Journal of Andrology
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Published-Ahead-of-Print August 12, 2010, DOI:10.2164/jandrol.110.010397

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Perceived Ejaculate Volume Reduction in Subjects with Erectile Dysfunction: Psycho-Biological Correlates

Giovanni Corona , Valentina Boddi , Mauro Gacci , Alessandra Sforza , Gianni Forti , Edoardo Mannucci , and Mario Maggi *

* To whom correspondence should be addressed. E-mail: m.maggi{at}dfc.unifi.it.

The disorders of orgasm/ejaculation encompass a heterogeneous group of dysfunctions including premature ejaculation, delayed ejaculation and perceived ejaculate volume reduction (PEVR). The aim of this study is exploring specific associations of PEVR in a consecutive series of 3141 subjects (mean age 51.6±13.1 years old) consulting for ED. Among these, 71 have been excluded because they underwent prostate surgery. Different clinical and biochemical factors were evaluated along with parameters derived from SIEDY structured interview evaluating the contribution of organic, relational and intrapsychic factors to ED. After adjustment for confounders, PEVR was specifically associated with the use of androgen deprivation therapy as well as with different other medicaments including alpha-blockers, serotonergic reuptake inhibitor antidepressants and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. A higher prevalence of diabetes mellitus and hypogonadism was observed in subjects with PEVR when compared to the rest of the sample (23.0 vs. 14.1% and 9.1 vs. 5.3% respectively; both p<0.05). In addition, different sexual parameters such as severe ED (HR=1.25[1.11-1.41]; p<0.0001) patient's (HR=1.53[1.38-1.70]; p<0.0001) and partner's (HR=1.21[1.07-1.36]; p<0.005) hypoactive sexual desire (HSD) were also significantly related to PEVR. Furthermore, PEVR was associated with an impairment of both the relational and intrapsychic components of ED. In a multivariate model, adjusting for age, BMI, smoking habit and medicaments, both hypogonadism, diabetes mellitus, and severe ED as well as patient's and partner's HSD were all independently associated with PEVR. Our results indicate that PEVR is important not only for couple reproductive purposes, but it also appears to have a distinct role in the couple's sexual performance.


Key words: Androgen • Erectile Dysfunction • Hormone




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