Skip to main content

Advertisement

Log in

Sexual dysfunction and depression: Etiology, prevalence, and treatment

  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Sexual dysfunction and depression are very common conditions that are age-related and chronic. In men, epidemiologic studies have confirmed a strong correlation between erectile dysfunction and symptoms of depression. Both conditions have a significant negative impact on the quality of life of patients and their partners. Several studies showed that restoration of normal sexual function improves the quality of life of patients and their partners, regardless of treatment method. The literature review and recent observations emphasize the multifactorial nature of sexual dysfunction and, more specifically, erectile dysfunction and underline the importance of the comor-bidity and bidirectional relationship between erectile dysfunction and depression. Research is progressing on the possible link between andropause, sexual dysfunction, and depression, thus opening potential new opportunities to address issues of aging-related morbidities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Basson R, Berman J, Burnett A, et al.: Report of the international consensus development conference on female sexual dysfunction: definitions and classifications. J Urol 2000, 163(3):888–893.

    Article  PubMed  CAS  Google Scholar 

  2. Segraves KB, Segraves RT: Hypoactive sexual desire disorder: prevalence and comorbidity in 906 subjects. J Sex Marital Ther 1991, 17:55–58.

    PubMed  CAS  Google Scholar 

  3. Laumann EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors JAMA 1999, 281:537–544. [Published erratum appears in JAMA 1999, 2811(3):1174. Important epidemiologic work assessing the prevalence and risk experiencing sexual dysfunction across various social groups and examining the determinants and health consequences of these disorders in a national probability sample of 1749 women and 1410 men aged 18 to 59 years.

    Article  PubMed  CAS  Google Scholar 

  4. NIH Consensus Development Panel on Impotence: Impotence. JAMA 1993, 270:83–90.

    Article  Google Scholar 

  5. Kinsey AC, Pomeroy WB, Martin CE: Age and sexual outlet. In Sexual Behavior of the Human Male. Edited by Kinsey AC, Pomeroy WB, Martin CE. Philadelphia: WB Saunders; 1948:218–262.

    Google Scholar 

  6. Feldman HA, Goldstein I, Hatzichristou DG, et al.: Impotence and its medical and psychological correlates: results of the Massachusetts Male Aging Study. J Urol 1994, 151:54–61. This very important study provides current, normative data on the prevalence of impotence and its physiologic and psychosocial corre-lates in a general population using results from a community-based, random sample observational survey of noninstitutionalized men 40 to 70 years old conducted from 1987 to 1989 in cities and towns near Boston, Massachusetts. It was concluded by the authors that impo-tence is strongly associated with age and has multiple determinants, including some risk factors for vascular disease.

    PubMed  CAS  Google Scholar 

  7. Slag MF, Morley JE, Elson MK, et al.: Impotence in medical clinic outpatients. JAMA 1983, 249:1736–1740.

    Article  PubMed  CAS  Google Scholar 

  8. Mulligan T, Retchin SM, Chinchilli VM, Bettinger CB: The role of aging and chronic disease in sexual dysfunction. J Am Geriatr Soc 1988, 36:520–524.

    PubMed  CAS  Google Scholar 

  9. Diokno AC, Brown MB, Herzog R: Sexual function in the elderly. Arch Intern Med 1990, 150:197–200.

    Article  PubMed  CAS  Google Scholar 

  10. Ellenberg M: Sexual function in diabetic patients. Ann Intern Med 1980, 92:331–333.

    PubMed  CAS  Google Scholar 

  11. Perez ED, Mulligan T, Wan T: Why men are interested in an evaluation for a sexual problem. J Am Geriatr Soc 1993, 41:233–237.

    PubMed  CAS  Google Scholar 

  12. Laumann EO, Paik A, Rosen RC: Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999, 281:537–544.

    Article  PubMed  CAS  Google Scholar 

  13. Segraves RT: Psychiatric illness and sexual function. Int J Impot Res 1998, 10(suppl 2):S131-S133; discussion S138–S140.

