Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment

Sexual dysfunction, which is increasingly recognized as a cause of male infertility, may be influenced by environmental factors such as phthalic acid diesters (phthalates) and prenatal androgen exposure. This study aimed to investigate the association between male sexual function and recent exposure...

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Main Authors: Kazumitsu Yamasaki, Masahiro Uchida, Yuki Mizuno, Teruaki Iwamoto, Shoko Konishi
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:American Journal of Men's Health
Online Access:https://doi.org/10.1177/15579883251352972
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author Kazumitsu Yamasaki
Masahiro Uchida
Yuki Mizuno
Teruaki Iwamoto
Shoko Konishi
author_facet Kazumitsu Yamasaki
Masahiro Uchida
Yuki Mizuno
Teruaki Iwamoto
Shoko Konishi
author_sort Kazumitsu Yamasaki
collection DOAJ
description Sexual dysfunction, which is increasingly recognized as a cause of male infertility, may be influenced by environmental factors such as phthalic acid diesters (phthalates) and prenatal androgen exposure. This study aimed to investigate the association between male sexual function and recent exposure to phthalates and prenatal testosterone. The cross-sectional study included 177 males seeking fertility treatment. The index-to-ring-finger length ratio (2D:4D) was calculated as a measure of prenatal androgen exposure. To evaluate recent phthalate exposure, urinary concentrations of seven phthalate metabolites were measured. Their associations with International Index of Erectile Function (IIEF) scores were analyzed using generalized linear models. One standard deviation increase of mono-methyl phthalate was negatively associated with IIEF domains A (erectile function; exponentiated coefficient, 0.95; exponentiated 95% confidence interval, CI, [0.91, 0.98]) and D (intercourse satisfaction; exponentiated coefficient, 0.91; exponentiated [0.85, 0.97]). While mono-butyl phthalate was positively associated with domain A, mono-ethyl phthalate, monobenzyl phthalate, and the molar sum of di (2-ethylhexyl) phthalate metabolites showed no significant association with IIEF domain scores. When the serum testosterone concentration was included as an exposure variable, the overall association between urinary phthalates and IIEF domain scores remained similar. The left- and right-hand 2D:4D ratios did not show significant associations with any IIEF domain scores. Recent phthalate exposure may affect male sexual function by decreasing testosterone levels and other potential mechanisms.
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institution Kabale University
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spelling doaj-art-65076d0fa3f84dc0a36d945bb3b5e6192025-08-20T03:28:21ZengSAGE PublishingAmerican Journal of Men's Health1557-98912025-06-011910.1177/15579883251352972Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility TreatmentKazumitsu Yamasaki0Masahiro Uchida1Yuki Mizuno2Teruaki Iwamoto3Shoko Konishi4Sanno Hospital, Minato-ku, Tokyo, JapanDepartment of Urology, Tsukuba Gakuen Hospital, Ibaraki, JapanDepartment of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, JapanDepartment of Urology, St Marianna University, Miyamae-ku, Kawasaki, JapanDepartment of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, JapanSexual dysfunction, which is increasingly recognized as a cause of male infertility, may be influenced by environmental factors such as phthalic acid diesters (phthalates) and prenatal androgen exposure. This study aimed to investigate the association between male sexual function and recent exposure to phthalates and prenatal testosterone. The cross-sectional study included 177 males seeking fertility treatment. The index-to-ring-finger length ratio (2D:4D) was calculated as a measure of prenatal androgen exposure. To evaluate recent phthalate exposure, urinary concentrations of seven phthalate metabolites were measured. Their associations with International Index of Erectile Function (IIEF) scores were analyzed using generalized linear models. One standard deviation increase of mono-methyl phthalate was negatively associated with IIEF domains A (erectile function; exponentiated coefficient, 0.95; exponentiated 95% confidence interval, CI, [0.91, 0.98]) and D (intercourse satisfaction; exponentiated coefficient, 0.91; exponentiated [0.85, 0.97]). While mono-butyl phthalate was positively associated with domain A, mono-ethyl phthalate, monobenzyl phthalate, and the molar sum of di (2-ethylhexyl) phthalate metabolites showed no significant association with IIEF domain scores. When the serum testosterone concentration was included as an exposure variable, the overall association between urinary phthalates and IIEF domain scores remained similar. The left- and right-hand 2D:4D ratios did not show significant associations with any IIEF domain scores. Recent phthalate exposure may affect male sexual function by decreasing testosterone levels and other potential mechanisms.https://doi.org/10.1177/15579883251352972
spellingShingle Kazumitsu Yamasaki
Masahiro Uchida
Yuki Mizuno
Teruaki Iwamoto
Shoko Konishi
Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
American Journal of Men's Health
title Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
title_full Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
title_fullStr Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
title_full_unstemmed Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
title_short Association of the Ratio of Second to Fourth Digit Length and Phthalate Exposure With Sexual Function in Japanese Men Seeking Fertility Treatment
title_sort association of the ratio of second to fourth digit length and phthalate exposure with sexual function in japanese men seeking fertility treatment
url https://doi.org/10.1177/15579883251352972
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