Psychiatric Morbidity Is Frequently Undetected in Patients With Erectile Dysfunction

Mallis, Dimitrios; Moysidis, Kyriakos; Nakopoulou, Evangelia; Papaharitou, Stamatis; Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios

doi:10.1097/01.ju.0000176746.73667.3c

Cited by 54 publications

(46 citation statements)

References 13 publications

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“…6,7 Even higher rates (25-55%) were reported in men attending andrology clinics. 8,9 Furthermore, Shabsigh et al 8 found that patients with ED and concomitant depression were more likely to discontinue therapy, making assessment of depression symptoms an important aspect of ED evaluation.…”

Section: Introductionmentioning

confidence: 99%

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

et al. 2007

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Depression and hypogonadism are associated with erectile dysfunction (ED). We evaluated the prevalence of both conditions in men presenting to an ED specialty clinic, and tested whether hypogonadism correlated with the presence of depressive symptoms using a validated questionnaire. From July 2001 to June 2003, 157 men referred to an ED specialty clinic prospectively filled the Center for Epidemiologic Studies Depression Scale (CES-D), the abbreviated International Index of Erectile Function (IIEF-5) and had testosterone serum levels drawn. Median age was 53 (range ¼ 21-85 years). Hypogonadism, defined as serum T (testosterone)o300 mg/dl, was present in 36% of patients. This proportion was higher in men over the median age compared to younger patients (45 and 26%, respectively, P ¼ 0.002). Overt depression symptoms, defined as a CES-DX22, were found in 24% of men. Mean age of men with overt depression was 49.9710.1 years vs 55.1715.8 years for those with CES-Do22 (P ¼ 0.02). Hypogonadal men were more likely to have overt depression scores compared to eugonadal counterparts (35 vs 18%, P ¼ 0.02). This association was statistically stronger after correcting for age in a multivariate linear model (P ¼ 0.005). The relative risk of having overt depression was 1.94 times higher in men with hypogonadal testosterone level (95% confidence interval: 1.13 to 3.7). We conclude that in an ED referral population, symptoms of hypogonadism and depression symptoms are fairly prevalent, and that overt depression symptoms are strongly associated with hypogonadism. Clinicians should consider testosterone measurements in all men with high depression symptom scores.

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Section: Introductionmentioning

confidence: 99%

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

et al. 2007

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“…The prevalence of ED increases with age from 2% to 9% in men between the ages of 40-49 years, to 20-40% in men aged 60-69 years, and 50-100% in those aged >70 years [1,3,4]. ED is often multifactorial and includes neuronal, hormonal, vascular, myogenic and psychological causes [1,[5][6][7] with clinical implications, such as reduced quality of life [8].…”

Section: Introductionmentioning

confidence: 99%

Mirabegron causes relaxation of human and rat corpus cavernosum: could it be a potential therapy for erectile dysfunction?

