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Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study

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Abstract

The interrelationship between male sexual desire and erectile dysfunction (ED) has been scantly investigated. Thus, we aimed at investigating the prevalence of and the predictors of unrecognised low sexual desire/interest (uLSD/I) in a cohort of men with new onset ED. Complete data from 1587 men seeking for first medical help for ED between 2010 and 2021 were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). At entrance, all patients were asked to self-report low sexual desire/interest and completed the International Index of Erectile Function (IIEF) and the Beck Depression Inventory (BDI) (depressive symptoms scored as BDI ≥ 11). The IIEF-erectile function (IIEF-EF) domain was categorised according to Cappelleri’s criteria. The median value of the IIEF-sexual desire domain (IIEF-SD) was used to dichotomise men with uLSD/I along with ED (IIEF-SD < 7) vs. ED-only (IIEF-SD ≥ 7). Circulating hormones were measured in every patient. Hypogonadism was defined as total testosterone (tT) <3.0 ng/mL. Descriptive statistics and logistic regression models tested the association between clinical variables and uLSD/I. Of 1197 patients not self-reporting LSD/I, 369 (30.8%) had IIEF-SD < 7. Patients with ED + uLSD/I were older [median (IQR) 54(41–63) vs. 49(36–59) years], had lower IIEF-EF [10.5(5–22) vs. 22(11–28)] but higher BDI [6(3–12) vs. 4(1–8)] and lower tT [4.3(3.2–5.7) vs. 4.8(3.2–6.3) ng/mL] compared to ED-only men (all p < 0.05). Overall, ED + uLSD/I men had higher rate of severe ED (49.9% vs. 23.9%), and of BDI ≥ 11 (30.6% vs. 18.2%) (all p < 0.05). At multivariable logistic regression analysis, lower tT (OR: 0.82), lower IIEF-EF scores (OR:0.95) and BDI ≥ 11 (OR:2.51) were independently associated with ED + uLSD/I, after accounting for age (all p < 0.05). Almost 30% of men seeking first medical help for ED-only had also uLSD/I. Men with both conditions were older, had higher rates of severe ED and more depressive symptoms. A detailed investigation of sexual desire should be always included in men self-complaining only of ED.

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Authors and Affiliations

  1. Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy

    Simone Cilio, Edoardo Pozzi, Giuseppe Fallara, Federico Belladelli, Christian Corsini, Alessia d’Arma, Francesco Montorsi & Andrea Salonia

  2. Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy

    Simone Cilio, Ciro Imbimbo, Alessandro Palmieri & Vincenzo Mirone

  3. Department of Urology, Foundation IRCCS Ca’ Granda -Ospedale Maggiore Policlinico, Milan, Italy

    Luca Boeri

  4. University Vita-Salute San Raffaele, Milan, Italy

    Edoardo Pozzi, Giuseppe Fallara, Federico Belladelli, Christian Corsini, Francesco Montorsi & Andrea Salonia

  5. Department of Urology, Circolo & Fondazione Macchi Hospital -ASST Sette Laghi, Varese, Italy

    Paolo Capogrosso

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  1. Simone Cilio
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Contributions

Conception and design of the study: SC, LB, PC, AS. Data acquisition: FB, AD, EP. Analysis and interpretation of data: SC, LB, GF, AS. Drafting the manuscript: SC, LB, CC. Style revision: CI, VM, AP, FM. All authors revised the manuscript and read and approved the version submitted.

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Correspondence to Andrea Salonia.

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Data collection followed the principles outlined in the Declaration of Helsinki; all patients had signed an informed consent agreeing to deliver their own anonymous information for future studies. The study was approved by our local ethics committee.

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Cilio, S., Boeri, L., Pozzi, E. et al. Prevalence and predictors of unrecognised low sexual desire/interest in men with new onset erectile dysfunction: findings from a cross-sectional, real-life study. Int J Impot Res 36, 83–88 (2024). https://doi.org/10.1038/s41443-022-00647-4

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