Holden et al. BMC Public Health 2010, 10:96 http://www.biomedcentral.com/1471-2458/10/96 R E S E A R C H A R T I C L E Open Access Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS) Carol A Holden1*, Robert I McLachlan1,2, Marian Pitts3, Robert Cumming4, Gary Wittert5, Johnathon P Ehsani6, David M de Kretser7, David J Handelsman8 Abstract Background: The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS). Methods: A representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression. Results: Controlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses. Conclusion: A range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health. Background Several studies have investigated a range of overlapping risk factors in relation to male reproductive health. These include socio-demographic characteristics (such as age, education, socio-economic status), lifestyle fac- tors (such as alcohol consumption, smoking, physical activity) and biomedical risk factors (such as heart dis- ease, diabetes, drug therapies) [1-3]. * Correspondence: carol.holden@med.monash.edu.au 1Andrology Australia, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia Age is consistently associated with increased prevalence of lower urinary tract symptoms (LUTS), erectile dysfunc- tion (ED) and benign prostatic hyperplasia (BPH) [1,4,5]. While some older men may consider poorer reproductive health a consequence of the ageing process [4-6], younger men express high levels of concern about developing reproductive health problems in later years [4]. Most studies focus on ED as the predominant male reproductive health disorder, with evidence suggesting that lifestyle risk factors (such as obesity and sedentary life- styles) for ED are similar to those for cardiovascular disease and diabetes [7,8]. These suggestions are based on observa- tions that men with other such co-morbid conditions also © 2010 Holden et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.