A preliminary study comparing psychological factors associated with erectile dysfunction in heterosexual and homosexual men

Anxiety and depression among Greek men with primary erectile dysfunction and premature ejaculation

BACKGROUND

Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent sexual disorders among males associated with significant distress and impairment in quality of life. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among patients with primary ED and PE.

METHODS

A sample of 57 men (ED = 31; PE = 26) were compared to 25 male outpatients with anxiety disorder (AD) and 25 healthy controls. Principal assessment measures included the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI).

RESULTS

Greater levels of STAI state anxiety were reported among the ED, PE, and AD groups as compared to healthy controls. In contrast ED and AD groups scored higher than controls on the STAI trait anxiety and BDI, but PE scores were not different from healthy controls in both measures.

CONCLUSIONS

The study findings suggest that both primary ED and PE are conditions associated with significant state anxiety; however, PE appears to be less associated with trait anxiety and depression compared to ED, a finding that corroborates the recent acknowledgement of PE as a more biologically based condition. Limitations and potential clinical implications are also discussed.

Internalized Heterosexism

This article provides an integrated critical review of the literature on internalized heterosexism/internalized homophobia (IH), its measurement, and its psychosocial correlates. It describes the psychometric properties of six published measures used to operationalize the construct of IH. It also critically reviews empirical studies on correlates of IH in the areas of sexual identity formation and the coming-out process; mental, psychosocial, and physical health; substance use; sexual risk-taking behavior; intimate relationships; parenting and family issues; gender roles and feminism; race and ethnicity; religion; career issues; and counselor—client interactions and treatment interventions. Last, it discusses limitations of the body of research and provides suggestions for future research throughout the review.

Erectile and ejaculatory problems in gay and heterosexual men

The prevalence of erectile difficulties (ED) and problems with rapid ejaculation (RE) were studied in a convenience sample of gay men (n = 1379) and an age-matched sample of heterosexual men (n = 1558). ED was reported more frequently by gay men and RE more frequently by heterosexual men. The heterosexual men were more likely to be in exclusive relationships and those in a current relationship (exclusive or non-exclusive) were more likely to report ED than those not in a relationship. Heterosexual men in an exclusive relationship were more likely to report RE than the rest. These associations were not found in the gay sample. The following personality traits were assessed as possible predictors of ED and RE: sexual inhibition proneness (SIS1 and SIS2), sexual excitation proneness, impact of mood on sexuality, and trait measures of depression and anxiety. Age and SIS1 (inhibition due to threat of performance failure) were strong predictors of ED in both gay and heterosexual men. Gay men scored higher on SIS1 whether or not they reported ED, consistent with greater concerns about performance failure in gay men. Anxiety was predictive of RE, but only in the heterosexual men. If replicated in other samples, these differences may reflect a greater importance of erectile function in the sexual lives of gay men and greater importance of ejaculatory control in heterosexual relationships.

Psychogenic erectile dysfunction

OBJECTIVE

To educate healthcare professionals on the historical aspects, clinical diagnosis, and current treatment methods of psychogenic erectile dysfunction.

METHOD

A topic review of current literature was performed. Chief sources included primarily mainstream journals in the fields of urology, psychiatry/psychology, impotence/erectile dysfunction, epidemiology, and internal medicine. MEDLINE and PsycINFO databases were utilized.

DATA EXTRACTION

Data from clinical studies, trials, and review articles concerned primarily with psychological aspects of the arousal (erectile function) phase of the male sexual response cycle were collected, analyzed, and summarized in this review article.

RESULTS

There has been a shift in how erectile dysfunction has been perceived and treated over the past 30 years. With the current focus now on the very prevalent organic causes of ED, psychological factors are increasingly overlooked, though they remain important to the treatment of the patient as a whole. This article provides a complete, concise review of the interplay between psychological components and erectile function, reviews the work-up and diagnosis of psychogenic ED, and discusses treatment methods.

CONCLUSIONS

Erectile dysfunction is a prevalent problem that can affect, and can be affected by, psychosocial aspects of a man's life. Medical or pharmacological interventions are often appropriate to treat ED, but the psychosocial aspects should not be ignored. It has become easier for practitioners to put aside patients' psychosocial and interpersonal concerns regarding sexual health. Clinicians provide the best possible treatment if they recognize that erectile dysfunction is a complex, multifactorial disorder, and treat accordingly.