Evaluation of drug abuse in male patients with sexual dysfunction in Upper Egypt: a cross sectional study
Abdelhamed, A1; A. Mohammed, S2; M. El sayed, R2; H. Mohammed, M2
1: Department of Dermatology,Venereology and Andrology, Sohag University, Egypt; 2: Department of Forensic Medicine & Clinical Toxicology, Sohag University, Egypt
Objectives: Most studies investigate sexual dysfunction in drug abusers. However, no data is available about drug abuse in patients with sexual dysfunction in Upper Egypt. Therefore, this study aims to assess the pattern of drug abuse in patients with sexual dysfunction, and its potential hormonal impact.
Material and Methods: The study included 50 male patients with history of sexual dysfunction for at least 6 months. Initial evaluation with history, general & local examinations were done. Sexual dysfunction was evaluated with the Arabic version of Sexual health inventory for men (SHIM), Erection hardness score (EHS), and the Arabic Index of Premature Ejaculation (AIPE). Morning blood sample was used for assessment of Total Testosterone (TT), LH, and FSH. Urine sample was screened by (ABON™ Multi-Drug) dipstick kits for the following drug abuse tramadol, opiate, THC (Marijuana), amphetamine, barbiturate, cocaine and benzodiazepines. Positive results were confirmed by drug analyzer (CDX90) (Thermo fisher scientific co, Supplier AMG Company).
Results: Patients' characteristics showed age 38.5 ± 8.2 years with 52% were smoker. Sexual dysfunction complaints included PE (86%), ED (50%), and combined (40%), with average duration of 12 months. Patients' hormonal profile showed TT 5.09 ±2.6 ng/ml, FSH 3.5 (0.23-17.3) mIU/ml, and LH 3.23± 1.84mIU/ml. SHIM, EHS, and AIPE were 15.4±4.5, 2.6±0.5, and 20.4±4.9 respectively. Urine screening was positive in 46% (23/50). Confirmation by drug analyzer revealed 3 patients were false positive. Therefore, total positive drug abuse was 40% (20/50); with tramadol 26% (13/50), THC (Marijuana) 12% (6/50), and each of opiate & barbiturate was equal 4% (2/50). Other drugs were negative. Patients with positive drug abuse were significantly heavy smokers (p=0.002) with significantly reduced LH (p=0.02) in comparison with patients with negative drug abuse.
Conclusions: Drug abuse is prevalent among Egyptian male patients with sexual dysfunction, especially tramadol. The drug abuse is common among smoker, and could be associated with potential hormonal negative impact particularly LH reduction. More patient awareness and legal regulations should be considered to reduce drug abuse.
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