Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Effects of obsessive beliefs and anxiety on sexual function in HPV-positive men

International Journal of Impotence Research (2024)Cite this article

Subjects

Abstract

Our study aimed to investigate the effects of anxiety and obsessive beliefs on sexual function in men with human papillomavirus (HPV) and healthy men. Ninety HPV-positive men (mean age=32.26 ± 6.63 years) from the Urology Outpatient Clinic and 75 healthy men (mean age=33.51 ± 5.67 years) who worked in the hospital were assessed using the International Index of Erectile Function-15 (IIEF-15), Obsessive Beliefs Questionnaire-44 (OBQ), and State-Trait Anxiety Inventory (STAI) in 2023. The mean IIEF-15 scores of the patients with HPV and healthy individuals were 24.59 ± 6.14 vs. 23.16 ± 6.23 for the IIEF-erectile function; 8.30 ± 2.34 vs. 7.79 ± 1.77 for the IIEF-orgasmic function; 7.40 ± 1.73 vs. 7.23 ± 1.53 for the IIEF-sexual desire; 11.30 ± 3.38 vs. 11 ± 3.10 for the IIEF-intercourse satisfaction; and 7.62 ± 2.18 vs. 7.53 ± 2.02 for the IIEF-overall satisfaction (p > 0.05 for all). However, the mean OBQ and STAI scores of patients with HPV and healthy individuals were 46.66 ± 16.06 vs. 36.44 ± 19.25 for the OBQ-inflated responsibility/overestimation of threat (OBQ-RT); 45.91 ± 17.31 vs. 36.53 ± 19.08 for the OBQ-perfectionism/intolerance of uncertainty (OBQ-PU); 28.04 ± 12.31 vs. 23.80 ± 11.74 for the OBQ-importance of thought/control thoughts (OBQ-IC); 37.58 ± 12.06 vs. 33.59 ± 11.09 for the STAI-state anxiety (p < 0.05 for all); and 32.83 ± 8.34 vs. 33.44 ± 11.05 for the STAI-trait anxiety (p = 0.689). Our results showed that the STAI-state anxiety (β = −0.37; β = −0.32; and β = −0.43, respectively) and OBQ-IC (β = −0.57; β = −0.43; and β = −0.48, respectively) scores were the main predictors of the IIEF-erectile function, IIEF-orgasmic function, and IIEF-overall satisfaction scores in the HPV-positive group. The OBQ-RT (β = 0.46), OBQ-PU (β = −0.51) and STAI-state anxiety (β = −0.56) scores were unique predictors of the IIEF-sexual desire score, and the OBQ-RT (β = 0.41), OBQ-PU (β = −0.42), and OBQ-IC (β = −0.43) scores were the main predictors of the IIEF-intercourse satisfaction score in the HPV-positive group. However, regression models for the IIEF-15 subscales for the control group were not significant (p ˃ 0.05). Understanding the role of obsessive beliefs and anxiety in sexual dysfunction among HPV-positive men might be important for developing psychotherapeutic interventions.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

Data availability

All relevant data are within the paper and they are available from the corresponding author on reasonable request.

References

  1. Human Papilloma Virus Statistics (Centers for Disease Control and Prevention, 2023); https://www.cdc.gov/std/hpv/stats.htm.

  2. Voltaggio L, McCluggage WG, Iding JS, Martin B, Longacre TA, Ronnett BM. A novel group of HPV-related adenocarcinomas of the lower anogenital tract (vagina, vulva, and anorectum) in women and men resembling HPV-related endocervical adenocarcinomas. Mod Pathol. 2020;33:944–52.

    Article  CAS  PubMed  Google Scholar 

  3. Bennett KF, Waller J, Ryan M, Bailey JV, Marlow LA. The psychosexual impact of testing positive for high‐risk cervical human papillomavirus (HPV): a systematic review. Psychooncology. 2019;28:1959–70.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Nagele E, Reich O, Greimel E, Dorfer M, Haas J, Trutnovsky G. Sexual activity, psychosexual distress, and fear of progression in women with human papillomavirus-related premalignant genital lesions. J Sex Med. 2016;13:253–9.

    Article  PubMed  Google Scholar 

  5. Mercan R, Mercan S, Durmaz B, Sur H, Kilciksiz CM, Kacar AS, et al. Sexual dysfunction in women with human papilloma virus infection in the Turkish population. J Obstet Gynaecol. 2019;39:659–63.

    Article  PubMed  Google Scholar 

  6. Alay I, Kaya C, Karaca I, Yildiz S, Baghaki S, Cengiz H, et al. The effect of being diagnosed with human papillomavirus infection on women’s sexual lives. J Med Virol. 2020;92:1290–7.

