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Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction

Abstract

We studied the psychological and biological correlates of hypoactive sexual desire (HSD) in a consecutive series of 428 patients with erectile dysfunction (ED), by using the structured interview SIEDY©. A complete physical examination and a series of biochemical, hormonal, psychometric, and penile vascular tests were also performed. Among the patients studied, 22.8% reported a mild, 12.9% a moderate, and 4.6% a complete loss of sexual interest. Patients reporting HSD showed significantly lower testosterone (T) levels than the rest of the sample, although the prevalence of hypogonadism (T<10 nM) was comparable in the two groups. Only a minority (<2%) had severe hyperprolactinemia (>700 mU/l), which, nonetheless, was closely associated with a relevant HSD. Both mental disorders and use of medication interfering with sexual function were significantly associated with HSD, as well as depressive and anxiety symptoms. HSD patients showed significantly higher scores in SIEDY© scale 2, which explores the relational component of ED. In particular, perceived partner's libido and climax were crucially associated with an impairment of patients' sexual desire. In conclusion, HSD in ED is associated with several biological, psychological, and relational factors that can be simultaneously identified and quantified using the SIEDY©structured interview.

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References

  1. Kandeel FR, Koussa VK, Swerdloff RS . Male sexual function and its disorders: physiology, pathophysiology, clinical investigation, and treatment. Endocr Rev 2001; 22: 342–388.

    CAS  Article  Google Scholar 

  2. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 4th edn., Text revision ed. American Psychiatric Association: Washington, DC, 2000.

  3. Rochira V et al. Sex steroids and desire mechanism. J Endocrinol Invest 2003; 26(Suppl 3): 29–36.

    CAS  PubMed  Google Scholar 

  4. Davidson JM, Camargo CA, Smith ER . Effects of androgen on sexual behavior in hypogonadal men. J Clin Endocrinol Metab 1979; 48: 955–958.

    CAS  Article  Google Scholar 

  5. Colao A et al. Gender differences in the prevalence, clinical features and response to cabergoline in hyperprolactinemia. Eur J Endocrinol 2003; 148: 325–331.

    CAS  Article  Google Scholar 

  6. Prescott RW et al. Hyperprolactinaemia in men—response to bromocriptine therapy. Lancet 1982; 1: 245–248.

    CAS  Article  Google Scholar 

  7. Govier FE, McClure RD, Kramer-Levien D . Endocrine screening for sexual dysfunction using free testosterone determinations. J Urol 1996; 156: 405–408.

    CAS  Article  Google Scholar 

  8. Randeva HS, Davidson RM, Boluloux PMG . Endocrinology. In: Carson C, Kirby R, Goldstein I (eds). Textbook of Erectile Dysfunction. Isis Medical Media Ltd: Oxford, 1999, pp 89–104.

    Google Scholar 

  9. Bodie J, Lewis J, Schow D, Monga M . Laboratory evaluations of erectile dysfunction: an evidence based approach. J Urol 2003; 169: 2262–2264.

    Article  Google Scholar 

  10. Petrone L et al. Structured interview on erectile dysfunction (SIEDY©): a new, multidimensional instrument for quantification of pathogenetic issues on erectile dysfunction. Int J Impot Res 2003; 15: 210–220.

    CAS  Article  Google Scholar 

  11. Broderick GA, Foremann MM . Iatrogenic erectile dysfunction: pharmacological and surgical therapies that alter male sexual behaviour and erectile performance. In: Carson C, Kirby R, Goldstein I (eds). Textbook of Erectile Dysfunction. Isis Medical Media Ltd: Oxford, 1999, pp 149–168.

    Google Scholar 

  12. Crown S, Crisp AH . A short clinical diagnostic self-rating scale for psychoneurotic patients. The Middlesex Hospital Questionnaire (M.H.Q.). Br J Psychiatry 1966; 112: 917–923.

    CAS  Article  Google Scholar 

  13. Lehmann K et al. Variable response to intracavernous prostaglandin E1 testing for erectile dysfunction. Urology 1999; 54: 539–543.

    CAS  Article  Google Scholar 

  14. Mancini M et al. The presence of arterial anatomical variations can affect the results of duplex sonographic evaluation of penile vessels in impotent patients. J Urol 1996; 155: 1919–1923.

