Skip to main content

Advertisement

Log in

Exploring complex links: inflammatory rheumatic diseases and men's health

  • Review
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

This article examines the complex interactions between inflammatory rheumatic diseases (IRDs) and men's health. It delves into the effects of IRDs on reproductive health, erectile dysfunction, prostate involvement, male osteoporosis, body composition, physical activity, and coping mechanisms. The findings show that the prevalence of sexual dysfunction varies among different diseases, underscoring the necessity for comprehensive counseling. The link between IRDs and prostate health, with a substantial rise in benign prostatic hyperplasia among IRD patients, demonstrates the condition's importance. In contrast to popular belief, osteoporosis mostly affects women; the current study highlights the growing identification of male osteoporosis, particularly in the setting of IRDs. Male RA patients had a significant loss in bone mineral density, highlighting the importance of increasing awareness and tailored therapy to address osteoporosis in men. IRDs affect body composition, with male RA patients showing imbalances characterized by decreased lean body mass and increased fat mass. Given the dynamic nature of these conditions, coping with IRDs necessitates thorough and individualized diversified approaches. The complex link between IRDs and men's health demands continuing research, including longitudinal studies and tailored therapies. The essay promotes a patient-centered approach, recognizing the unique obstacles that males with IRDs confront.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Data availability

There is no stored data set associated with the article.

References

  1. Cuervo FM, Santos AM, Londono J et al (2022) The burden of the most common rheumatic disease in Colombia. BMC Rheumatol 6:7. https://doi.org/10.1186/s41927-021-00234-y

    Article  PubMed  PubMed Central  Google Scholar 

  2. Al Maini M, Adelowo F, Al Saleh J et al (2015) The global challenges and opportunities in the practice of rheumatology: white paper by the World Forum on Rheumatic and Musculoskeletal Diseases. Clin Rheumatol 34:819–829. https://doi.org/10.1007/s10067-014-2841-6

    Article  PubMed  Google Scholar 

  3. Doukas C, Saltiki K, Mantzou A, Cimponeriu A, Terzidis K, Sarika L, Mavrikakis M, Sfikakis P, Alevizaki M (2013) Hormonal parameters and sex hormone receptor gene polymorphisms in men with autoimmune diseases. Rheumatol Int 33:575–582. https://doi.org/10.1007/s00296-012-2386-4

    Article  CAS  PubMed  Google Scholar 

  4. Shah S, Danda D, Kavadichanda C, Das S, Adarsh MB, Negi VS (2020) Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment. Rheumatol Int 40:1539–1554. https://doi.org/10.1007/s00296-020-04639-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Adelowo O, Mody GM, Tikly M, Oyoo O, Slimani S (2021) Rheumatic diseases in Africa. Nat Rev Rheumatol 17:363–374. https://doi.org/10.1038/s41584-021-00603-4

    Article  PubMed  PubMed Central  Google Scholar 

  6. Baker P (2018) Men’s health: time for a new approach. Phys Ther Rev 23:144–150. https://doi.org/10.1080/10833196.2018.1452562

    Article  Google Scholar 

  7. Nuzzo JL (2020) Men’s health in the United States: a national health paradox. Aging Male 23:42–52. https://doi.org/10.1080/13685538.2019.1645109

    Article  CAS  PubMed  Google Scholar 

  8. Sakkas LI, Chikanza IC (2023) Sex bias in immune response: it is time to include the sex variable in studies of autoimmune rheumatic diseases. Rheumatol Int. https://doi.org/10.1007/s00296-023-05446-8

    Article  PubMed  Google Scholar 

  9. Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD (2011) Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 31:1409–1417. https://doi.org/10.1007/s00296-011-1999-3

    Article  PubMed  Google Scholar 

  10. Fraczek M, Kurpisz M (2015) Cytokines in the male reproductive tract and their role in infertility disorders. J Reprod Immunol 108:98–104. https://doi.org/10.1016/j.jri.2015.02.001

    Article  CAS  PubMed  Google Scholar 

  11. Loveland KL, Klein B, Pueschl D, Indumathy S, Bergmann M, Loveland BE, Hedger MP, Schuppe HC (2017) Cytokines in Male Fertility and Reproductive Pathologies: Immunoregulation and Beyond. Front Endocrinol (Lausanne) 8:307. https://doi.org/10.3389/fendo.2017.00307

    Article  PubMed  Google Scholar 

  12. Gregory M, Cyr DG (2014) The blood-epididymis barrier and inflammation. Spermatogenesis. https://doi.org/10.4161/21565562.2014.979619