    Article  CAS  PubMed  Google Scholar 

  7. McCaffery K, Waller J, Forrest S, Cadman L, Szarewski A, Wardle J. Testing positive for human papillomavirus in routine cervical screening: examination of psychosocial impact. BJOG. 2004;111:1437–43.

    Article  PubMed  Google Scholar 

  8. Juang S-E, Ma KS-K, Kao P-E, Wei JC-C, Yip H-T, Chou M-C, et al. Human papillomavirus infection and the risk of erectile dysfunction: a nationwide population-based matched cohort study. J Pers Med. 2022;12:699.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kucukunal A, Altunay IK, Mercan S. Sexual dysfunction in men suffering from genital warts. J Sex Med. 2013;10:1585–91.

    Article  PubMed  Google Scholar 

  10. Bancroft J, Graham CA, Janssen E, Sanders SA. The dual control model: Current status and future directions. J Sex Res. 2009;46:121–42.

    Article  PubMed  Google Scholar 

  11. Kane L, Dawson SJ, Shaughnessy K, Reissing ED, Ouimet AJ, Ashbaugh AR. A review of experimental research on anxiety and sexual arousal: Implications for the treatment of sexual dysfunction using cognitive behavioral therapy. J Exp Psychopathol. 2019;10.

  12. Diaz ML. Counseling the patient with HPV disease. Obstet Gynecol Clin N Am. 2013;40:391–402.

    Article  Google Scholar 

  13. Graziottin A, Serafini A. HPV infection in women: psychosexual impact of genital warts and intraepithelial lesions. J Sex Med. 2009;6:633–45.

    Article  PubMed  Google Scholar 

  14. McCaffery K, Forrest S, Waller J, Desai M, Szarewski A, Wardle J. Attitudes towards HPV testing: a qualitative study of beliefs among Indian, Pakistani, African-Caribbean and white British women in the UK. Br J Cancer. 2003;88:42–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Daley EM, Vamos CA, Wheldon CW, Kolar SK, Baker EA. Negative emotions and stigma associated with a human papillomavirus test result: A comparison between human papillomavirus–positive men and women. J Health Psychol. 2015;20:1073–82.

    Article  PubMed  Google Scholar 

  16. Leal PC, Goes TC, da Silva LCF, Teixeira-Silva F. Trait vs. state anxiety in different threatening situations. Trends Psychiatry Psychother. 2017;39:147–57.

    Article  PubMed  Google Scholar 

  17. Downing MJ Jr, Chiasson MA, Hirshfield S. Recent anxiety symptoms and drug use associated with sexually transmitted infection diagnosis among an online US sample of men who have sex with men. J Health Psychol. 2016;21:2799–812.

    Article  PubMed  Google Scholar 

  18. Ekici E, Ugurlu M, Yigman F, Safak Y, Ozdel K. How much are they predictive for obsessive-compulsive symptom dimensions: beliefs, emotions, emotional schemas? Curr Psychol. 2023;42:29481–98.

    Article  Google Scholar 

  19. Smith AH, Wetterneck CT, Hart JM, Short MB, Björgvinsson T. Differences in obsessional beliefs and emotion appraisal in obsessive compulsive symptom presentation. J Obsessive Compuls Relat Disord. 2012;1:54–61.

    Article  Google Scholar 

  20. Group OCCW. Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—Part 2: Factor analyses and testing of a brief version. Behav Res Ther. 2005;43:1527–42.

    Article  Google Scholar 

  21. Pozza A, Marazziti D, Mucci F, Angelo NL, Prestia D, Dèttore D. Sexual response in obsessive–compulsive disorder: the role of obsessive beliefs. CNS Spectr. 2021;26:528–37.

    Article  Google Scholar 

  22. Basson R, Gilks T. Women’s sexual dysfunction associated with psychiatric disorders and their treatment. Womens Health (Lond). 2018;14:1745506518762664.

    CAS  PubMed  Google Scholar 

  23. Stoeber J, Harvey LN. Multidimensional sexual perfectionism and female sexual function: A longitudinal investigation. Arch Sex Behav. 2016;45:2003–14.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Habke AM, Hewitt PL, Flett GL. Perfectionism and sexual satisfaction in intimate relationships. J Psychopathol Behav Assess. 1999;21:307–22.

    Article  Google Scholar 

  25. Ekmez M, Ekmez F. Effects of HPV Positivity in Women on Couples Sexual Behavior. J Sex Marital Ther. 2022;48:748–55.

    Article  PubMed  Google Scholar 

  26. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub, 2013.

  27. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.

    Article  CAS  PubMed  Google Scholar 

  28. Akkus E, Kadioglu A, Esen A, Doran S, Ergen A, Anafarta K, et al. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol. 2002;41:298–304.

    Article  PubMed  Google Scholar 

  29. Serefoglu EC, Atmaca AF, Dogan B, Altinova S, Akbulut Z, Balbay MD. Problems in understanding the Turkish translation of the international index of erectile function. J Androl. 2008;29:369–73.

