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


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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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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Correspondence to M Maggi.

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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).

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