    Article  PubMed  PubMed Central  Google Scholar 

  13. El Miedany Y, El Gaafary M, El Aroussy N, Youssef S, Ahmed I (2012) Sexual dysfunction in rheumatoid arthritis patients: arthritis and beyond. Clin Rheumatol 31:601–606. https://doi.org/10.1007/s10067-011-1891-2

    Article  PubMed  Google Scholar 

  14. van Berlo WT, van de Wiel HB, Taal E, Rasker JJ, Weijmar Schultz WC, van Rijswijk MH (2007) Sexual functioning of people with rheumatoid arthritis: a multicenter study. Clin Rheumatol 26:30–38. https://doi.org/10.1007/s10067-006-0216-3

    Article  PubMed  Google Scholar 

  15. Tengstrand B, Carlström K, Hafström I (2009) Gonadal hormones in men with rheumatoid arthritis–from onset through 2 years. J Rheumatol 36:887–892. https://doi.org/10.3899/jrheum.080558

    Article  CAS  PubMed  Google Scholar 

  16. Wilton KM, Achenbach SJ, Davis JM 3rd, Myasoedova E, Matteson EL, Crowson CS (2021) Erectile Dysfunction and Cardiovascular Risk in Men With Rheumatoid Arthritis: A Population-based Cohort Study. J Rheumatol 48:1641–1647. https://doi.org/10.3899/jrheum.201226

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rostom S, Mengat M, Mawani N, Jinane H, Bahiri R, Hajjaj-Hassouni N (2013) Sexual activity in Moroccan men with ankylosing spondylitis. Rheumatol Int 33:1469–1474. https://doi.org/10.1007/s00296-012-2535-9

    Article  PubMed  Google Scholar 

  18. Sariyildiz MA, Batmaz I, Dilek B, Inanir A, Bez Y, Tahtasiz M, Em S, Cevik R (2013) Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis. Rheumatol Int 33:623–629. https://doi.org/10.1007/s00296-012-2432-2

    Article  PubMed  Google Scholar 

  19. Cakar E, Dincer U, Kiralp MZ, Taskaynatan MA, Yasar E, Bayman EO, Ozgul A, Dursun H (2007) Sexual problems in male ankylosing spondylitis patients: relationship with functionality, disease activity, quality of life, and emotional status. Clin Rheumatol 26:1607–1713. https://doi.org/10.1007/s10067-007-0545-x

    Article  PubMed  Google Scholar 

  20. Ramonda R, Foresta C, Ortolan A, Bertoldo A, Oliviero F, Lorenzin M, Pizzol D, Punzi L, Garolla A (2014) Influence of tumor necrosis factor α inhibitors on testicular function and semen in spondyloarthritis patients. Fertil Steril 101:359–365. https://doi.org/10.1016/j.fertnstert.2013.10.048

    Article  CAS  PubMed  Google Scholar 

  21. Nukumizu LA, GonçalvesSaad C, Ostensen M, Almeida BP, Cocuzza M, Gonçalves C, Saito O, Bonfá E, Silva CA (2012) Gonadal function in male patients with ankylosing spondylitis. Scand J Rheumatol 41:476–481

    Article  CAS  PubMed  Google Scholar 

  22. Almeida BP, Saad CG, Souza FH, Moraes JC, Nukumizu LA, Viana VS, Bonfá E, Silva CA (2013) Testicular Sertoli cell function in ankylosing spondylitis. Clin Rheumatol 32:1075–1079. https://doi.org/10.1007/s10067-013-2215-5

    Article  PubMed  Google Scholar 

  23. Merayo-Chalico J, Barrera-Vargas A et al (2019) Epidemiologic Profile of Erectile Dysfunction in Patients with Systemic Lupus Erythematosus: The Latin American Landscape. J Rheumatol 46:397–404. https://doi.org/10.3899/jrheum.180292

    Article  CAS  PubMed  Google Scholar 

  24. Vecchi AP, Borba EF, Bonfá E, Cocuzza M, Pieri P, Kim CA, Silva CA (2011) Penile anthropometry in systemic lupus erythematosus patients. Lupus 20:512–518. https://doi.org/10.1177/0961203310384121

    Article  CAS  PubMed  Google Scholar 

  25. Soares PM, Borba EF, Bonfa E, Hallak J, Corrêa AL, Silva CA (2007) Gonad evaluation in male systemic lupus erythematosus. Arthritis Rheum 56:2352–2361. https://doi.org/10.1002/art.22660

