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Published in Nature Reviews Urology, a comment piece by the Leverhulme Centre for Demographic Science calls for researchers and policymakers to take a closer look at the relationship between male fertility, mental health, and sexual function.

The comment piece, authored by Vincent Straub and Professor Melinda Mills, emphasises the need for a deeper understanding of how lifestyle behaviours linked to mental health impact male sexual function and fertility.

Professor Melinda Mills, Director of the Leverhulme Centre for Demographic Science and Demographic Science Unit said, ‘This piece stresses the need to consider the often-forgotten topic of reproductive health and infertility for men, so that we can fully comprehend global trends in live births and improve reproductive health for all.’

The piece points out that while male infertility is finally being acknowledged as a significant health issue, many diagnoses still lack clear, evidence-based connections to their underlying causes. For example, the comment highlights that factors beyond genetics and the environment such as physical inactivity and substance use play a crucial role.

The piece calls on the urgent need to integrate male reproductive health into national health strategies, including pro-natal policies, and emphasises the role of mental health in fertility. It also calls for a more integrated research approach that emphasises the two-way relationship between sexual function and mental health, with mental health acting as a mediator and moderator in male fertility.

Conditions like erectile dysfunction, for example, can lead to symptoms of depression or anxiety, which in turn negatively impact sexual performance and fertility. Conversely, persistent sexual performance issues, something that is often tied to societal views of masculinity, can trigger mental health challenges, further exacerbating fertility issues.

The comment also draws attention to the rising trend of delayed paternity in industrialised countries, which has been linked to intergenerational negative effects on offspring, particularly in terms of mental and physical health. For example, rising paternal age has been linked to heightening the susceptibility of their offspring to conditions like schizophrenia and bipolar disorder. The understanding of this interplay is a focal point in terms of policies seeking to incentivise healthy births and populations. Rather than focussing on individual interventions, the comment points out that promoting lifestyle changes as a whole may provide a better outcome.

Vincent Straub, DPhil student at the Leverhulme Centre for Demographic Science and Demographic Science Unit said, ‘This piece calls for a unified approach to research and policy surrounding male health and reproductive outcomes, and advocates the integration of epidemiological studies on mental health, genetics, and lifestyle risk factors with research on their urological effects on reproductive health.’