    PubMed  Google Scholar 

  14. Araujo AB, Durante R, Feldman HA, et al.: The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med 1998, 60:458–465.

    PubMed  CAS  Google Scholar 

  15. Casper RC, Redmond DE, Katz MM, et al.: Somatic symp-toms in primary affective disorder. Presence and relationship to the classification of depression. Arch Gen Psychiatry 1985, 42:1098–1104.

    PubMed  CAS  Google Scholar 

  16. Mathew RJ, Weinman M, Claghorn JL: Tricyclic side effects without tricyclics in depression. Psychopharmacol Bull 1980, 16:58–60.

    PubMed  CAS  Google Scholar 

  17. Shabsigh R, Klein LT, Seidman S, et al.: Increased incidence of depressive symptoms in men with erectile dysfunction. Urology 1998, 52:848–852.

    Article  PubMed  CAS  Google Scholar 

  18. Ackerman MD, D’Attilio JP, Antoni MH, et al.: The predictive significance of patient-reported sexual functioning in RigiScan sleep evaluations. J Urol 1991, 146(6):1559–1563.

    PubMed  CAS  Google Scholar 

  19. Roose SP, Seidman SN: Sexual dysfunction and cardiac risk: is depression a contributing factor? Am J Cardiol 2000, 86(suppl):38f-40f.

    Article  PubMed  CAS  Google Scholar 

  20. Ahto M, Isoaho R, Puolijoki H, et al.: Coronary heart disease and depression in the elderly—a population-based study. Fam Pract 1997, 14(6):436–445.

    PubMed  CAS  Google Scholar 

  21. Goldstein I: The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction. Am J Cardiol 2000, 86(suppl):41f-45f. This review addresses very accurately the associations between depression and cardiovascular disease, erectile dysfunction and cardiovascular disease, and depression and erectile dysfunction. Variables including age, heart disease, hypertension, sedentary behavior, related medications, cigarette smoking, and abnormal lipids have been found to be highly associated with depressive symptoms, cardiovascular disease, and erectile dysfunction.

    Article  PubMed  CAS  Google Scholar 

  22. Carney RM, Rich MW, Freedland KE, et al.: Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosom Med 1988, 50:627–633.

    PubMed  CAS  Google Scholar 

  23. Schleifer SJ, Macari-Hinson MM, Coyle DA, et al.: The nature and course of depression following myocardial infarction. Arch Intern Med 1989, 149:1785–1789.

    Article  PubMed  CAS  Google Scholar 

  24. Fraser-Smith N, Lesperance F, Talajic M: Depression following myocardial infarction. Impact on 6 month survival. JAMA 1993, 270:1819–1861.

    Article  Google Scholar 

  25. Sesso HD, Kawachi I, Vokonas PS, Sparrow D: Depression and risk of coronary heart disease in the Normative Aging Study. Am J Cardiol 1998, 82(7):851–856.

    Article  PubMed  CAS  Google Scholar 

  26. Musselman DL, Evans DL, Nemeroff CB: The relationship of depression to cardiovascular disease. Arch Gen Psychiatry 1998, 55:580–592.

    Article  PubMed  CAS  Google Scholar 

  27. Roose SP, Dalack GW: Treating the depressed patients with cardiovascular problems. J Clin Psychiatry 1992, 53(suppl):25–31.

    PubMed  Google Scholar 

  28. Morales A, Heaton JP, Carson CC: Andropause: a misnomer for a true clinical entity. J Urol 2000, 163(3):705–712.

    Article  PubMed  CAS  Google Scholar 

  29. Basaria S, Dobs AS: Risks versus benefits of testosterone therapy in elderly men. Drugs Aging 1999, 15(2):131–142.

    Article  PubMed  CAS  Google Scholar 

  30. Klerman, GL: Depression and related disorders of mood. In The New Harvard Guide to Psychiatry. Edited by Nicholi AM. Cambridge, MA: Harvard University Press; 1988:309–336.