    Article  PubMed  Google Scholar 

  26. Suehiro RM, Borba EF, Bonfa E, Okay TS, Cocuzza M, Soares PM, Silva CA (2008) Testicular Sertoli cell function in male systemic lupus erythematosus. Rheumatology (Oxford) 47:1692–1697. https://doi.org/10.1093/rheumatology/ken338

    Article  CAS  PubMed  Google Scholar 

  27. Tiseo BC, Bonfá E, Borba EF, Munhoz GA, Wood G, Srougi M, Silva CA, Cocuzza M (2019) Complete urological evaluation including sperm DNA fragmentation in male systemic lupus erythematosus patients. Lupus 28:59–65. https://doi.org/10.1177/0961203318815764

    Article  CAS  PubMed  Google Scholar 

  28. Ostojic P, Damjanov N (2007) The impact of depression, microvasculopathy, and fibrosis on development of erectile dysfunction in men with systemic sclerosis. Clin Rheumatol 26:1671–1674. https://doi.org/10.1007/s10067-007-0567-4

    Article  PubMed  Google Scholar 

  29. Foocharoen C, Tyndall A, Hachulla E et al (2012) Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group. Arthritis Res Ther 14:R37. https://doi.org/10.1186/ar3748

    Article  PubMed  PubMed Central  Google Scholar 

  30. Erdoğru T, Koçak T, Serdaroğlu P, Kadioğlu A, Tellaloğlu S (1999) Evaluation and therapeutic approaches of voiding and erectile dysfunction in neurological Behçet’s syndrome. J Urol 162:147–153. https://doi.org/10.1097/00005392-199907000-00036

    Article  PubMed  Google Scholar 

  31. Hiz O, Ediz L, Gülcü E, Tekeoglu I (2011) Effects of Behçet’s disease on sexual function and psychological status of male patients. J Sex Med 8:1426–1433. https://doi.org/10.1111/j.1743-6109.2010.02040.x

    Article  PubMed  Google Scholar 

  32. Gül IG, Kartalcı Ş, Cumurcu BE, Karıncaoğlu Y, Yoloğlu S, Karlıdağ R (2013) Evaluation of sexual function in patients presenting with Behçet’s disease with or without depression. J Eur Acad Dermatol Venereol 27:1244–1251. https://doi.org/10.1111/j.1468-3083.2012.04698.x

    Article  PubMed  Google Scholar 

  33. Luo L, Xiang Q, Deng Y, Zhao S, Zhu Z, Liu Y, Wang J, Zhao Z (2019) Gout is associated with elevated risk of erectile dysfunction: a systematic review and meta-analysis. Rheumatol Int 39:1527–1535. https://doi.org/10.1007/s00296-019-04365-x

    Article  PubMed  Google Scholar 

  34. Richter JG, Becker A, Specker C, Schneider M (2008) Hypogonadism in Wegener’s granulomatosis. Scand J Rheumatol 37:365–369. https://doi.org/10.1080/03009740801998796

    Article  CAS  PubMed  Google Scholar 

  35. Tuin J, Sanders JS, Buhl BM, van Beek AP, Stegeman CA (2013) Androgen deficiency in male patients diagnosed with ANCA-associated vasculitis: a cause of fatigue and reduced health-related quality of life? Arthritis Res Ther 15:R117. https://doi.org/10.1186/ar4297

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Perez-Garcia LF, Röder E, Goekoop RJ et al (2021) Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility). Ann Rheum Dis 80:1545–1552. https://doi.org/10.1136/annrheumdis-2021-220709

    Article  CAS  PubMed  Google Scholar 

  37. Verze P, Cai T, Lorenzetti S (2016) The role of the prostate in male fertility, health and disease. Nat Rev Urol 13:379–386. https://doi.org/10.1038/nrurol.2016.89

    Article  CAS  PubMed  Google Scholar 

  38. Bushman WA, Jerde TJ (2016) The role of prostate inflammation and fibrosis in lower urinary tract symptoms. Am J Physiol Renal Physiol 311:F817–F821. https://doi.org/10.1152/ajprenal.00602.2015

    Article  CAS  PubMed  Google Scholar 

  39. Fowke JH, Koyama T, Fadare O, Clark PE (2016) Does Inflammation Mediate the Obesity and BPH Relationship? An Epidemiologic Analysis of Body Composition and Inflammatory Markers in Blood, Urine, and Prostate Tissue, and the Relationship with Prostate Enlargement and Lower Urinary Tract Symptoms. PLoS ONE. https://doi.org/10.1371/journal.pone.0156918

    Article  PubMed  PubMed Central  Google Scholar 

  40. Parsons JK, Sarma AV, McVary K, Wei JT (2013) Obesity and benign prostatic hyperplasia: clinical connections, emerging etiological paradigms and future directions. J Urol 189:S102-106. https://doi.org/10.1016/j.juro.2012.11.029

