Sexual functioning mirrors overall men's health status, even irrespective of cardiovascular risk factors

Abstract

SUMMARYErectile dysfunction has been described as a sentinel marker of co-existing and undetected cardiovascular disease. Beside cardiovascular diseases, a correlation between erectile dysfunction and other major comorbidities has been also reported. The study was aimed to analyze the association between sexual functioning and overall men's health in sexually active, Caucasian-European men with new-onset sexual dysfunction. Data from the last 881 consecutive patients seeking first medical help for sexual dysfunction were cross-sectionally analyzed. The International Classification of Diseases, 9th revision, Clinical Modification was used to classify healthsignificant comorbidities, which were scored with the Charlson Comorbidity Index (CCI). A modified CCI score from which all potential cardiovascular risk factors (CCI-CV) were subtracted was then calculated for every patient. Patients were requested to complete the International Index of Erectile Function (IIEF). The main outcome of the study was the association between the IIEF domain scores and CCI, which scored health-significant comorbidities even irrespective of cardiovascular risk factors (CCI-CV). The final sample included 757 patients (85.9%) (Median age: 48 years; IQ range: 37-59). Overall, erectile dysfunction was found in 540 (71.4%) patients. Of these, 164 (21.6%) had a CCI ≥ 1 and 138 (18.2%) had a CCI-CV ≥ 1, respectively. At the analysis of variance, IIEF-Erectile Function (EF) scores significantly decreased as a function of incremental CCI and CCI-CV scores (all p < 0.01). At multivariable logistic regression analysis, both IIEF-EF and IIEF-total score achieved independent predictor status for either CCI ≥ 1 or CCI-CV ≥ 1, after accounting for potential confounders (p < 0.01). We report novel findings of a significant association between erectile dysfunction severity and overall men's health, even irrespective of cardiovascular risk factors. Thereof, erectile dysfunction severity could serve as a proxy for general men's health, thus encouraging physicians to comprehensively assess patients complaining of sexual dysfunction in the real-life everyday clinical practice.

The role of neutrophil‐to‐lymphocyte ratio in men with erectile dysfunction—preliminary findings of a real‐life cross‐sectional study

“…Erectile dysfunction was shown to anticipate a clinically manifest CAD in a relevant proportion of men (Montorsi et al ., ) and now is recognized as a major risk factor for development of CAD and cardiovascular events (Guo et al ., ; Vignozzi et al ., ; Yamada et al ., ; Vlachopoulos et al ., ). Moreover, ED is recognized as a sentinel of general health status, both considering and irrespective of cardiovascular comorbidities (Salonia et al ., ; Capogrosso et al ., ). Therefore, it is of paramount clinical relevance to identify men at risk of both future cardiac events and health status decline.…”

“…ED may significantly increase the risk of cardiovascular disease (CVD), coronary heart disease, stroke, overall atherosclerotic cardiovascular events (Batty et al ., ; Dong et al ., ). Despite this, ED severity was shown to be associated with overall men's health, even irrespective of cardiovascular risk factors (Capogrosso et al ., ). Metabolic disorders, cardiovascular comorbidities, and ED are closely related, sharing several pathophysiological factors, including systemic low‐grade inflammation (Vlachopoulos et al ., ).…”

Lamotrigine-induced sexual dysfunction and non-adherence: case analysis with literature review

“…Male sexual dysfunction has multiple presentations (decreased libido, lack of libido, erectile dysfunction, impotence, ejaculatory inhibition, anejaculation, delayed orgasm, anorgasmia, priapism, premature ejaculation and retrograde ejaculation) 23,24 with multiple reported aetiologies (medical conditions including, but not limited to, neurologic disorders, hypertension, cardiovascular disease and hormonal disorders; psychiatric disorders including, but not limited to mood, anxiety, trauma-related and substance use disorders; and pharmacotherapies). 16,[18][19][20][21][22][23][24][25][26][27][28][29][30] This unique case permits discussion of these issues in the context of the patient's comorbid conditions and pharmacotherapies from which a determination of probable aetiology for this patient's lack of libido can be ascertained. 31 First, the patient had three psychiatric diagnoses: major depression, panic disorder and PTSD.…”

Real-world observational results from a database of 48 million men in the United States: Relationship of cardiovascular disease, diabetes mellitus and depression with age and erectile dysfunction

“…Several medical conditions have been linked to ED in epidemiological studies . For example, cardiovascular disease (CVD) can interfere with arterial blood flow to the cavernous body; adequate blood flow is critical for erection .…”

“…1 Several medical conditions have been linked to ED in epidemiological studies. [5][6][7] For example, cardiovascular disease (CVD) can interfere with arterial blood flow to the cavernous body; 6 adequate blood flow is critical for erection. 2 Diabetes mellitus (DM) is associated with neuropathy, endothelial dysfunction and changes in smooth muscle, all of which can contribute to ED.…”