikin tsofaffi da tsofaffi daga 40 zuwa 80 shekaru. Gundumomi ashirin da biyu sun rabu a matsayin yankunan tsakiyar birane, yankunan birane da yankunan birane da malaman wariyar launin fata. An tabbatar da al'umma bakwai don gudanar da bincike ta hanyar samfurin samfurin samfur. Mahalarta daga al'ummomin da ba a zaɓa ba sun haɗa su ta hanyar posters. A lokacin binciken (daga 2008 zuwa 2011), mutanen da ke da kula da kansu da kuma zama a cikin birnin har tsawon shekara guda sun cancanci hira. Abun da ke da ciwon haɓaka na ciwo da / ko nakasar jiki, cututtuka masu tsanani (watau cututtukan zuciya mai tsanani da / ko cututtukan ƙwayar cuta, mahimmanci na ƙwayar cuta ko kuma mai cutarwa) da kuma ɗan kishili ko bisexual orientation, an cire su a tsarin binciken yadda za a cancanta. Dukkanin matsalar ta tabbatar da kai, rahotanni na likita da kuma hira. Daga 1,720 masu cancanta, 1,591 ya kammala asali a cikin gida. Daga ainihin 1,591 masu amsawa zuwa binciken binciken asali, an cire 60 a matsayin rikice-rikice ko cikakke bayanai, wanda ya bar 1,531 maza cancanci lissafin.

Matakan Amfani

An kirkiro yarjejeniyar filin bisa ga samfurin Massachusetts Nazarin Aiki [4]. A takaice dai, wani masanin fasaha / kwararren likita ya ziyarci kowane batu a Cibiyar Gidan Sadarwar Jama'a ko gidansa bisa ga ka'idodin bincike na yau da kullum da aka samo asali don manyan ayyuka [5], tattara bayanan alƙaluma, gudanar da tambayoyin kiwon lafiyar lafiyar jama'a da kuma katunan jima'i, da kuma samo samfurori masu azumi. Wannan binciken ya sami amincewa da hukumar kulawa da hukumomi (Renji Hospital, Shanghai, No. RJLS2008175), kuma dukkanin masu nazarin ya ba da sanarwar izini. An tattara duk bayanan da aka tattara a cikin wani asusun da aka kafa ta hanyar amfani da tsarin ACCESS da tsarin aikin, wanda za'a iya samunsa a hukumar kimiyya da fasaha na Shanghai da kuma Cibiyar Andrology ta Shanghai.

An samo ma'aunin jini na uku. An ƙididdige alamar jigilar jiki (BMI) a matsayin auna ma'auni a cikin kilogiram na raba ta hanyar auna tsawo a mita mita kuma an rarraba ta amfani da labarun Lafiya ta Duniya (WHO) [6]: nauyi (≥25 kg / m²) ko a'a (<25 kg / m²). An yi amfani da ma'aunin kumbura (WC) a matsayin ma'aunin matsakaicin matsakaici, kuma an rarraba shi gida biyu: kiba (-90 cm) ko a'a (<90 cm)) [7].

Game da ƙididdigar halin jima'i, an ba da wani tambayi mai gudanarwa game da yin jima'i a kowane batun don kammalawa a cikin masu zaman kansu. A cikin jerin tambayoyin jima'i na maza da maza suka tsara kansu cikin matakai guda biyu: babu jima'i ko yin jima'i a cikin watanni 6 da suka gabata. Wani nau'i na 5 na International Index of Erectile Function (IIEF-5) an ba da shi ga al'amuran da ke cikin jima'i ≥1 lokaci a kowace wata a cikin watanni 6 da suka wuce, kuma an rarraba su cikin matakai uku: wadanda ba ED ba. (IIEF-5M22), m ED (21MIIEF-5≥12) da kuma matsananci mai tsanani ED (11≥IIEF-5≥5). Masu amsawa ba tare da yin gwagwarmayar jima'i ba a kalla watanni 6 an bayyana cewa suna da matsayi na asali. Bayanan da suka shafi dangantaka tsakanin maza da mata, ciki har da abokin auren mata ("auren mata, gwaurarru, saki ko rabu" da kuma "saduwa da mata"), halayen jima'i ("ba damuwa game da jima'i"), matsalolin kafa ("wahala"), jima'i (halin da ake ciki ba tare da zama dole ba don yin jima'i a wannan zamani), damuwa da zamantakewa da rayuwa ("damuwa mai tsanani", "gajiya mai tsanani" da "jinƙan rai") da kuma al'aura ("masturbatory erection" da "rauni masturbatory erection" ), an tattara su a kowanne ɗayan jama'a. A ƙarshe, ƙayyadaddun dalilan da aka sa a kan matsayi na yau da kullum an cire su daga bayanan da aka tattara na tambayoyin.