    Article  PubMed  Google Scholar 

  41. Vickman RE, Aaron-Brooks L, Zhang R et al (2022) TNF is a potential therapeutic target to suppress prostatic inflammation and hyperplasia in autoimmune disease. Nat Commun 13:2133. https://doi.org/10.1038/s41467-022-29719-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Tzeng YM, Kao LT, Lin HC, Huang CY (2015) A Population-Based Study on the Association between Benign Prostatic Enlargement and Rheumatoid Arthritis. PLoS ONE. https://doi.org/10.1371/journal.pone.0133013

    Article  PubMed  PubMed Central  Google Scholar 

  43. Ou J, Zou L, Wu Y, Zhang Q, Fang Y, Qiu M, Tian X, Ma L, Bi H, Liu C (2023) Causal inference between rheumatoid arthritis and prostate cancer. Clin Exp Med 23:4681–4694. https://doi.org/10.1007/s10238-023-01151-9

    Article  CAS  PubMed  Google Scholar 

  44. Yatsyshyn R, Zimba O, Bahrii M, Doskaliuk B, Huryk V (2019) Prostate involvement in granulomatosis with polyangiitis. Rheumatol Int 39:1269–1277. https://doi.org/10.1007/s00296-019-04321-9

    Article  CAS  PubMed  Google Scholar 

  45. Liu H, Wallace ZS, Harvey L, Crotty R, Wu CL, Deshpande V, O’Shea A, Harisinghani M, Ghebremichael M, Nehra A, Stone JH, Perugino CA (2020) Prostate and pancreas involvement are linked in IgG4-related disease. Semin Arthritis Rheum 50:1245–1251. https://doi.org/10.1016/j.semarthrit.2020.09.002

    Article  CAS  PubMed  Google Scholar 

  46. Loures MAR, Zerbini CAF, Danowski JS, Pereira RMR, Moreira C, Paula AP, Castro CHM, Szejnfeld VL, Mendonça LMC, Radominiski SC, Bezerra MC, Simões R, Bernardo WM (2017) Guidelines of the Brazilian Society of Rheumatology for the diagnosis and treatment of osteoporosis in men. Rev Bras Reumatol Engl Ed 57(Suppl 2):497–514. https://doi.org/10.1016/j.rbre.2017.07.003

    Article  PubMed  Google Scholar 

  47. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413. https://doi.org/10.1007/pl00004148

    Article  CAS  PubMed  Google Scholar 

  48. Willson T, Nelson SD, Newbold J, Nelson RE, LaFleur J (2015) The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol 7:65–76. https://doi.org/10.2147/CLEP.S40966

    Article  PubMed  PubMed Central  Google Scholar 

  49. Nolla JM, Roig-Vilaseca D, Gomez-Vaquero C, Mateo L, Juanola X, Rodriguez-Moreno J, Narvaez J, Valverde J (2006) Frequency of osteoporosis in 187 men with rheumatoid arthritis followed in a university hospital. J Rheumatol 33:1472–1475

    PubMed  Google Scholar 

  50. Kweon SM, Sohn DH, Park JH, Koh JH, Park EK, Lee HN, Kim K, Kim Y, Kim GT, Lee SG (2018) Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors. Medicine (Baltimore). https://doi.org/10.1097/MD.0000000000011122

    Article  PubMed  PubMed Central  Google Scholar 

  51. Theander L, Jacobsson LTH, Turesson C (2023) Osteoporosis-related fractures in men and women with established and early rheumatoid arthritis: predictors and risk compared with the general population. BMC Rheumatol 7:28. https://doi.org/10.1186/s41927-023-00354-7

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kramer HR, Fontaine KR, Bathon JM, Giles JT (2012) Muscle density in rheumatoid arthritis: associations with disease features and functional outcomes. Arthritis Rheum 64:2438–2450. https://doi.org/10.1002/art.34464

    Article  PubMed  PubMed Central  Google Scholar 

  53. Müller R, Kull M, Põlluste K, Valner A, Lember M, Kallikorm R (2019) Factors Associated With Low Lean Mass in Early Rheumatoid Arthritis: A Cross- Sectional Study. Medicina (Kaunas) 55:730. https://doi.org/10.3390/medicina55110730

    Article  PubMed  Google Scholar 

  54. Giles JT, Allison M, Blumenthal RS, Post W, Gelber AC, Petri M, Tracy R, Szklo M, Bathon JM (2010) Abdominal adiposity in rheumatoid arthritis: association with cardiometabolic risk factors and disease characteristics. Arthritis Rheum 62:3173–3182. https://doi.org/10.1002/art.27629

