Psychosexual Disorders amongst Toll-Like Receptors Triggered Erectile Dysfunction in Asian-Indian and American Men in the Covid-19 Global Pandemic Era: Enigmatic Snapshot in Urology and Reproductive Immunology

Introduction

In my expert opinion as a globally reputed biomedical and clinical researcher with substantial proven expertise in urology, reproductive immunology and life sciences, evidence- based pragmatic timeline-driven dynamic collaborations are essential for intricately dissecting the complex biochemical- molecular-metabolic regulatory networks underlying “psychosexual disorders” amongst Toll-Like Receptors [1] triggered erectile dysfunction in Asian-Indian and American ethnicity men in the Covid-19 global pandemic/ vaccination era. “Infertility” is defined as the inability to conceive following 12 months of regular unprotected sexual intercourse; psychosocial counseling-based intervention(s): marital-relationship counseling/therapy, timely referrals for psychological assessments, psychiatric treatments, primarily cognitive impairment, obsessive compulsive disorder, schizophrenia, and/or clinical depression are immensely beneficial in overall psychological well-being of patients symptomatic of psychosexual disorders [2, 3, 4]. The overwhelming disproportionate share of psychological problems associated with azoospermic, oligospermic and asthenospermic males in andrology clinics/laboratories is indeed escalating at an astonishingly rapid pace; psychosexual medicine research has demonstrated that erectile dysfunction, premature ejaculation, and Dhat syndrome are Opinion the most common psychosexual dysfunctions observed in psychiatry outpatients [5]. TLR-3/TLR-9 genetic variants’- mediated immunomodulation in aberrant reproductive physiological mileu may significantly modulate (upregulate/ downregulate) the risk in Mycobacterium tuberculi - positive infertile patients with Chlamydia trachomatis - positive oligospermic/azoospermic male-partners, and multiple- comparisons in stratified subgroups with smaller sample- size comprising ethnically disparate population-subsets of > 50% - 75% tobacco-users: cigarettes/e-cigarettes smokers and/or chewers) with relatively higher concordance (> 95%/kappa > 0.9) in Chlamydia-positivity in semen/FVU- specimens) may confer borderline association amongst genetically susceptible cohorts of American (Caucasian/ Hispanic/White/African-American) and Asian-Indian (Brahmin caste, etc.) descents/lineage as well as other diverse ethnic population-pools globally [6, 7].

Future multicentric sexual medicine research studies for critically addressing the marital-relationship/spouse compatibility issues, psychological factors, psychiatric disorders in infertile Asian-Indian and American men presenting with erectile dysfunction, and perceived financial distress/hardships owing to exorbitant cost of infertility treatment in Indian Rupees (INR) and American Dollars (USD) coupled with referrals to psychiatric/sexual medicine clinics for an overall holistic-healing care with eventual long-term efficacy-based psychosexual outcomes in terms of successfully fulfilling the long cherished dream of having a family with the inherent satisfaction of nurturing a baby, are warranted for eventual design of “tailor-made” TLR-immunotherapeutics and predictive biomarkers in psychosexual disorders amongst genetically susceptible males of varying ethnic landscapes. Fascinating scientifically stimulating “TLR-Psychosexual Medicine”-roadmap offers spectacular gains in our current understanding of the biochemical/cellular/molecular signaling intersections in Erectile Dysfunction and interrelated reproductive disorders in population-pools of genetically distinct profiles/lineage(s).