Sexual Dysfunction in Men with COPD: Impact on Quality of Life and Survival
- 728 Downloads
Most patients with chronic obstructive pulmonary disease (COPD) are middle-aged or older, and by definition all have a chronic illness. Aging and chronic illness decrease sexual interest, sexual function, and testosterone levels. To date, researchers have not simultaneously explored prevalence, risk factors, and impact of sexual dysfunctions on quality of life and survival in men with COPD. We tested three hypotheses: First, sexual dysfunctions, including erectile dysfunction, are highly prevalent and impact negatively the quality of life of those with COPD. Second, gonadal state is a predictor of erectile dysfunction. Third, erectile dysfunction, a potential maker of systemic atherosclerosis, is a risk factor for mortality in men with COPD.
In this prospective study, sexuality was assessed in 90 men with moderate-to-severe COPD (40 hypogonadal) by questionnaire. Testosterone levels, comorbidities, dyspnea, depressive symptoms, and survival (4.8 years median follow-up) were recorded.
Seventy-four percent of patients had at least one sexual dysfunction, with erectile dysfunction being the most common (72 %). Most were dissatisfied with their current and expected sexual function. Severity of COPD was equivalent in patients with and without erectile dysfunction. Low testosterone, depressive symptoms, and presence of partner were independently associated with erectile dysfunction. Severity of lung disease and comorbidities, but not erectile dysfunction, were independently associated with mortality (p = 0.006).
Sexual dysfunctions, including erectile dysfunction, were highly prevalent and had a negative impact on quality of life in men with COPD. In addition, gonadal state was an independent predictor of erectile dysfunction. Finally, erectile dysfunction was not associated with all-cause mortality.
KeywordsEndocrine Erectile dysfunction Testosterone Sexuality Aging Outcome
This work was supported in part by grants from AMVETS and the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development Rehabilitation Research and Development Service.
Conflict of interest
Eileen G. Collins, Sahar Halabi, Mathew Langston, Timothy Schnell, Martin Tobin, and Franco Laghi have no conflicts of interest of financial ties to disclose.
- 1.NHLBI (National Heart, Lung and Blood Institute). Morbidity and Mortality 2009 Chartbook on Cardiovascular, Lung, and Blood Diseases. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, Bethesda, MD. Available at http://www.nhlbi.nih.gov/resources/docs/cht-book.htm (Accessed 15 January 2012)
- 16.Morelli A, Filippi S, Mancina R, Luconi M, Vignozzi L, Marini M, Orlando C, Vannelli GB, Aversa A, Natali A, Forti G, Giorgi M, Jannini EA, Ledda F, Maggi M (2004) Androgens regulate phosphodiesterase type 5 expression and functional activity in corpora cavernosa. Endocrinology 145:2253–2263PubMedCrossRefGoogle Scholar
- 28.Laumann EO, Paik A, Glasser DB, Kang JH, Wang T, Levinson B, Moreira ED Jr, Nicolosi A, Gingell C (2006) A cross-national study of subjective sexual well-being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors. Arch Sex Behav 35:145–161PubMedCrossRefGoogle Scholar
- 34.Stewart AL, Ware JE (1992) Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Duke University Press, DurhamGoogle Scholar
- 59.Wu CJ, Hsieh JT, Lin JS, Hwang TI, Jiann BP, Huang ST, Wang CJ, Lee SS, Chiang HS, Chen KK, Lin HD (2007) Comparison of prevalence between self-reported erectile dysfunction and erectile dysfunction as defined by five-item International Index of Erectile Function in Taiwanese men older than 40 years. Urology 69:743–747PubMedCrossRefGoogle Scholar
- 60.De Berardis G, Franciosi M, Belfiglio M, Di Nardo B, Greenfield S, Kaplan SH, Pellegrini F, Sacco M, Tognoni G, Valentini M, Nicolucci A (2002) Erectile dysfunction and quality of life in type 2 diabetic patients: a serious problem too often overlooked. Diabetes Care 25:284–291PubMedCrossRefGoogle Scholar
- 61.Liverman CT, Blazer DG (eds) (2004) Future research directions. In: Testosterone and aging: clinical research directions. Washington, DC: The National Academic Press, pp 112–158Google Scholar
- 64.Basaria S, Coviello AD, Travison TG, Storer TW, Farwell WR, Jette AM, Eder R, Tennstedt S, Ulloor J, Zhang A, Choong K, Lakshman KM, Mazer NA, Miciek R, Krasnoff J, Elmi A, Knapp PE, Brooks B, Appleman E, Aggarwal S, Bhasin G, Hede-Brierley L, Bhatia A, Collins L, LeBrasseur N, Fiore LD, Bhasin S (2010) Adverse events associated with testosterone administration. N Engl J Med 363:109–122PubMedCrossRefGoogle Scholar