•  
  •  
 

Abstract

Background: Erectile function (EF) in healthy young adults and students is underexplored, as erectile dysfunction (ED) is typically linked to aging. This study aimed to quantify EF in university students and examine its association with quality of life (QL).

Method: This cross-sectional survey was conducted among 1,556 undergraduate students (aged 16 to 22 years; median: 18, IQR: 18–19) at the largest university in Kazakhstan, Almaty. Participants completed a web-based anonymous survey assessing EF using the IIEF-5 and QL using the WHOQOL-BREF. The association between EF and QL was analyzed using multivariate linear regression.

Results: Quality of life (QL) scores were very high across all domains: physical health (PH) median 100 (IQR 77-100), psychological (P) median 100 (IQR 67-100), social relationships (SR) median 100 (IQR 80-100), and environment (E) median 100 (IQR 78-100), with age being a strong predictor of QL decline. In students with sexual experience (N=1,306), IIEF-5 scores ranged from 21 to 25 (median: 25, IQR: 21–25), indicating excellent EF. IIEF-5 score was a strong predictor of all QL domains. Adjusted for age and ethnicity, the beta-coefficient for IIEF-5 was: PH 6.96 (95% CI 6.80–7.12), P 8.61 (95% CI 8.53–8.69), SR 6.89 (95% CI 6.66–7.12), and E 7.12 (95% CI 6.92–7.32).

Conclusions: Erectile dysfunction (ED) is uncommon among otherwise healthy young adults of student age in Kazakhstan. ED and QL are closely related, and the underlying mechanisms of this association should be further explored.

Keywords: Erectile function, Quality of life, University students, Kazakhstan

References

[1] Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Annu Rev Public Health 2022 Apr 5;43:355e73. https://doi.org/10.1146/annurev-publhealth052120-012811.

[2] Thomson WM,Broder HL. Oral-health-related quality of life in children and adolescents. Pediatr Clin North Am 2018 Oct; 65(5):1073e84. https://doi.org/10.1016/j.pcl.2018.05.015.

[3] Wu XY, Han LH, Zhang JH, Luo S, Hu JW, Sun K. The inf luence of physical activity, sedentary behavior on healthrelated quality of life among the general population of children and adolescents: A systematic review. PLoS One 2017 Nov 9;12(11):e0187668. https://doi.org/10.1371/journal.pone.0187668.

[4] Lee E, Cha S, Kim GM. Factors affecting health-related quality of life in multimorbidity. Healthcare (Basel) 2021 Mar 16;9(3):334. https://doi.org/10.3390/healthcare9030334.

[5] Zimmermann IR, Silva MT, Galvao TF, Pereira MG. Healthrelated quality of life and self-reported long-term conditions: a population-based survey. Braz J Psychiatry 2017 Jan-Mar; 39(1):62e8. https://doi.org/10.1590/1516-4446-2015-1853.

[6] Larsen SM, Terjesen T, Jahnsen RB, Diseth TH, Ramstad K. Health-related quality of life in adolescents with cerebral palsy; a cross-sectional and longitudinal population-based study. Child Care Health Dev 2023 Mar;49(2):373e81. https://doi.org/10.1111/cch.13055.

[7] Estancial Fernandes CS, Lima MG, Barros MBA. Emotional problems and health-related quality of life: populationbased study. Qual Life Res 2019 Nov;28(11):3037e46. https://doi.org/10.1007/s11136-019-02230-9.

[8] Weber MD, Draghi TTG, Rohr LA, Cavalcante Neto JL, Tudella E. Health-related quality of life in children with developmental coordination disorder: a systematic review. Health Qual Life Outcomes 2023 Jun 29;21(1):62. https://doi.org/10.1186/s12955-023-02146-6.

[9] Lemmon ME, Huffstetler HE, Reeve BB. Measuring healthrelated quality of life in pediatric neurology. J Child Neurol 2020 Sep;35(10):681e9. https://doi.org/10.1177/0883073820923809.

[10] Santos T, de Matos MG, Sim~oes C, Leal I, do Ceu Machado M. (Health-related) quality of life and psychosocial factors in adolescents with chronic disease: a systematic literature review. Int J Adolesc Med Health 2017 Nov 23; 31(4).

[11] Randa H, TodbergT, SkovL,Larsen LS,ZachariaeR. Healthrelated quality of life in children and adolescents with psoriasis: a systematic review and meta-analysis. Acta Derm Venereol 2017 May 8;97(5):555e63. https://doi.org/10.2340/00015555-2600.

[12] Gagliardi J, Brettschneider C, K€ onig HH. Health-related quality of life of refugees: a systematic review of studies using the WHOQOL-Bref instrument in general and clinical refugee populations in the community setting. Confl Health 2021 Jun 2;15(1):44. https://doi.org/10.1186/s13031-02100378-1.

[13] Oluchi SE, Manaf RA, Ismail S, Kadir Shahar H, Mahmud A, Udeani TK. Health related quality of life measurements for diabetes: a systematic review. Int J Environ Res Public Health 2021 Sep 1;18(17):9245. https://doi.org/10.3390/ijerph18179245.

