Article

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

Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
International Journal of Impotence Research (Impact Factor: 1.37). 07/2004; 16(3):275-81. DOI: 10.1038/sj.ijir.3901158
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ABSTRACT 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.
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    • "One minute is the most widely accepted cut-off limit to define PE (see Waldinger et al, 2004, 2005 for review). Hypoactive sexual desire (HSD) was assessed with question 14 of SIEDY᭧ Structured Interview as previously described (Corona et al, 2004a). Intimacy during sexual intercourses was analyzed using a standard question: ''Do you have enough intimacy during your sexual activity?'' "
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    ABSTRACT: Anxiety has a relevant impact on everyday life, including sexual life, and therefore is considered the final common pathway by which social, psychological, and biological stressors negatively affect sexual functioning. The aim of this study is to define the psycho-biological correlates of free-floating anxiety in a large sample of patients complaining of erectile dysfunction (ED)-based sexual problems. We studied a consecutive series of 882 ED patients using SIEDY, a 13-item structured interview, composed of 3 scales that identify and quantify organic, relational, and intrapsychic domains. MHQ-A scoring from Middlesex Hospital Questionnaire (MHQ) was used as a putative marker of free-floating anxiety symptoms (AS). Metabolic and hormonal parameters, nocturnal penile tumescence (NPT) test, and penile Doppler ultrasound (PDU) examination were also performed. MHQ-A score was significantly higher in patients complaining of difficulties in maintaining erection and in those reporting premature ejaculation (6.5 +/- 3.3 vs 5.8 +/- 3.3 and 6.6 +/- 3.3 vs 6.1 +/- 3.3, respectively; both P < .05). Moreover, ASs were significantly correlated to life stressors quantified by SIEDY scale 2 (relational component) and scale 3 (intrapsychic component) scores, as dissatisfaction at work or within the family or couple relationships. Among physical, biochemical, or instrumental parameters tested, only end-diastolic velocity at PDU was significantly (P < .05) related to ASs. In conclusion, in patients with ED-based sexual problems, ASs are correlated to many relational and life stressors. Conversely, organic problems are not necessarily associated with MHQ-A score.
    Journal of Andrology 01/2006; 27(1):86-93. DOI:10.2164/jandrol.05070 · 1.69 Impact Factor
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    • "E, ancora, su quanto possa essere preziosa la collaborazione tra ginecologo e proctologo, per la diagnosi e il trattamento di comorbilità mediche e sessuologiche (Giovannelli e Graziottin, 2006). Basti pensare alla stipsi, specie di tipo ostruttivo, in cui l'ipertono dell'elevatore rappresenta il denominatore comune non solo delle difficoltà di evacuazione, ma anche del dolore nei rapporti, e spesso, di cistiti recidivanti, specie post-coitali, e di stimoli irritativi vescicali, fino all'incontinenza da urgenza (Bourcier et al., 2004, Graziottin 2006 b). Non ultimo, la riabilitazione del pavimento pelvico , con bio-feedback elettromiografico, nel caso di inversione del comando con contrazione paradossa dell'elevatore nel momento del ponzamento, potrebbe rivelarsi preziosa non solo per curare la stipsi di tipo ostruttivo, ma anche in ambito ostetrico. "
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