    Article  PubMed  Google Scholar 

  30. Bayraktar Z, Atun AI. Despite some comprehension problems the International Index of Erectile Function is a reliable questionnaire in erectile dysfunction. Urol Int. 2012;88:170–6.

    Article  PubMed  Google Scholar 

  31. Boysan M, Besiroglu L, Çetinkaya N, Atli A, Aydin A. The Validity and Reliability of the Turkish Version of the Obsessive Beliefs Questionnaire-44 (OBQ-44). Arch. Neuropsychiatry. 2010;47:216.

    Google Scholar 

  32. Spielberger C, Gorsuch R, Lushene R. State-trait anxiety inventory STAI (Form Y). Redw City Mind Gard, 1983.

  33. Oner N, Le Compte A. Durumluk Sürekli Kaygı Envanteri El Kitabı. Boğaziçi Yayınları, İstanbul, 1985.

  34. Enders CK. Dealing with missing data in developmental research. Child Dev Perspect. 2013;7:27–31.

    Article  Google Scholar 

  35. Lavery MR, Acharya P, Sivo SA, Xu L. Number of predictors and multicollinearity: What are their effects on error and bias in regression? Commun Stat Simul. 2019;48:27–38.

    Article  Google Scholar 

  36. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.

    Article  PubMed  Google Scholar 

  37. Shiel G, Cartwright F. National Assessments of Educational Achievement, Volume 4: Analyzing Data from a National Assessment of Educational Achievement, vol. 4: World Bank Publications, 2015.

  38. Hedon F. Anxiety and erectile dysfunction: a global approach to ED enhances results and quality of life. Int. J. Impot. Res. 2003;15:16–S19.

    Article  Google Scholar 

  39. Nia MH, Rahmanian F, Ghahartars M, Janghorban R. Sexual function and sexual quality of life in men with genital warts: a cross-sectional study. Reprod Health. 2022;19:1–7.

    Article  Google Scholar 

  40. Doron G, Derby DS, Szepsenwol O, Talmor D. Tainted love: Exploring relationship-centered obsessive compulsive symptoms in two non-clinical cohorts. J Obsessive Compuls Relat Disord. 2012;1:16–24.

    Article  Google Scholar 

  41. Qi S-Z, Wang S-M, Shi J-F, Wang Q-Q, Chen X-S, Sun L-J, et al. Human papillomavirus-related psychosocial impact of patients with genital warts in China: a hospital-based cross-sectional study. BMC Public Health. 2014;14:1–8.

    Article  Google Scholar 

  42. Lee TS, Kothari-Talwar S, Singhal PK, Yee K, Kulkarni A, Lara N, et al. Cross-sectional study estimating the psychosocial impact of genital warts and other anogenital diseases in South Korea. BMJ Open. 2019;9:e025035.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Gyoerkoe K, Wiegartz P. The Worrier’s Guide to Overcoming Procrastination: Breaking Free from the Anxiety that Holds You Back. New Harbinger Publications, 2011.

  44. Slade PD, Owens RG. A dual process model of perfectionism based on reinforcement theory. Behav Modif. 1998;22:372–90.

    Article  CAS  PubMed  Google Scholar 

  45. O’Connor DB, O’Connor RC, Marshall R. Perfectionism and psychological distress: Evidence of the mediating effects of rumination. Eur J Personality: Published for the European Association of Personality Psychology. 2007;21:429–52.

    Article  Google Scholar 

  46. Abdolmanafi A, Owens RG, Winter S, Jahromi RG, Peixoto MM, Nobre P. Determinants of women’s sexual dissatisfaction: Assessing a cognitive-emotional model. J Sex Med. 2016;13:1708–17.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Yuksek Ihtisas University, Faculty of Medicine, Department of Urology, Memorial Ankara Hospital, Ankara, 06520, Turkey

    Emrah Yakut

  2. Yuksek Ihtisas University, Faculty of Medicine, Department of Psychiatry, Memorial Ankara Hospital, Ankara, 06520, Turkey

    Esengul Ekici

Authors
  1. Emrah Yakut
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Esengul Ekici
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Emrah Yakut and Esengül Ekici designed the study and contributed to data extraction. The study was written by Emrah Yakut. Esengül Ekici contributed to the writing of the paper and editing. Both of them approved the final version and submitted the paper to the journal.

Corresponding authors

Correspondence to Emrah Yakut or Esengul Ekici.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

The study was done under ethical approval (Approval date: June 8th, 2023, Reference number: 2023/31).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yakut, E., Ekici, E. Effects of obsessive beliefs and anxiety on sexual function in HPV-positive men. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00887-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41443-024-00887-6

Search

Advanced search

Quick links