[14] Vinnikov D, Raushanova A, Romanova Z, Tulekov Z. Healthrelated quality of life in a general population sample in Kazakhstan and its sociodemographic and occupational determinants. Health Qual Life Outcomes 2021 Aug 21;19(1): 199. https://doi.org/10.1186/s12955-021-01843-4.

[15] Pequeno NPF, Cabral NLA, Marchioni DM, Lima SCVC, Lyra CO. Quality of life assessment instruments for adults: a systematic review of population-based studies. Health Qual Life Outcomes 2020 Jun 30;18(1):208. https://doi.org/10.1186/s12955-020-01347-7.

[16] Cohen SD. The challenge of erectile dysfunction management in the young man. Curr Urol Rep 2015 Dec;16(12):84. https://doi.org/10.1007/s11934-015-0553-3.

[17] Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M. Men's Attitudes to Life Events and Sexuality (MALES) study. the multinational men's attitudes to life events and sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin 2004 May;20(5):607e17. https://doi.org/10.1185/030079904125003467.

[18] Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men-a review of the prevalence and risk factors. Sex Med Rev 2017 Oct;5(4):508e20. https://doi.org/10.1016/j.sxmr.2017.05.004.

[19] The Ministry of Health of the Republic of Kazakhstan, The United Nations Population Fund [UNFPA]. A summary of the sociological survey on the status of reproductive health of adolescents and young people aged 15-19, their sexual behaviour and access to reproductive health services and information. Kazakhstan: UNFPA; 2018 [cited 2024 Dec]. Available from: https://kazakhstan.unfpa.org/en/ publications/summary-sociological-survey-statusreproductive-health-adolescents-and-young-people.

[20] Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pe~ na BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999 sj.ijir.3900472. Dec;11(6):319e26. https://doi.org/10.1038/.

[21] van Kollenburg RAA, de Bruin DM, Wijkstra H. Validationof the electronic version of the international index of erectile function (IIEF-5 and IIEF-15): A crossover study. J Med Internet Res 2019 Jul 2;21(7):e13490. https://doi.org/10.2196/13490.

[22] Neijenhuijs KI, Holtmaat K, Aaronson NK, Holzner B, Terwee CB, Cuijpers P, Verdonck-de Leeuw IM. The international index of erectile function (IIEF)-A systematic review of measurement properties. J Sex Med 2019 Jul;16(7): 1078e91. https://doi.org/10.1016/j.jsxm.2019.04.010.

[23] World Health Organization [WHO]. WHOQOL-BREF: introduction, administration, scoring, and generic version of the assessment. Geneva: WHO; 1996.

[24] Skevington SM, Lotfy M, O'Connell KA, WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 2004 Mar;13(2):299e310. https://doi.org/10.1023/B:QURE.0000018486.91360.00.

[25] Development of the World Health Organization. WHOQOLBREF quality of life assessment. The WHOQOL Group. Psychol Med 1998 May;28(3):551e8. https://doi.org/10.1017/s0033291798006667.

[26] Molina-Vega M, Asenjo-Plaza M, Banderas-Donaire MJ, Hernandez-Ollero MD, Rodríguez-Moreno S, AlvarezMillan JJ, et al. Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men: results from a regional study. Asian J Androl 2020 Jul-Aug;22(4):372e8. https://doi.org/10.4103/aja.aja_106_19.

[27] Choi EK, Ji Y, Han SW. Sexual function and quality of life in youngmenwithSpinaBifida:could it be neglected aspects in clinical practice? Urology 2017 Oct;108:225e32. https://doi.org/10.1016/j.urology.2016.11.052.

[28] Luo ZR, Liao DS, Chen LW. Comparative analysis of postoperative sexual dysfunction and quality of life in type a aortic dissection patients of different ages. J Cardiothorac Surg 2021 May 1;16(1):117. https://doi.org/10.1186/s13019021-01468-0.

[29] Vinnikov D, Kapanova G, Romanova Z, Krugovykh I, Kalmakhanov S, Ualiyeva A, et al. Occupational burn-out, fatigue and stress in professional rescuers: a cross-sectional study in Kazakhstan. BMJ Open 2022 Jun 28;12(6):e057935. https://doi.org/10.1136/bmjopen-2021-057935.

[30] Vinnikov D, Romanova Z, Kapanova G, Raushanova A, Kalmakhanov S, Zhigalin A. Testosterone and occupational burnout in professional male firefighters. BMC Public Health 2021 Feb 23;21(1):397. https://doi.org/10.1186/s12889-02110446-z.

[31] Vinnikov D, Tulekov Z, Akylzhanov A, Romanova Z, Dushpanova A, Kalmatayeva Z. Age and work duration do not predict burnout in firefighters. BMC Public Health 2019 Mar 14;19(1):308. https://doi.org/10.1186/s12889-019-6643-2.

Share

COinS