Corona, G. et al. Psycho-biological correlates of hypoactive sexual desire in patients with erectile dysfunction. Int. J. Impot. Res. 16, 275-281

Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
International Journal of Impotence Research (Impact Factor: 1.76). 07/2004; 16(3):275-81. DOI: 10.1038/sj.ijir.3901158
Source: PubMed


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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Available from: Leonardo Fei, Aug 13, 2014
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    • "In accordance with this prediction, one study found that the co-presence of low sexual desire and erectile dysfunction to be common (Corona et al. 2004). Similarly, another study employed a sample of 5255 men aged 18–75 years from Portugal, Croatia, and Norway and found that those with low sexual interests also reported other sexual difficulties, the most common being erectile dysfunction in approximately half of the cases (Carvalheira et al. 2014). "
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    ABSTRACT: Successful sexual intercourse is a prerequisite for successful reproduction, a fact that translates into strong evolutionary pressures being exercised on mechanisms that regulate sexual functioning to work optimally. In effect, selection forces would remove from the gene pool any alleles that pre-dispose for sexual dysfunctions, limiting their prevalence to very low levels. But this did not happen with epidemiological studies indicating that sexual dysfunctions are common, with approximately one in three men facing such a difficulty. This raises the question why evolutionary forces have allowed such variation in sexual functioning given its importance in reproduction. The present paper attempts to address this question by applying three evolutionary models on anthropological and historical evidence that depicts the ancestral human condition. It is argued that the high prevalence of sexual dysfunctions in men is predominantly explained by the mismatch between ancestral and modern environments, with selection forces not having sufficient time to optimize sexual functioning mechanisms to the demands of modern conditions. The proposed evolutionary framework is employed to derive predictions which are examined against the available evidence on sexual dysfunctions.
    07/2015; DOI:10.1007/s40806-015-0026-4
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    • "In 2008, Corona et al. reported for the 1st time that different T levels might lead to various severities of ejaculatory disturbances. In line with previous studies, they added that T levels clearly affect sexual desire.[626272829] They also reported higher TT and FT levels in their youngest subjects (aged between 25 and 40 years) suffering from PE while the oldest age group (55-70 years) with DE had lower TT and FT levels. "
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    ABSTRACT: To investigate the role of testosterone (T) in the pathogenesis of ejaculatory symptoms, particularly premature ejaculation (PE). A total of 41 male patients with PE as well as 41 controls with no sexual dysfunction were recruited in this cross-sectional study. We used the stopwatch measurement to monitor the intravaginal ejaculatory latency time (IELT). Patients with mean IELT values lower than 60 s were considered to have PE. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), total testosterone (TT) and free testosterone (FT) were measured in patients as well as controls. Patients with thyroid dysfunction, hypogonadism, hypertension and dyslipidemia were excluded from the study. The serum levels of FT and FSH were significantly higher in cases (P = 0.036 and 0.003, respectively). There was no significant difference between TT, LH and PRL levels of the two groups. Patients with PE have higher FT and FSH levels compared with normal men. The causative relationship between these entities and also the clinical importance of this finding has to be determined by more comprehensive studies.
    01/2014; 3(1):6. DOI:10.4103/2277-9175.124633
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    • "Indeed, urologists are familiar with the rapid disappearance of the libido in men treated with medical or surgical castration, although there are some men in whom sexual interest is preserved. Several cross-sectional studies have shown a significant association between serum testosterone concentration and the level of sexual desire in aging outpatients23,24 and men with ED.25,26 A longitudinal study also showed a close relationship between the serum testosterone level and sexual desire.27 "
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    ABSTRACT: Testosterone is important in the physiology of various organs and tissues. The serum testosterone concentration gradually declines as one of the processes of aging. Thus, the concept of late-onset hypogonadism has gained increasing attention in the last few years. Reported symptoms of late-onset hypogonadism are easily recognized and include diminished sexual desire and erectile quality, particularly in nocturnal erections, changes in mood with concomitant decreases in intellectual activity and spatial orientation, fatigue, depression and anger, a decrease in lean body mass with associated decreases in muscle volume and strength, a decrease in body hair and skin alterations, and decreased bone mineral density resulting in osteoporosis. Among these various symptoms, sexual dysfunction has been the most common and necessary to treat in the field of urology. It is well known that a low serum testosterone level is associated with erectile dysfunction and hypoactive sexual libido and that testosterone replacement treatment can improve these symptoms in patients with hypogonadism. Recently, in addition to sexual dysfunction, a close relationship between metabolic syndrome, characterized by central obesity, insulin resistance, dyslipidemia, and hypertension, and late-onset hypogonadism has been highlighted by several epidemiologic studies. Several randomized control trials have shown that testosterone replacement treatment significantly decreases insulin resistance in addition to its advantage for obesity. Furthermore, metabolic syndrome is one of the major risk factors for cardiovascular disease, and a low serum testosterone level is closely related to the development of atherosclerosis. Presently, it is speculated that a low serum testosterone level may increase the risk for cardiovascular disease. Thus, testosterone is a key molecule in men's health, especially that of elderly men.
    08/2013; 31(2):126-135. DOI:10.5534/wjmh.2013.31.2.126
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