    Google Scholar 

  31. Turner LA, Althof SE, Levine SB, et al.: Self-injection of papav-erine and phentolamine in the treatment of psychogenic impotence. J Sex Marital Ther 1989, 15(3):163–176.

    PubMed  CAS  Google Scholar 

  32. Wells KB, Stewart A, Hays RD, et al.: The functioning and well-being of depressed patients. Results from the Medical Outcomes Study [see comments]. JAMA 1989, 262:914–919.

    Article  PubMed  CAS  Google Scholar 

  33. Rosen RC: Quality of life assessment in sexual dysfunction trials. Int J Impot Res 1998, 10(suppl 2):S21-S23; discussion S24–S26.

    PubMed  Google Scholar 

  34. Williams G, Abbou CC, Amar ET, et al.: The effect of transure-thral alprostadil on the quality of life of men with erectile dysfunction, and their partners. MUSE Study Group. Br J Urol 1998, 82:847–854.

    PubMed  Google Scholar 

  35. Segraves RT: Antidepressant-induced sexual dysfunction. J Clin Psychiatry 1998, 59:48–54.

    PubMed  CAS  Google Scholar 

  36. Seidman S, Roose SP, Menza MA, et al.: Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled trial with sildenafil citrate. Am J Psychiatry 2001, 158:1623–1630. In this multi-institutional survey, a 12-week randomized, double-blind, placebo-controlled trial was conducted at 20 urologic clinics to evaluate the effects of sildenafil treatment in men with erectile dysfunction and mild-to-moderate comorbid depressive illness. It could be demonstrated that sildenafil is efficacious for erectile dysfunction in men with mild-to-moderate depressive illness and that improvement of erectile dysfunction is associated with marked improvement in depressive symptoms and quality of life.

    Article  PubMed  CAS  Google Scholar 

  37. Lane RM: A critical review of selective serotonin reuptake inhibitor-related sexual dysfunction; incidence, possible aetiology and implications for management. J Psychopharmacol 1997 11:72–82.

    Article  PubMed  CAS  Google Scholar 

  38. Starkstein SE, Berthier ML, Fedoroff P, et al.: Anosognosia and major depression in 2 patients with cerebrovascular lesions. Neurology 1990, 40(9):1380–1382.

    PubMed  CAS  Google Scholar 

  39. Krishnan KR, McDonald WM: Arteriosclerotic depression. Med Hypotheses 1995, 44(2):111–115.

    Article  PubMed  CAS  Google Scholar 

  40. Kraft IA: Psychiatric complications of cardiac transplantation. Semin Psychiatry 1971, 3(1):58–69.

    PubMed  CAS  Google Scholar 

  41. Bosley CM, Fosbury JA, Cochrane GM: The psychological factors associated with poor compliance with treatment in asthma. Eur Respir J 1995, 8(6):899–904.

    PubMed  CAS  Google Scholar 

  42. Breslau N, Davis GC, Schultz LR, Peterson EL: Joint 1994 Wolff Award Presentation. Migraine and major depression: a longitudinal study. Headache 1994, 34(7):387–393.

    Article  PubMed  CAS  Google Scholar 

  43. Rothenberger A, Lischewski R: Organic versus functional factors in the diagnosis of conversion disorders. Psychiatr Prax 1982, 9(2):51–55.

    PubMed  CAS  Google Scholar 

  44. Massey EW, Bullock R: Peroneal palsy in depression. J Clin Psychiatry 1978, 39(4):291–292.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shabsigh, R., Zakaria, L., Anastasiadis, A.G. et al. Sexual dysfunction and depression: Etiology, prevalence, and treatment. Curr Urol Rep 2, 463–467 (2001). https://doi.org/10.1007/s11934-001-0040-x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11934-001-0040-x

Keywords

Navigation