Association between Psychosocial Factors and Domains of Sexual Function among Men with Erectile Dysfunction

Abstract

Background: Several psychosocial factors have been associated with erectile dysfunction (ED) either as causative factors or complications of ED. These can disrupt intimate relationships, quality of life, and family dynamics. The aim of this study was to determine the association of psychosocial factors with the domains of sexual function in men with ED.
Methods: A cross-sectional study conducted among men attending the general outpatient clinic of a tertiary hospital between June and August 2018. Of the 901 men screened for ED with the International Index for Erectile Function (IIEF-5) tool, 310 participants were recruited. An interviewer-administered semi-structured questionnaire was used in collecting data which included sociodemographic characteristics. Depression, anxiety and stress were assessed with the Depression, Anxiety and Stress Scale (DASS-21) while the domains of sexual function were assessed using the International Index of Erectile Function (IIEF)-15. Data analysis was carried out with the Statistical Package for the Social Sciences (SPSS) version 20. Bivariate and multivariate analyses were carried out and the level of significance was set at 5%
Results: The median age of participants was 40 years with interquartile range of 32-49 years. The majority (231, 75%) were married, of whom 93% were in monogamous marriages. Increasing age was associated with decreasing erectile function scores (p=.005), while being in a polygamous marriage was associated with higher erectile function scores (p=.037). Lower orgasmic function was associated with depression (p=.005) and anxiety (p<.001).
Conclusions: Our study indicates that age, number of sexual partners and anxiety are important determinants of sexual function, and a biopsychosocial domain specific approach should be considered in the management of ED especially in young and middle-aged men with lower risks of organic aetiology of ED.

Keywords: Impotence, Sociodemographic characteristics, Depression, Anxiety, Stress