{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:21:36Z","timestamp":1762431696319,"version":"3.37.3"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:00:00Z","timestamp":1568160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:00:00Z","timestamp":1568160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"name":"Brazilian National Research Council (CNPq)."},{"name":"Brazilian National Research Council"},{"DOI":"10.13039\/501100003593","name":"CNPq","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Erectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame\u2019s Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM\/TSP), probable HAM\/TSP, or HTLV-1 carrier. Chi-square and Fisher\u2019s exact tests were used to compare the groups, and regression analyses were used to show predictors of ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measure<\/jats:title><jats:p>Sexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ED was associated with age older than 60 years (P &amp;lt; .001), degree of neurologic involvement (P\u00a0&amp;lt;\u00a0.001), depression (P\u00a0= .009), and anxiety (P\u00a0= .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>Neurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths &amp; Limitations<\/jats:title><jats:p>The statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jsxm.2019.07.028","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T21:22:07Z","timestamp":1568236927000},"page":"1763-1768","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1"],"prefix":"10.1093","volume":"16","author":[{"given":"Cassius Jos\u00e9 Vitor","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Federal University of Bahia School of Medicine , Salvador, Bahia , Brazil"},{"name":"Immunology 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