Alcohol Consumption Is Associated with Hypogonadism and Decreased Sexual Function in Ghanaian Diabetics

Introduction: Alcohol usage has largely been seen as a risk factor for the development of sexual dysfunction as well as erectile dysfunction. Others have reported that prolonged alcohol usage and abuse is compatible with normal sexual function in the absence of endocrinological problems as well as hepatic dysfunction. About seventy five (75) percent of alcoholics have various sexual difficulties with improvements in sexual functions occurring after treatment of alcoholism and psychosexual therapy. It is evident from the various reports over the years that mild and occasional alcohol usage is not as much implicated in the causation of SD and its other forms as heavy, addictive or dependent alcohol usage. Alcohol usage has also long been linked to hypogonadism, testicular atrophy as well as leydig cell toxicity. Alcohol induced hypogonadism has been reported to resolve after withdrawal of alcohol use. Since both diabetes and alcohol usage have been strongly associated with both hypogonadism and sexual dysfunction, it is logical to expect that diabetics who frequently consume alcohol will have a worsened hypogonadal state and sexual function. This research therefore seeks to provide evidence of an association between alcohol consumption in diabetics and a worsened sexual dysfunction in comparison to diabetics who did not consume alcohol. Methods: Type II diabetic patients attending the Diabetic Clinic at the Maamobi General Hospital between the periods of January 2010 and March 2011 were consecutively recruited for this study. Diabetics with other known endocrinological diseases and physical disabilities were excluded from the study. Sexual function was assessed using the GRISS-M. Early morning fasting samples were used in lipid and testosterone profile assays. Results: Study participants who consumed alcohol recorded higher levels of triglycerides and LDL-Cholesterol. They also recorded significantly lower levels of bioavailable testosterone. Furthermore they also recorded higher scores for impotence, premature ejaculation, non-sensuality and infrequency but lower scores for avoidance and were about six times more likely to be infrequent in their sexual activity in comparison with those who did not consume alcohol. Conclusion: Alcohol consumption among diabetic males is associated with hypogonadism and has an impact on several domains of male sexual function. Diabetic males should be advised to avoid alcohol abuse in order to facilitate the management of diabetes associated sexual dysfunction.

The Use of Hormonal Contraceptives and Preeclampsia among Ghanaian Pregnant Women

Hormonal contraceptives (HC) are thought to play a role in the pathogenesis of cardiovascular diseases. The study evaluated the use of HC as a primary cause of preeclampsia (PE) among Ghanaians. This study comprised 30 preeclamptic women and 30 healthy normotensive pregnant women with over 20 weeks of gestation at the Comboni Hospital, Ghana using a randomized case-control study. Blood pressure, weight, height, socio-demographics, medical and previous obstetric history were taken and recorded. Blood samples were collected for the estimation of homocysteine and fasting lipids. Estimated foetal weight (EFW) and infant birthweight (BWT) were obtained from maternal records. This study was carried out in 2019. 80.0% of women with PE used the hormonal contraceptive “depot medroxyprogesterone acetate” (DMPA) prior to pregnancy. The use of DMPA was associated with about thirty-fold increase in the odds of developing PE (OR = 29.71, p < 0.001). Systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.001), triglycerides (P = 0.024), LDL-C (P = 0.026), and homocysteine levels (P < 0.001) were significantly elevated in the PE cases than the normal pregnant (NP) women, whilst EFW (P < 0.001), BWT (P < 0.001) and HDL-C levels (P = 0.001) were significantly reduced in the PE cases when compared to NP women. 50% and 47% of PE cases had intrauterine growth restriction and low birthweight infants, respectively. In conclusion, DMPA use predisposes women to a high risk of developing PE. DMPA could partly contribute to endothelial dysfunction, hyperhomocysteinaemia, dyslipidaemia and excessive weight gain, all of which characterize PE.