Heart Rate Variability and Erectile Function in Younger Men: A Pilot Study

Abstract

Erectile dysfunction (ED) in younger men is an increasing concern. In middle aged and older men, ED was related to lower resting heart rate variability (HRV), but research in younger men is lacking. The present study examined, in a nonclinical sample of 105 men between 18 and 39 years, the association of ED with several parameters of resting HRV. Scores of the 5-item version of the International Index of Erectile Function (IIEF-5) below 22 were considered as indicating ED. Eighteen men (17.1%) reported ED (mild in 16, mild to moderate in 2). Welch's tests revealed that ED was associated with lower low-frequency power (LF), lower high-frequency power (HF), lower standard deviation of interbeat intervals, and lower standard deviation of the heart rate, which is influenced by both sympathetic and parasympathetic activity. After removing outliers, ED was unrelated to HF. In younger men, erections might be facilitated by a combination of higher parasympathetic tone and relatively higher sympathetic tone in the heart, as indicated by LF and greater standard deviation of the heart rate, a largely overlooked parameter in HRV research. Keywords Heart rate variability • Standard deviation of the heart rate • Erectile dysfunction • Younger men Erectile dysfunction (ED) in younger men is an increasingly recognized problem (

Evaluation of psychological stress, cortisol awakening response, and heart rate variability in patients with chronic prostatitis/chronic pelvic pain syndrome complicated by lower urinary tract symptoms and erectile dysfunction

“…The lower HRV was also a psychophysiological correlate of ED in middle-aged and elderly men (Kessler et al, 2019). Specifically, the HF values of ED patients were lower and LF/HF ratios were higher than those of the controls (Lee et al, 2011;Shim et al, 2018;Costa et al, 2021). In this study, we still observed that there were high LF/HF ratios in all patients, but only patients with both CP/CPPS and ED exhibited significantly higher LF/HF ratio, the increased LF/HF ratio indicating that sympathetic activity is higher than parasympathetic activity (Shim et al, 2018;Kayacan et al, 2021).…”

“…Both methods have a high correlation with sympathetic and parasympathetic structures, which are known to accurately measure cardiac baroreflex activity and autonomic activity (Kayacan et al, 2021). Previous studies have shown that an imbalance in ANS activity is associated with many urologic diseases, including CP/CPPS (Cho et al, 2011), LUTS (Choi et al, 2010;Shim et al, 2018), and ED (Chen et al, 2009;Lee et al, 2011;Costa et al, 2021). Our findings found that none of the timedomain parameters differed significantly, but on frequencydomain analysis, all patients, including patients with CP/CPPS, ED, or both, exhibited significantly lower HF than healthy controls.…”

“…Consequently, combined with our research, we can deduce that psychological factors ultimately contribute to both ED and LUTS in CP/CPPS, and the potential psychopathological mechanisms may be as follows. First, long-term mental stress, such as anxiety and depression, triggers a cascade of neuroendocrine changes that involve alterations in neurobiological stress systems, such as the ANS and HPA axis, especially increasing the activity of sympathetic nerves innervating the prostate sphincter, the bladder sphincter and detrusor, as well as the smooth muscle of the cavernous body of the penis (Chen et al, 2009;Choi et al, 2010;Cho et al, 2011;Lee et al, 2011;Shim et al, 2018;Costa et al, 2021). the aforementioned smooth muscles are stimulated, causing "spasms" or "contractions" in the bladder neck, prostate urethra and penile cavernous body, finally resulting in obstructive urination symptoms and impotence, and in severe cases, urine reflux into the prostatic duct induces CP/CPPS.…”