et al. 2016

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ObjectiveTo examine the effects of mirabegron, a selective b 3 -adrenoceptor agonist that has recently been approved for the treatment of overactive bladder (OAB), on erectile function. Stimulation of b 3 -adrenoceptors localised in cavernosal smooth muscle cells may play a physiological role in mediating penile erection, and offer a beneficial pharmacological action for patients who have OAB and erectile dysfunction (ED). Materials and MethodsCorpus cavernosal (CC) specimens were obtained from patients with ED and Peyronie's disease undergoing penile prosthesis implantation. Erectile responses were also evaluated in vivo after intracavernosal injection (ICI) of mirabegron in anaesthetised rats. Mirabegron-elicited relaxation responses (10 -8 -10-3 M) on phenylephrine-induced contraction were seen in human CC (HCC) and rat CC strips in isolated organbath studies. The effects of inhibitors, namely L-NAME [N G -nitro-L-arginine methyl ester, a competitive inhibitor of nitric oxide synthase (NOS), 100 lM], ODQ [1H-(1,2,4) oxadiazolo (4,3-a) quinoxalin-1-one, a soluble guanylyl cyclase (sGC) inhibitor, 30lM], methylene blue (a NOS and sGC inhibitor, 20lM), SR59230A (b 3 -adrenoceptor blocker, 1 lM), and fasudil [Rho-associated protein kinase (ROCK) inhibitor, 0.1 lM], on mirabegron-induced relaxation responses were evaluated. Responses to mirabegron were compared with responses to isoprenaline and nebivolol. Immunohistochemistry was used to localise b 3 -adrenoceptors and ROCK in CC smooth muscle cells. In vivo rat data were expressed as intracavernosal pressure (ICP)/mean arterial pressure, and total ICP. ResultsMirabegron resulted in a relaxation of phenylephrineevoked CC contractions in a concentration-dependent manner and SR59230A antagonised the mirabegron-induced relaxations in HCC and rat CC. Other inhibitors, L-NAME, ODQ, and methylene blue, did not affect the mirabegroninduced relaxation responses. Mirabegron relaxation responses at concentrations (0.1-10 lM) were enhanced by fasudil (ROCK inhibitor) in rat but not in HCC strips. KCl-induced contractions in HCC and rat CC were partially inhibited by mirabegron. In vivo, ICI of mirabegron (doses of 0.1-1 mg/kg) had a minor effect on ICP when compared with vehicle administration. Immunohistochemistry data showed b 3 -adrenoceptors localised in the smooth muscle cells of the HCC and rat CC. ConclusionsMirabegron markedly relaxed isolated CC strips by activating b 3 -adrenoceptors independently of the NO-cGMP pathway. There is also evidence of the existence of a close functional link between b 3 -adrenoceptors and the RhoA/ROCK pathway. These results may support further clinical studies using combinations of mirabegron with ROCK and phosphodiesterase type 5 inhibitors (PDE5i) for the treatment of ED, especially in patients who do not respond to PDE5i therapy.

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“…15 Among males suffering from ED, are usually found to have a 2.5% to 37% prevalence of disorders of anxiety. 16 Anxiety (P= 0.0043) is significantly associated with PE in our study. Dunn KM et al, study suggests that anxiety is associated with PE.…”

Section: Discussionmentioning

confidence: 49%

Role of depression, anxiety, testosterone and luteinizing hormone levels in disorders of sexual function

Jakka

Ramesh

2017

Int J Adv Med

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Background: Hypogonadism as well as deficiency of testosterone can lead to disorder of sexual function in males. The initial clinical manifestations of this are mostly erectile dysfunction (ED) and hypoactive sexual desire disorder (HSSD). This not only causes the sexual dysfunction but can also lead to many health problems. To study the role of depression, anxiety, testosterone and luteinizing hormone levels in disorders of sexual functionMethods: A hospital based cross sectional study was conducted at department of General Medicine, Kamineni Academy of Medical Sciences, Hyderabad for a period of one year among 60 eligible study subjects to study the role of depression, anxiety, testosterone and luteinizing hormone levels in disorders of sexual function. All male patients aged between 21-60 years, who had stable heterosexual relationship, were included. Patients with severe diseases, users of alcohol and smoking, having marital disharmony were excluded. Informed consent was obtained from all the patients.Results: Testosterone and LH levels are significantly lower in subjects with SD, suggesting that a state of hypogonadotropic hypogonadism prevails in male diabetics with SD. Depression and anxiety are significant factors associated with SD. Premature Ejaculation is significantly associated with Anxiety.Conclusions: Testosterone and LH levels are significantly lower in subjects with SD. Depression and anxiety is significant factors associated with SD. Premature Ejaculation is significantly associated with anxiety.

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Psychiatric Morbidity Is Frequently Undetected in Patients With Erectile Dysfunction

Cited by 54 publications

References 13 publications

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

Mirabegron causes relaxation of human and rat corpus cavernosum: could it be a potential therapy for erectile dysfunction?

Role of depression, anxiety, testosterone and luteinizing hormone levels in disorders of sexual function

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