Ana amfani da bayanai daga cikin tambayoyin farko don tantance abubuwan da suke da sha'awa. An tambayi masu zama game da motsa jiki na yau da kullum a cikin shekaru 5 da suka wuce ("a yau da kullum" an bayyana shi a kalla sau ɗaya a mako, domin fiye da watanni 3 ci gaba) [8]. Abubuwan da ake amfani da su '' 'barazanar shan barasa da aka kai su ne ta hanyar rahoton kansu ta hanyar amfani da tsarin Khavari da Farber [9]. An yi amfani da hayaki na taba taba ta hanyar rahoton kai, kuma an bayyana masu shan taba a yanzu kamar suna shan taba a lokacin binciken kuma sun taba shan taba fiye da 100 cigare a rayuwarsu [10]. An shayar da shan shan shayi ta hanyar tambayoyin tambayoyi a cikin shekaru 5 da suka gabata kuma an rarraba su a cikin gida ("na yau da kullum" an bayyana a kalla sau ɗaya a rana, saboda fiye da 1 shekara gaba).

Domin tabbatar da irin wadannan sakamakon cutar da aka ruwaito kanmu, mun yi amfani da hanyoyi daban-daban ciki harda nazarin labarun kiwon lafiya, nazarin rahoton lissafi, hira da tarho, ko tambayoyi masu yawa. Hawan hawan hawan jini a ma'auni ya nuna idan an hadu da ɗaya ko fiye daga cikin wadannan yanayi: 1) labarin da aka yi amfani da shi na amfani da maganin antihypertensive; 2) Halin jini na systolic na jini ko kuma 140 mmHg ko jini na jini diarrhus ko 90 mmHg [11]. Dyslipidemia an bayyana shi azaman kwayoyin cutar cholesterol ko 5.72 mmol / L; da / ko triglyceridesM1.70 mmol / L; da / ko low density lipoprotein cholesterol ×3.64 mmol / L; da kuma / ko amfani da maganin cholesterol-downering. Ciwon sukari an bayyana shi azaman glucose mai azumi mai azumi ko 7.0 mmol / L da / ko yin amfani da maganin ciwon sukari. Yin amfani da Cibiyar Harkokin Kiwon Lafiyar Lafiya na Labaran Kwayoyin Prostatitis (NIH-CPSI), an nuna alamun bayyanar cutar ta prostatitis (PLS) a matsayin ciwon alamun urinary tract (LUTS), ko / da perineal da / ko kuma mai ciwo ko rashin jin kunya [12]. An yi amfani da jarrabawar ƙwararru ta kasa da kasa (IPSS), jarrabawar jarrabawa na zamani (DRE), rikodin likita na duban dan tayi da karbar maganin maganin maganin magungunan maganin magunguna don gano ainihin mai karfin kansa wanda ke da cikakkiyar hyperplasia prostatic (BPH).

Dukkan masu binciken sun samu nasarar kammala shirin horon da ya dace da su ga manufofin binciken da kuma wasu kayan aiki da hanyoyin da ake amfani dasu. Ɗaya daga cikin samfurin samfurin jini mai azumi ya karɓa don glucose na sukari (wanda aka auna ta hanyar amfani da hanyar hawan enzymatic mai gyaran ƙwayar hexokinase) da kuma maganin lipid (yayi nazari akan ƙwayoyin cuta ta hanyar amfani da haɗin mai samuwa) [13]. Ƙari biyu na ƙananan bugun jini na samfurori marasa azumi an ɗora su ne don gwajin hormon [14], [15], [16] da kuma dukkanin antigen takaddama (TPSA) [17], bi da bi. An gudanar da dukkanin gwaje-gwaje na jini a cibiyar nazarin gine-gine (Renji Hospital, Shanghai, China).