    CAS  Article  Google Scholar 

  15. Aversa A et al. Penile pharmacotesting in diagnosing male erectile dysfunction: evidence for lack of accuracy and specificity. Int J Androl 2002; 25: 6–10.

    Article  Google Scholar 

  16. Mancini M et al. Duplex ultrasound evaluation of cavernosal peak systolic velocity and waveform acceleration in the penile flaccid state: clinical significance in the assessment of the arterial supply in patients with erectile dysfunction. Int J Androl 2000; 23: 199–204.

    CAS  Article  Google Scholar 

  17. Ackerman MD et al. The predictive significance of patient-reported sexual functioning in RigiScan sleep evaluations. J Urol 1991; 146: 1559–1563.

    CAS  Article  Google Scholar 

  18. Ackerman MD et al. Patient-reported sexual symptomatology in predicting functional and insufficient erectile capacity. Urology 1991; 38: 437–442.

    CAS  Article  Google Scholar 

  19. Geisser ME et al. Use of the Florida Sexual History Questionnaire to differentiate primary organic from primary psychogenic impotence. J Androl 1993; 14: 298–303.

    CAS  Google Scholar 

  20. Levine LA, Kloner RA . Importance of asking questions about erectile dysfunction. Am J Cardiol 2000; 86: 1210–1213.

    CAS  Article  Google Scholar 

  21. Morley JE . Impotence. Am J Med 1986; 80: 897–905.

    CAS  Article  Google Scholar 

  22. Buvat J et al. Hyperprolactinemia and sexual function in men. Horm Res 1985; 22: 196–203.

    CAS  Article  Google Scholar 

  23. Johri AM, Heaton JP, Morales A . Severe erectile dysfunction is a marker for hyperprolactinemia. Int J Impot Res 2001; 13: 176–182.

    CAS  Article  Google Scholar 

  24. Carter JN et al. Prolactin-screening tumours and hypogonadism in 22 men. N Engl J Med 1978; 299: 847–852.

    CAS  Article  Google Scholar 

  25. Lee JC, Surridge D, Morales A, Heaton JPW . The prevalence and influence of significant psychiatric abnormalities in men undergoing comprehensive management of organic erectile dysfunction. Int J Impot Res 2000; 12: 47–51.

    CAS  Article  Google Scholar 

  26. Cassano GB, Pini S, Saettoni M, Dell'Osso L . Multiple anxiety disorder comorbidity in patients with mood spectrum disorders with psychotic features. Am J Psychiatry 1999; 156: 474–476.

    CAS  Article  Google Scholar 

  27. Hedon F . Anxiety and erectile dysfunction: a global approach to ED enhances results and quality of life. Int J Impot Res 2003; 15(Suppl 2): S16–S19.

    Article  Google Scholar 

  28. Wespes E, Schulman CC . Male andropause: myth, reality, and treatment. Int J Impot Res 2002; 14(Suppl 1): S93–S98.

    Article  Google Scholar 

  29. Kaiser FE et al. Impotence and aging: clinical and hormonal factors. J Am Geriatr Soc 1988; 36: 511–519.

    CAS  Article  Google Scholar 

  30. Diokno AC, Brown MB, Herzog AR . Sexual function in the elderly. Arch Intern Med 1990; 150: 197–200.

    CAS  Article  Google Scholar 

  31. Padoani W et al. Influence of cognitive status on the sexual life of 352 elderly Italians aged 65–105 years. Gerontology 2000; 46: 258–265.

    CAS  Article  Google Scholar 

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Acknowledgements

We would like to thank Angela Magini, Csilla Krausz, Andrology Unit of the University of Florence, for their helpful clinical collaboration during the course of the study. Antonio Cilotti, Andrology Unit, and Marco Bartolini, Radiology Unit, of the University of Florence and Mario Mancini, Andrology Unit, of the Azienda Ospedaliera San Paolo, Milano, performed all penile doppler ultrasound investigations. We also wish to thank Emmanuele Jannini of the Department of Experimental Medicine, University of L'Aquila, L'Aquila, Italy, for his critical reading of the manuscript. This study was partially supported by a grant from, Eli Lilly & Co, Sesto Fiorentino, Florence, Italy. Note: a patent is pending on the use of SIEDY©.

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Corona, G., Mannucci, E., Petrone, L. et al. Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction. Int J Impot Res 16, 275–281 (2004). https://doi.org/10.1038/sj.ijir.3901158

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