Leader: Mario Maggi (UNIFI); Other collaborator(s): Daniele Vignoli (UNIFI), Giulia Rastelli (UNIFI), Clotilde Sparano - UNIFI
The ongoing postponement of fertility decisions make research on sexual life and procreation important to understand low fertility. Task 2.3 will develop research in the fields of the pathophysiology and therapy of andrological conditions in the ageing male, including sexual dysfunction, infertility and lower urinary tract symptoms/benign prostatic hyperplasia. These topics have been also developed in both preclinical and clinical settings with studies that highlighted still undiscovered connections of the andrological diseases with metabolic conditions, such as liver steatosis, insulin resistance, diabetes, and cardiovascular disease. The identification of these pathophysiologic connections allowed to design intervention studies either on animal models or in human (randomised clinical trials) aimed to evaluate the effect of medications for andrological conditions (e.g., testosterone therapy) on the associated metabolic diseases.
Brief description of the activities and of the intermediate results
During the last months, the manuscript about the phenomenon of age-disparate couple relationships and their implications on general and andrological health has been refined and is currently under authors’ revision for the next submission. The same study has been presented as a poster for the XXII National Congress of the Italian Association of Endocrinology (AME) (November 9th-12th 2023) and as an oral communication during the XV National Congress of the Italian Society of Andrology and Sexual Medicine (SIAMS) which took place in Rome the 18th – 20th January 2024. Finally, the same study has just been selected for an oral session in the next Venice General Meeting of May 20-22th. An educational workshop for general practitioners by the present Task is underway. The general outline has been designed and formal practices are ongoing. This event will take place in May in Florence. A new study about the predictors of hypoactive sexual desire disorder is ongoing and the longitudinal data from the European Male Ageing Study are under analysis. New manuscripts are currently ongoing or submitted. Their main topics are: the impact of GH deficiency and excess on men’s sexual health and fertility and the role of β-blockers on erectile dysfunction. A book chapter about testosterone and sexual function is under revision.
Main policy, industrial and scientific implications
Our study on couples on age disparities underlines the biological impact of age asymmetry in relationships. Men with younger partners usually disclose better fertility and female mates with better sexual functioning; conversely, they have no benefits in terms of erectile function and also show a higher rate of major cardiovascular events.
Our recent manuscripts focused on the treatment of hypogonadism and the available drug options. Finally, a recent meta-analysis investigated the safety of testosterone replacement therapy on the cardiovascular system.
Brief description of the activities and of the intermediate results: This Task represents an exemplary case of transdisciplinary collaboration bringing together experts from both the social and biomedical sciences. Specifically, researchers in demography, representing the social science perspective, have worked closely with specialists in endocrinology, and andrology, representing the biomedical perspective. This collaboration has allowed for a comprehensive exploration of the intersection between fertility, fecundity, and male and female sexuality. The resulting synergy has led to key joint publications, including Sparano et al. (2024). The collaboration continues by analysing a new category of relationships, known as LAT (Living Apart Together) relationships. This study aims to verify whether or not LAT is improving sexual relationships in those subjects suffering from sexual dysfunction.
Data Analysis: Analysis of secondary data is either completed or currently in progress.
Scientific Publications: Writing of scientific articles is either completed or ongoing (refer to the publications section).
Dissemination Activities: Dissemination efforts have already begun and are ongoing.
Brief description of the activities and of the intermediate results: On May 18th 2024 the educational workshop for general practitioners titled “Invecchiamento, sessualità e fertilità: un vademecum per MMG” took place in Florence. This event involved several experts in the field and addressed specific issues about ageing and sexual health. The study about age-disparate couple relationships and their implications on general and andrological health was presented during this event and later, as an oral session, during the Venice General Meeting of May 20-22th. Finally, the manuscript “Age disparity in couples and the sexual and general health of the male partner” has been published in August 2024 in Andrology (Q1). A new study about the “living apart together” (LAT) relationships was started in July 2024. Its aim is exploring sexual and health differences compared to stable cohabiting couples, starting from a large sample of patients seeking andrological care. The manuscript Is “Living Apart Together” a real advantage for patients consulting for sexual dysfunction? A cohort study has been submitted and is currently under minor revision in Andrology (Q1). Preliminary analyses of the LAT relationship model are ongoing on a large European population of male subjects.
Data Analysis: Analysis of secondary data is either completed or currently in progress.
Scientific Publications: Writing of scientific articles is either completed or ongoing (refer to the publications section).
Dissemination Activities: Dissemination efforts are ongoing, as testified by several participations to national and international conferences.