ilimin kididdiga Analysis

Dukkan mahalarta an rarraba su cikin ƙungiyoyi hudu bisa ga yawan shekarun da aka bincika yawan mutanen binciken (40-51, 52-59, 60-64, da 65-80). An rarraba matsayi na jima'i cikin ƙungiyoyi hudu: waɗanda ba ED, m ED, matsayi mai tsanani da tsanani ED da matsayin matsakaici. Wata hanyar ANOVA (bayanai sun sadu da rarraba ta al'ada), Kruskal-Wallis (bayanai sun sadu da rarraba ba tare da al'ada ba) da kuma nazarin shafuka (bayanai) don amfani da su a cikin ƙungiyoyi hudu akan duk halayen da suka danganci, kuma ana amfani da gyaran Bonferroni don rikici da nuna bambanci da kwatancen da yawa. A ƙarshe, tsarin rikice-rikice iri-iri yayi bincike ko al'amuran da suka dace na farko, yanayin asibiti da kuma salon rayuwa sun danganta da halin jima'i. An bayar da mahimmancin canje-canje a matsayin maƙasudin ± daidai (SD) ko tsakani (matsakaici kadan). Bayanan lissafi P<0.05 an dauke shi yana mai nuna alamun bambance-bambance masu mahimmancin asibiti tsakanin ƙungiyoyi. Dukkanin nazarin ilimin lissafi an yi su ta amfani da SPSS13.0 (SPSS Inc., Chicago, Illinois, Amurka).

results

Daga 1,720 masu cancantar amsawa, mun karbi amsa daga darussan 1,591 (92.5 bisa dari) da kuma samfurori daga samfurin 1,531 (89.0 kashi). Sakamakon nau'in sakonnin tsofaffin shekarun sune 12.9% (40-51), 22.6% (52-59), 28.0% (60-64) da kuma 36.4% (65-80), daidai da haka. Kwancen adadin da aka tsara na ED da kuma matsayi na yau da kullum shine 49.9% (765 / 1,531) da 37.2% (569 / 1,531), bi da bi. An rarraba rarraba cutar rashin lafiya da lalacewa tsakanin 'yan shekarun haihuwa Figure 1. Dalili akan dalilai na matsakaici, ciki har da mahimman dalilai "kada ku damu game da jima'i" (53.5%), "wahala mai mahimmanci" (52.9%), "ba dole ba ne don yin jima'i a wannan zamani" (47.7%), "mai tsanani danniya "(44.4%) da kuma" erectar masturbatory "(26.9%), an taƙaita a cikin Figure 2.

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Hoto 1. Rarraba cuta da ciwon jima'i tsakanin 'yan shekaru.

Doi: 10.1371 / journal.pone.0092794.g001

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Hoto 2. Dalilin da ya sa ake yin nazari a cikin jama'a ba tare da jima'i ba.

Doi: 10.1371 / journal.pone.0092794.g002

Table 1 ya taƙaita bambance-bambance na abubuwan haɗari da suka haɗa da ED a cikin ƙungiyoyi hudu. Yanayin matsakaicin yawancin jama'a sun tsufa, hawan jini na jini, FBG mafi girma, ciwon halittar Halitta da TPSA, da ƙananan matakin LH; kuma ya gabatar da yawan ciwon sukari da hauhawar jini.

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Table 1. Yanayin mutum da kuma yanayin halayen maza na halaye kamar yadda shirin IIEF-5 yake.

Doi: 10.1371 / journal.pone.0092794.t001

Table 2 ya nuna ƙungiyoyi tsakanin yanayin jima'i da abubuwan haɗari na ED. Amfani da rikici na layi, mun sami wata ƙungiya mai kyau tsakanin matsakaici da tsanani ED da tsufa (rashin daidaituwa (OR) = 8.01, 95% CI: 3.62-17.71; P<0.001), ciwon sukari (OR = 2.36, 95% CI: 1.16-4.80; P = 0.02), hawan jini (OR = 1.72, 95% CI: 1.07-2.79; P = 0.03), BPH (OR = 3.58, 95% CI: 1.55-8.25; P = 0.03) da PLS (OR = 5.88, 95% CI: 1.20-28.79; P = 0.03); da kuma haɗakarwa tsakanin daidaitaccen matsayi da tsoho (OR = 18.49, 95% CI: 10.34-33.05; P<0.001), ciwon sukari (OR = 2.40, 95% CI: 1.36-4.25; P = 0.003) da hauhawar jini (OR = 1.78; 95% CI: 1.25-2.55; P = 0.002).

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Table 2. Bivariate da ƙungiyoyi masu yawa na tasiri masu tasiri tare da aikin jima'i.

