Predictors of Sexual Dysfunction Incidence and Remission in Men

Abstract

Introduction The progress and determinants of sexual dysfunction in middle-aged and elderly men remain unclear. Aim To describe the incidence or remission and biopsychosocial predictors of erectile dysfunction (ED) and low sexual desire (SD). Main Outcome Measures Erectile function (International Index of Erectile Function) and sexual desire (Sexual Desire Inventory 2) were assessed at follow-up. Sociodemographic, lifestyle, and health-related factors were examined in multivariate models of ED and low SD. Methods Data were collected from 810 randomly selected men residing in northern and western Adelaide, Australia, and aged 35–80 years at baseline, who made clinic visits 5 years apart. Results At baseline, 23.2% (n = 123) of men had ED. ED incidence and remission were observed in 31.7% (n = 179) and 29.0% (n = 71) of eligible men, respectively. At baseline, 19.2% (n = 165) had low solitary sexual desire, and 6.0% (n = 50) had low dyadic sexual desire; incidence of low sexual desire occurred in 17.6% (n = 83) (solitary) and 8.3% (n = 51) (dyadic), while remission occurred in 15.4% (n = 68) (solitary) and 22.6% (n = 40) (dyadic) of men. In the final regression models, predictors of incident ED were higher age, lower income, higher abdominal fat mass, low alcohol intake, higher risk of obstructive sleep apnea (OSA) risk, voiding lower urinary tract symptoms (LUTS), depression, and diabetes. Predictors of ED remission were lower age, current employment, and absence of voiding LUTS, angina, diabetes, and dyslipidemia. Predictors of low dyadic SD incidence included higher age, never having been married, widowhood, being unemployed, being retired, insufficient physical activity, and low alcohol intake. Predictors of low dyadic SD remission were being married, not being widowed, higher income, lower abdominal fat mass, lower OSA risk, and higher plasma testosterone. Predictors of low solitary SD included never having been married, being unemployed, low alcohol intake, lower testosterone, storage LUTS, and hypertension. Predictors of low solitary SD remission were being married, being employed, higher income, higher physical activity, moderate alcohol intake, and depression. Conclusions Sexual dysfunction in aging men is a dynamic disorder whose incidence and remission are predicted by a range of modifiable risk factors.

Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015

“…5 Of 179 men who were normal at baseline, 31.7% developed ED at 5-year follow-up. Another important study on the incidence of ED is the Olmsted County Study in the United States.…”

“…Of the men with normal erectile function at baseline, 31.7% developed ED at 5-year follow-up but 29.0% had remission of ED at 5-year follow-up. 5 It is especially important to note that there are great variances in the designs, methodologies, and definitions of ED in many studies. These variances are responsible for the disparities in prevalence in the different studies and they make comparison of studies difficult or impossible.…”

Urological Manifestations of Obstructive Sleep Apnea Syndrome: A Review of Current Literature

“…Males with sexual dysfunction tend to have higher systolic blood pressure and TNF-alpha [69]. Sexual dysfunction severity in aging men is due to modifiable risk factors [70]. There are many sexual dysfunctions in men that seem to be linked such as erectile dysfunction (ED), low dyadic, and solitary sexual desire, which share many risk factors.…”

Obstructive sleep apnoea: a diabetologist’s perspective

“…2,5 Other symptoms such as choking, insomnia, nocturia, sweating, fatigue, morning headache, erectile dysfunction and autonomic symptoms have been reported. 2,6 Many of these are also common in type 2 diabetes (T2D) and contribute to the burden of disease. OSA should be considered as a cause of such symptoms in patients with T2D after ruling out hypoglycaemia or hyperglycaemia as CPAP treatment can improve these symptoms.…”