Erectile dysfunction (ED) is a prevalent condition affecting male sexual health, characterized by the inability to achieve or maintain satisfactory erections. ED has a multifactorial pathogenesis in which psychological, hormonal, neurologic, cardiovascular, and lifestyle factors all contribute to a progressive decline of erectile function. A critical underlying mechanism involves oxidative stress (OS), an imbalance between reactive oxygen species (ROS) production and antioxidant defenses, which disrupts endothelial function, reduces nitric oxide (NO) bioavailability, and contributes to vascular dysfunction. This narrative review explores the interplay between OS and ED, focusing on the roles of ROS sources such as NADPH oxidase, xanthine oxidase, uncoupled nitric oxide synthase, and mitochondrial dysfunction. It examines the impact of OS on chronic conditions like hypertension, diabetes mellitus, hyperlipidemia, hypogonadism, and lifestyle factors like smoking and obesity, which exacerbate ED through endothelial and systemic effects. Emerging research underscores the potential of antioxidant therapies and lifestyle interventions to restore redox balance, improve endothelial function, and mitigate ED’s progression. This review also highlights gaps in understanding the molecular pathways linking ROS to ED, emphasizing the need for further research to develop targeted therapeutic strategies.

Hypogonadism is associated with a wide range of physical and psychological symptoms that can affect the overall health of men. However, in a developing country, there are several imposing challenges in the diagnosis and treatment of hypogonadism, including a lack of awareness and understanding of the condition among healthcare providers and patients, limited resources and the high cost of treatment. This review aimed to examine the potential benefits and risks of testosterone replacement therapy (TRT) and provides a perspective of a developing country on the topic. A comprehensive literature review was conducted to gather relevant information on the impact of testosterone deficiency on ageing males and the effectiveness of TRT for treating hypogonadism. Published peer-reviewed articles were analyzed to evaluate the benefits and risks of TRT. Additionally, the unique challenges faced in the diagnosis and treatment of hypogonadism in a developing country were considered. Testosterone replacement therapy has been shown to be an effective treatment for hypogonadism, particularly in symptomatic men with low testosterone levels. It offers potential benefits such as improvements in symptoms and overall quality of life. However, there are associated risks and side effects that need to be considered. In a developing country, challenges such as limited awareness and understanding of hypogonadism, resource constraints, and high treatment costs pose additional barriers to accessing TRT and comprehensive care. In conclusion, TRT holds promise as a treatment for hypogonadism, but its implementation and accessibility face significant challenges in a developing country. Addressing these challenges, including raising awareness, allocating resources, and finding cost-effective solutions, is crucial for ensuring that men with hypogonadism in such settings receive appropriate diagnosis and treatment. Further research and efforts are needed to improve the management of hypogonadism in developing countries and optimize the potential benefits of TRT for affected individuals.

To explore the microbial etiology of urethritis in Vietnamese men and the association with patients’ characteristics, especially their sexual behaviors.This study was conducted on 349 men who prese...

Background: Despite social transitions in attitude toward the LGBT+ community, homonegativity, genderism, or transphobia persist, even found in healthcare providers (HCPs), which can hamper the goal of equality and equity in general health and that of gender minorities. The lack of knowledge about the community is also a problem, especially in developing countries. Aim: To investigate the influences of attitudes toward and knowledge about the LGBT+ community of HCPs who are not LGBT+ on how they practice in clinical settings. Methods: A survey was conducted on HCPs, mainly working in urology, nephrology, and andrology, who attended the annual congress on Urology and Nephrology in August 2023. The survey evaluated homophobia, genderism/transphobia, and knowledge about LGBT+ using the Attitude Toward Lesbians and Gay Men Scale–Short Version (ATLG-S), Genderism and Transphobia Scale–Revised–Short Form (GTS-R-SF), and Knowledge About Homosexuality Questionnaire (KAHQ). The behaviors of HCPs toward LGBT+ were also investigated. Outcome: HCPs’ attitudes toward and knowledge about LGBT+ were affected by individual-related factors and modulated behaviors toward LGBT+ patients in clinical settings. Results: Among 362 qualified respondents, levels of negative attitudes toward lesbians, gay men, and transgender people are mild at 5.5%, 13.0%, and 11.1%, respectively. Most respondents (93.4%) have a low to moderate level of knowledge, as measured by the KAHQ, about the LGBT+ community. Respondents having LGBT+ friends have more positive attitudes toward LGBT+ people and higher levels of knowledge about the community than others. Findings from the structural equation model indicate that improving knowledge is the key factor to change the attitudes and practices of Vietnamese HCPs while in contact with LGBT+ clients. Clinical Implications: Developing official and thoughtful curricula on the diversities of gender identities and sexual orientations for medical staff is crucial to reducing gender and sexual orientation discrimination. Strengths and Limitations: This study used validated questionnaires with the ability to exclude unintended respondents, improving the analyses’ accuracy. Since the sample did not represent all HCPs and other specialties, further studies are required. Conclusion: This study indicates the existence of mild levels of homophobia, genderism, and transphobia among HCPs. Improving the knowledge of HCPs about LGBT+ people plays a critical role in improving attitudes toward the community and ensuring equality and equity in providing health services for all patients regardless of their gender identity and sexual orientation.