Erectile Dysfunction and Premature Ejaculation in Men Who Have Sex with Men

Abstract

Introduction Quantitative research into sexual function and dysfunction in men who have sex with men (MSM) has been sparse due in large part to a lack of validated, quantitative instruments for the assessment of sexuality in this population. Aim To assess prevalence and associations of erectile problems and premature ejaculation in MSM. Methods MSM were invited to complete an online survey of sexual function. Ethnodemographic, sexuality, and health related factors were assessed. Main Outcome Measure Participants completed a version of the International Index of Erectile Function modified for use in MSM (IIEF-MSM) and the Premature Ejaculation Diagnostic Tool. Total score on the erectile function domain of the IIEF-EF (IIEF-MSM-EF) was used to stratify erectile dysfunction (ED) severity (25–30=no ED, 16–24 mild or mild moderate ED, 11–15 moderate ED, and ≤ 10 severe ED). PEDT scores were used to stratify risk of premature ejaculation (PE, diagnosed as PEDT score ≥9). Results Nearly 80% of the study cohort of 2,640 men resided in North America. The prevalence of ED was higher in older men whereas the prevalence of PE was relatively constant across age groups. Multivariate logistic regression revealed that increasing age, HIV seropositivity, prior use of erectogenic therapy, lower urinary tract symptoms (LUTS), and lack of a stable sexual partner were associated with greater odds of ED. A separate multivariate analysis revealed that younger age, LUTS, and lower number of lifetime sexual partners were associated with greater odds of PE. Conclusions Risk factors for sexual problems in MSM are similar to what has been observed in quantitative studies of non-MSM males. Urinary symptoms are associated with poorer sexual function in MSM.

The Gay Men Sex Studies: prevalence of sexual dysfunctions in Belgian HIV+ gay men

“…Shindel et al did a separate multivariate analysis for PE (defined by Premature Ejaculation Diagnostic Tool [PEDT] score ≥ 9), which confirmed our findings that a lower lifetime number of sexual partners is associated with PE 20. They found significant associations between ED as well as PE and age that could not be confirmed in our research.…”

“…This corresponds partly with the findings of the present study. Another recent, Internet-based survey done by Shindel et al focused on ED and PE in MSM 20. This study covered HIV + as well as non-HIV + MSM, also showing a significant association between seropositivity and ED.…”

“…The prevalence of hypoactive sexual desire disorder (HSDD) in the general male population is estimated to be 15%, in contrast to 30% in the female population 19. Premature ejaculation (PE) has had more attention from researchers, and some studies show that it is more present in HIV + MSM 20. The prevalence of PE in the general (heterosexual and homosexual) male population is estimated to be around 30%, varying from 25% to 60% depending on the diagnostic tools used 19.…”

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

“…MSM living with HIV report greater numbers of sexual problems and dysfunctions compared to MSM who are HIV negative (431,435,436,438). This has been related to psychological factors (432) and to duration of antiretroviral therapy, but no association has been found with any specific class of antiretrovirals (439).…”

“…Problems including low sexual desire, erectile dysfunction and ejaculatory dysregulation have been reported in large samples of MSM across the UK, US, Australia and Europe (429)(430)(431)(433)(434)(435)(436). Distress associated with anodyspareunia (pain with receptive anal penetration) has also been reported as having a negative impact on sexual pleasure and activity (436).…”