Depressive symptomatology and male sexual functions in late life

We aimed to investigate the association between depressive symptoms and various male sexual functions, and to identify which depressive symptoms are most predictive of erectile dysfunction (ED).

This was an analytic cross-sectional study with 160 sexually active men aged 50 or above recruited from a large primary care treatment centre. The 5 domains (erectile function, EF; intercourse satisfaction, IS; orgasmic function, OF; sexual desire, SD; overall satisfaction, OS) of the International Index of Erectile Function (IIEF-15) were used to assess various sexual functions. Depressive symptomatology was measured by Geriatric Depression Scale and reconfirmed with General Health Questionnaire.

The level of depressive symptoms was negatively associated with erectile function (p<0.01), orgasmic function (p=0.02), intercourse satisfaction (p=0.04) and overall satisfaction (p<0.01), and was independent of age, education and number of health conditions, but was not associated with sexual desire (p=0.97). Erectile dysfunction was significantly associated with age (OR=1.12; 95% CI 1.05-1.19; p<0.01) and level of depressive symptoms (OR=1.39; 95% CI 1.05-1.85; p=0.02) after multivariate adjustment. In particular, only "low mood" (p=0.03) and "worthlessness" (p=0.03) remained positively associated with ED after multivariate adjustments.

Cross-sectional design cannot demonstrate direction of causality.

We are the first to implicate "low mood" and "worthlessness" in the association between depressive symptoms and ED, and this is the first study to investigate the association in Chinese.