Doi: 10.1371 / journal.pone.0092794.t002

tattaunawa

Abubuwan da muka gano, dangane da bayanan wakilan jama'ar kasar daga Shanghai, sun nuna cewa mafi yawancin tsofaffi da tsofaffi suna da matsalolin jima'i, kuma haka ma, yawancin maza sun gabatar da matsayi na yau da kullum. Mutanen da ke da matsananciyar hali sun sha wahala fiye da yanayin da suka shafi yawancin mutane na ED kuma mafi yawan dalilan da suka shafi halayen su sun kasance tare da halayen da ba su da kyau, yayin da wasu 'yan maza da ke da matsayi na matsakaicin hali sun nuna cewa suna da tsararren al'ada a lokacin al'aura.

Hanyoyin da aka ƙaddara da kuma abubuwan haɗari na ED a cikin bincikenmu sun goyi bayan bincike na baya a kasashen Asiya da na Yamma [18], [19], [20], [21]. Hanyoyin haɗari na ED sun haɗa da tsofaffi, ciwon sukari, hauhawar jini, BPH da PLS, kuma tsofaffi shine lamarin haɗari mai zaman kanta. Duk da haka, mun kuma sami yawancin ɓaruwa a cikin wannan yawan. Hanyoyin da ED ta kasance a cikin maza da 40-51 shekaru sune 58.6%, wanda ya zama bambanta daga bayanan binciken da aka gudanar a baya (binciken daga 2% zuwa 39% a cikin maza tsakanin shekarun 40 da 50) [22]. Hakanan za'a iya bayyana yawancin ED na 40-51 shekaru kamar haka: da farko, ƙarin shaida a cikin 'yan shekarun nan sun nuna cewa tasirin ED yana karuwa sosai a cikin matasa da kuma masu tsufa. [23], [24]; abu na biyu, babban rabo na m ED (53.5% a duk, ba a nuna a sakamakon) gabatar a cikin wannan ƙungiyar, wanda sau da yawa ba a kula da shi a cikin aikin likita [25]; Abu na uku, al'adun gargajiya na al'adun Sin da zamantakewa na iya haifar da mummunan tasirin da aka samu a cikin 'yan tsofaffi na' yan Adam [26], yayin da nau'o'i na IIEF-5 ba su ƙyale ED [26], [27]. Babu ƙungiyoyi masu mahimmanci tsakanin ED, dyslipidemia da kuma salon rayuwa, wanda zai bambanta da binciken binciken Italiya da marasa lafiya da dyslipidemia [28] ko / da kuma yanayin da ba daidai ba [29], [30] sun kasance cikin haɗarin haɗarin bunkasa ED. Wadannan binciken da ba daidai ba na iya samuwa daga bambancin yawan jama'a. Smith et al. [31] gano cewa babu wata dangantaka tsakanin yawan IIEF-15 ko karfi na ED da sukarin cholesterol da ƙwayoyin triglyceride, da Hall et al [32] Har ila yau, ya gano cewa babu wata kyakkyawar ma'amala mai kyau tsakanin cutar hyperlipidemia da ba a kula da ita da kuma ED a cikin samfurin da yawa. A cikin yawan karatunmu, yawancin batutuwa sun tsufa (kashi 64.5 cikin 60> shekaru XNUMX) kuma sun sha fama da ƙaruwa da cututtuka, saboda haka yanayin rashin lafiyarsu zai buƙaci su inganta rayuwarsu (misali, haɓaka abinci da halayyar motsa jiki), wanda na iya amfani da ikon su na dyslipidemia da kiba. Amma a gefe guda, waɗannan binciken sun nuna cewa ED a cikin wannan rukuni na iya shafar tasirin gaske ta hanyar cututtukan tsari fiye da mummunan yanayin rayuwa.

