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Sexual dysfunction and male infertility

Key Points

  • Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances

  • Infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction

  • General health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health

  • Medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction

  • In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.

Abstract

Infertility affects up to 12% of all men, and sexual dysfunction occurs frequently in men of reproductive age, causing infertility in some instances. In infertile men, hypoactive sexual desire and lack of sexual satisfaction are the most prevalent types of sexual dysfunction, ranging from 8.9% to 68.7%. Erectile dysfunction and/or premature ejaculation, evaluated with validated tools, have a prevalence of one in six infertile men, and orgasmic dysfunction has a prevalence of one in ten infertile men. In addition, infertile men can experience a heavy psychological burden. Infertility and its associated psychological concerns can underlie sexual dysfunction. Furthermore, general health perturbations can lead to male infertility and/or sexual dysfunction. Erectile dysfunction and male infertility are considered proxies for general health, the former underlying cardiovascular disorders and the latter cancerous and noncancerous conditions. The concept that erectile dysfunction in infertile men might be an early marker of poor general health is emerging. Finally, medications used for general health problems can cause sperm abnormalities and sexual dysfunction. The treatment of some causes of male infertility might improve semen quality and reverse infertility-related sexual dysfunction. In infertile men, an investigation of sexual, general, and psychological health status is advisable to improve reproductive problems and general health.

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Acknowledgements

This work is funded by the Ministry of University and Scientific Research (SIR project to F.L. protocol number: RBSI14LFMQ).

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Correspondence to Mario Maggi.

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Lotti, F., Maggi, M. Sexual dysfunction and male infertility. Nat Rev Urol 15, 287–307 (2018). https://doi.org/10.1038/nrurol.2018.20

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