Abstract
BACKGROUND: High-altitude regions' harsh conditions like low oxygen can affect male reproductive health, yet few studies focus on male libido decline in these areas. AIM: To investigate the prevalence of decreased libido in men at high-altitudes and identify its risk factors. METHODS: In this cross-sectional study a total of 447 men living at high-altitudes in Ali, Tibet were recruited. Data on demographics, sleep quality, mental state, and sexual health were collected through face-to-face interviews and self-administered questionnaires. They were divided into a decreased libido group (n = 152) and a normal libido group (n = 295). Chi-square tests, t-tests, and multivariate logistic regression analysis were performed to analyze the differences between the two groups and find independent risk factors. Based on the results of the multivariable logistic regression analysis, the nomogram was constructed using the "rms" package in R software. OUTCOMES: Determined the prevalence of decreased libido and key factors differentiating men with and without libido decrease. RESULTS: Significant differences were observed between the two groups in terms of age, cumulative high-altitude exposure, resting heart rate, daily oxygen inhalation time, exercise duration, type of exercise, companionship duration with the opposite sex, weight loss, self-rated sleep scale scores, and patient health questionnaire-9 scores. Multivariate analysis revealed that older age (OR = 1.15, 95% CI 1.11-1.20), longer high-altitude residence (OR = 1.08, 95% CI 1.05-1.11), reduced oxygen inhalation time (OR = 0.67, 95% CI 0.45-0.98), shorter exercise duration (OR = 0.75, 95% CI 0.55-1.01), decreased companionship time with the opposite sex (OR = 0.47, 95% CI 0.34-0.65), weight loss (OR = 2.05, 95% CI 1.19-3.54), poorer sleep quality (OR = 1.06, 95% CI 1.01-1.10), and higher levels of depression (OR = 1.10, 95% CI 1.04-1.16) are independent risk factors for decreased libido in men living at high-altitudes. A nomogram was developed and served as a reliable predictive tool for estimating the likelihood of decreased libido in men at high-altitudes, which provided a practical approach for risk assessment. CLINICAL IMPLICATIONS: Medical staff can use these findings to offer targeted health advice to high-altitude-dwelling men at risk, aiming to improve their sexual and overall health. STRENGTHS AND LIMITATIONS: Strengths include a relatively large sample size and rigorous statistical methods. Limitations encompass potential recall bias in self-reported data, restricted generalizability to low-altitude populations, and the absence of hormonal profiling due to logistical constraints. CONCLUSION: Around 34% of men in high-altitude regions experience decreased libido. Understanding these risk factors is crucial for developing effective preventive and intervention strategies.