An yi amfani da tsarin IIEF (ko IIEF-5) don amfani da shi don kimanta aikin aiki [33], [34]. Duk da haka, tambayoyin, ba tare da la'akari da maza da "ba a cikin jima'i ba a cikin makonni na 4 na ƙarshe", an iyakance ne don kimanta matsayi na yau da kullum wanda aka bayyana a nan ba tare da yunkurin jima'i ba fiye da watanni 6. Yayinda babu takamaiman shawarwari don kimantawa a cikin magungunan likita, ana iya cire batutuwa da ke da matsayi na yau da kullum daga yawan masu karatu a yawancin rahotanni. Duk da haka, amsar wannan tambayar ta kasance muhimmiyar mahimmanci yayin da akwai ƙwararrun mutane waɗanda ke da wucin gadi na asexual, musamman ma tsofaffi [35], [36]. A cikin bincikenmu, 37.2% na tsakiyar shekaru da tsofaffin maza sun gabatar da matsayi na yaudara, saboda haka yana nuna cewa ba za a iya manta da bincike na wannan rukuni ba. Domin ya bayyana matsayin rashin daidaituwa na aiki mai tsafta (kammala ED ko aiki na al'ada) a cikin ƙungiyar tare da matsayi na asali, mun kwatanta matsayi na asali tare da matsananciyar ƙarfi da ED wanda bai dace ba dangane da abubuwan haɗari da suka haɗa da ED. Hanyoyin haɗarin haɗari na shekaru 60-64 da 65-80 shekaru a cikin masu amsawa tare da matsayi na matsakaicin matsayi sun fi girma a cikin ƙungiyar tare da matsananciyar tsanani da ED ta hanyar 2.5 ninka da kuma 2.2 ninka. Bugu da ƙari, haɗarin ciwon sukari da hauhawar jini a cikin maza da matsayi na matsakaicin matsayi sun fi girma fiye da mazajen ED mai tsanani da tsanani. Wadannan binciken sun nuna cewa mafi yawancin shari'ar tare da matsayi na matsakaicin hali zai iya dangantaka da cikakken ED, abin da yake fahimta tun da yawancin maza da ke da matsayi na asali sun rasa damar yin jima'i.

A cikin ƙoƙari na tabbatar da ƙididdigar da aka ƙayyade, mu ɗayan ɗayan sun tattara dalilai na kai-tsaye game da abubuwan da ke faruwa a cikin waɗannan maza ba tare da jima'i ba. Bayanin rahoton kai a cikin bincikenmu ya nuna cewa 52.9% na maza a cikin matsayi na matsayi na yanki na daukar "wahala mai mahimmanci" a matsayin ainihin dalilin wannan yarjejeniya, wanda ke goyan bayan tabbatarwa a kai tsaye. Bugu da ƙari kuma, gunaguni na "damuwa mai tsanani" (44.4%), "gajiya mai tsanani" (26.3%), "dangantaka mara kyau" (4.4%) da "rashin jin dadin rayuwa" (3.0%), wanda ke wakiltar zamantakewa, tunani da jiki damuwa da ke haifar da mummunar tasiri a kan ayyukan jima'i da kafa [37], [38], sune dalilai na ci gaba da al'adu a cikin wannan yawan. Wadannan binciken sun bayyana a wani bangare dalilin da ya sa yawancin maza da ke da matsanancin matsayi sun sha wahala. Mun lura cewa yawancin maza da ke da matsayi na 'yanci suna "ba damuwa game da jima'i" (53.5%) da "ba lallai ba ne don yin jima'i a wannan zamani" (47.7%) a matsayin wasu dalilai guda biyu na mahimmanci, kuma yana da alama mutane samar da waɗannan dalilai na iya samun aiki mai mahimmanci. A gaskiya ma, wannan lamari ya shafi bangarorin biyu: halaye game da jima'i da kuma rashin halayen jima'i. Kamar yadda mafi yawan maza da ke da matsayi na ma'amala sun yi aure ko sun kasance a cikin rayuwar jima'i na yau da kullum, matsayi na yau da kullum ya bambanta da yanayin da ake da shi na yau da kullum wanda yake hana yin jima'i da cin zarafi ya haifar da ra'ayin mutum ko addini ko / da jima'i [39]. Ta haka ne mafi mahimmancin dalili game da bambancin jima'i na iya zama damuwa cewa ayyukan jima'i zai cutar da lafiyarsu mai tsanani da karuwa. Rashin jima'i na iya haɗu da tsufa (ma'anar 65.70 ± 8.20 shekaru), ƙananan testosterone (idan aka kwatanta da wadanda ba ED ba) da kuma haɗuwa da cututtuka na yau da kullum, wanda ya dace da bayanan a cikin Nazarin Aiki na Turai (EMAS) [40]. Matsanancin kwayoyin testosterone zai haifar da hasara na libido [41], da kuma raunin testosterone na kwayoyin halitta zai iya haifar da dullfunction ta hanyar ƙetare vasodilation na penile arterioles da cavernous sinusoids [42]. Saboda haka, bambancin jinsi da rashin sha'awar jima'i sun haɗa da abubuwan haɗarin ED.

