Objectives: The aim of present study is to determine psychobiological characteristics of sexual dysfunction (SD) associated with metabolic syndrome (MS; as defined by National Cholesterol Education Programs Adult Treatment Panel III, NCEP-ATP-III criteria) in a consecutive series of 803 male out-patients.
Methods: Several hormonal, biochemical and instrumental (penile doppler ultrasound, PDU) parameters were studied, along with psychopathology scores (Middlesex Hospital Questionnaire modified MHQ). The Structured Interview on Erectile DYsfunction (SIEDY), was also applied.
Results: Among subjects studied, 236 patients (29.4%) were diagnosed as having a MS. Among them 96.5% reported ED, 39.6% hypoactive sexual desire, (HSD) 22.7% premature and 4.8% delayed ejaculation. Patients with MS were characterized by greater subjective (as assessed by SIEDY) and objective (as assessed by PDU) ED and by greater somatizated anxiety than the rest of the sample. The prevalence of overt hypogonadism (total testosterone <8 nM) was significantly higher in patients with MS. Circulating TT decreased as the number of MS components increased (B=−1.35±0.182 nmol/l; P<0.0001, after adjustment for age). Accordingly, the relative risk for hypogonadism was significantly higher in patients reporting 3 or more risk factors for MS. Among MS components, waist circumference and hyperglycemia were the best predictors of hypogonadism. Among patients with MS, hypogonadism was present in 11.9% and 3.8% in the rest of the sample (P<0.0001) and it was associated with typical hypogonadism-related symptoms, such as hypoactive sexual desire, low frequency of sexual intercourses and depressive symptoms.
Conclusion: Our data suggest that MS is associated with a more severe ED and induces somatization. Furthermore, MS is associated with a higher prevalence of hypogonadism in patients with SD. The presence of hypogonadism can further exacerbate the MS-associated sexual dysfunction, adding the typical hypogonadism-related symptoms. (including HSD, 66.7%).