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.
    Full-text · Article · Jul 2015
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    • "Of major relevance, during daily practice LSD/I may often be observed in men who, from the onset, have suffered from erectile dysfunction (ED), thus suggesting either a possible causal relationship between ED and impaired SD, or the existence of common pathogenetic factors for the two sexual complaints. In this specific situation, LSD/I is considered an acquired and psycho-pathogenetic consequence of ED (Corona et al., 2004); SOPs thus suggest to use 'LSD/I' as a general term for the symptom/syndrome which might be linked to different medical conditions, relationship factors, medications or abuse of recreational substances. Therefore, taking into account the fact that male sexual dysfunction is a complex cluster of interrelated biological, psychological and contextual factors (Althof & Needle, 2011), many conditions have been proposed as potential underlying factors of LSD/I (Rochira et al., 2003). "
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    ABSTRACT: Prevalence and risk factors of concomitant primary low sexual desire/interest (LSD/I) and subsequent new-onset erectile dysfunction (ED) in men have been only partially investigated. We looked at the sociodemographic and clinical predictors of the concomitant condition of primary LSD/I - defined as the reduction in the usual level of SD/I which precedes ED or another sexual dysfunction - and new-onset ED (LSD/I + ED) in a cohort of consecutive Caucasian-European patients seeking their first medical help for sexual dysfunction at a single outpatient clinic in the everyday clinical practice setting. Data from 439 sexually active patients were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients' LSD/I were evaluated according to the findings of a comprehensive sexual history. Moreover, patients completed the International Index of Erectile Function (IIEF). Descriptive statistics and logistic regression models tested the prevalence and predictors of LSD/I + ED as compared with ED only. Of the 439 men, LSD/I + ED was observed in 33 (4.2%) individuals. One of three men with LSD/I + ED was younger than 40 years. Patients complaining of LSD/I + ED or ED alone did not differ in terms of hormonal milieu. No significant differences emerged between groups in terms of sexual orientation, rates of stable sexual relationships, educational status, recreational habits and comorbid sexual dysfunctions. Patients with LSD/I + ED had significantly lower IIEF-sexual desire and IIEF-overall satisfaction scores than ED-only individuals (all p ≤ 0.003). At multivariable analysis younger age and severe CCI scores emerged as independent predictors of LSD/I + ED (all p ≤ 0.04). These findings showed that primary LSD/I is concomitant with new-onset ED in less than 5% of men seeking first medical help. Younger age and severe CCI emerged as independent predictors of LSD/I + ED. Patients with both conditions reported an impaired overall sexual satisfaction.
    Full-text · Article · Jun 2014 · Andrology
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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.
    Full-text · Article · Jan 2014
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