Maza maza da matsayi guda da al'amuran al'aura zasu iya nuna cewa suna ci gaba da aiki na al'ada ko da ba su da kalubalen jima'i. Duk da haka, mun gano cewa ƙananan mazajen da ke da matsayi na matsakaicin matsayi suna "ƙwararru, masu aure, waɗanda aka saki ko rabuwa" (4.3%) a matsayin dalilan da ake amfani da su a cikin binciken. Kodayake kimanin kashi] aya daga cikin maza na da labaran da suka nuna cewa suna da masaniyar masturbatory, kawai 35.3% daga gare su (9.5% a duk) sunyi la'akari da cewa suna da tsararren masturbatory. A takaice, ko da yake akwai dalilai daban-daban na maganganun da aka ruwaito, yawancin su na iya haifar da matsala da matsaloli.

Wannan binciken yana da ƙarfin da yawa, ciki har da ƙwararrun gwagwarmaya masu zaman kansu, yawancin samfurin samfurin da daidaitattun ka'idodin da masu horar da masu horarwa suka yi. An rage girman zabin da aka yi saboda yawan karfin da aka samu a lokacin daukar ma'aikata (92.5%). Mafi mahimmanci, mun ƙayyade matsayi na rashin daidaituwa tare da daidaituwa da kuma batutuwa waɗanda aka tsara tare da maganganu kamar ƙungiya ta ƙungiya don bincike. Binciken matsayi na yau da kullum game da batun rayuwa mai tsawo zai iya ƙara zuwa wallafe-wallafe ba tare da wani shawarwari na musamman ba domin kimantawa a cikin tsarin aiki na asibiti. Duk da haka, iyakancewar wannan binciken ya kamata a yi la'akari da fassarar sakamakon. Kamar mafi yawan binciken binciken da aka yi, damuwa daya shine gaskiyar cewa wasu bayanai sunyi rahoton kansu, kodayake hanyoyin da aka yi amfani da tambayoyin sun yarda da su sosai. Don magance wannan damuwa, mun tattara bayanai masu yawa kamar yadda zai yiwu don tallafawa sakamakon da aka ruwaito. Wani damuwa shi ne cewa ba mu tattara cikakkun bayanai game da yanayin lafiyar mata ba kuma ba mu binciko da kuma nazarin matsayi na rayuwar rayuwa ba wanda ya bambanta da rashin daidaituwa a cikin al'ummar mu.

A ƙarshe, matsayi na yau da kullum ya kasance a tsakanin masu tsufa zuwa tsufa, kuma mutanen da ke cikin wannan yanayin sun sha wahala ga abubuwan da suka fi damuwa ga ED fiye da maza waɗanda ke da matsanancin hali mai tsanani. Yawancin matsayi na jahiliyya za a iya danganta ga yanayin da yake da cikakke na ED, kodayake dalilan da ke tattare da matsayi na yau da kullum sun haɗa da halayyar jima'i da kuma bukatu, halayen jima'i da masturbation. Ana buƙatar ƙarin nazarin don tsara bincike mai dacewa don nazarin yadda ake aiwatar da kwayoyin halitta tare da aiki na kwayoyin halitta a cikin jama'a tare da matsayi na asali, da kuma gano wani ɓangare na mazaunin da ke da mahimmanci, ciki har da matasa da yawa, watau, zuwa 18 shekaru. Hakan zai taimaka wajen ayyana abubuwan da ba a san su ba, wanda zai iya sa matasa su raina rayuwa mai mahimmanci.

Acknowledgments

Masu marubuta suna so su gode wa Farfesa Cadavid Nestor Gonzalez-Cadavid (Ma'aikatar Urology, UCLA School of Medicine, Jami'ar Charles Drew) don taimakonsa da wannan takardun.

Marubucin Mataimaki

Ƙira da kuma tsara gwaje-gwajen: BC YW YH. An yi gwaje-gwaje: PP HW KH HY TF YJ TZ YH. An bincika bayanan: YH HW KH HY TF YJ TZ. Ayyuka masu haɓaka / kayan aiki / bincike: KH HY TF YJ TZ. Ya rubuta takarda: YH HW. Binciken shi don fahimtar ilimi: Bin Chen Ping Ping Hong-Xiang Wang Kai Hu Hao Yang Tan Feng Yan Jin Tao Zhang.