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Kitas GD (2011) Obesity in rheumatoid arthritis. Rheumatology (Oxford) 50:450–462. https://doi.org/10.1093/rheumatology/keq266

    Article  PubMed  Google Scholar 

  56. Katz PP, Yazdany J, Trupin L, Schmajuk G, Margaretten M, Barton J, Criswell LA, Yelin EH (2013) Sex differences in assessment of obesity in rheumatoid arthritis. Arthritis Care Res (Hoboken) 65:62–70. https://doi.org/10.1002/acr.21810

    Article  PubMed  Google Scholar 

  57. Baker JF, Long J, Ibrahim S, Leonard MB, Katz P (2015) Are men at greater risk of lean mass deficits in rheumatoid arthritis? Arthritis Care Res (Hoboken) 67:112–119. https://doi.org/10.1002/acr.22396

    Article  PubMed  Google Scholar 

  58. Nikiphorou E, Santos EJF, Marques A et al (2021) 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. Ann Rheum Dis 80:1278–1285. https://doi.org/10.1136/annrheumdis-2021-220249

    Article  PubMed  Google Scholar 

  59. Clarke LH, Bennett E (2013) “You learn to live with all the things that are wrong with you”: gender and the experience of multiple chronic conditions in later life. Ageing Soc 33:342–360. https://doi.org/10.1017/S0144686X11001243

    Article  PubMed  Google Scholar 

  60. Hammer NM, Midtgaard J, Hetland ML, Krogh NS, Esbensen BA (2018) Physical activity behaviour in men with inflammatory joint disease: a cross-sectional register-based study. Rheumatology (Oxford) 57:803–812. https://doi.org/10.1093/rheumatology/kex498

    Article  PubMed  Google Scholar 

  61. Flurey CA, Hewlett S, Rodham K, White A, Noddings R, Kirwan J (2016) Men, rheumatoid arthritis, psychosocial impact and self-management: A narrative review. J Health Psychol 21:2168–2182. https://doi.org/10.1177/1359105315572452

    Article  PubMed  Google Scholar 

  62. van Lunteren M, Scharloo M, Ez-Zaitouni Z, de Koning A, Landewé R, Fongen C, Ramonda R, Kaptein AA, van Gaalen FA, van der Heijde D (2018) The Impact of Illness Perceptions and Coping on the Association Between Back Pain and Health Outcomes in Patients Suspected of Having Axial Spondyloarthritis: Data From the SPondyloArthritis Caught Early Cohort. Arthritis Care Res (Hoboken) 70:1829–1839. https://doi.org/10.1002/acr.23566

    Article  PubMed  Google Scholar 

  63. Flurey CA, Hewlett S, Rodham K, White A, Noddings R, Kirwan JR (2016) Identifying different typologies of experiences and coping strategies in men with rheumatoid arthritis: a Q-methodology study. BMJ Open. https://doi.org/10.1136/bmjopen-2016-012051

    Article  PubMed  PubMed Central  Google Scholar 

  64. Flurey CA, Hewlett S, Rodham K, White A, Noddings R, Kirwan JR (2018) Coping Strategies, Psychological Impact, and Support Preferences of Men With Rheumatoid Arthritis: A Multicenter Survey. Arthritis Care Res (Hoboken) 70:851–860. https://doi.org/10.1002/acr.23422

    Article  PubMed  Google Scholar 

  65. Flurey CA, Pauling JD, Saketkoo LA, Denton CP, Galdas P, Khanna D, Williams A, Hughes M (2023) “I turned in my man card”: a qualitative study of the experiences, coping styles and support needs of men with systemic sclerosis. Rheumatology (Oxford) 62:2160–2167. https://doi.org/10.1093/rheumatology/keac585

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

Authors

Contributions

Study design: BFK, YF, KS, GYO and MY. Data acquisition and review of the literature: BFK, YF, and GYO. Making interpretations: BFK, YF, KS, GYO and MY. Drafting the manuscript: BFK. Critically reviewing the manuscript: BFK, YF, KS, GYO and MY. Final approval: BFK, YF, KS, GYO and MY.

Corresponding author

Correspondence to Burhan Fatih Kocyigit.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kocyigit, B.F., Fedorchenko, Y., Sultanbekov, K. et al. Exploring complex links: inflammatory rheumatic diseases and men's health. Rheumatol Int 44, 757–764 (2024). https://doi.org/10.1007/s00296-024-05549-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-024-05549-w

Keywords

Navigation