1. Erectile Dysfunction in Post-traumatic Stress Disorder Patients
Goran Arbanas
Outpatient clinic for sexual problems, General hospital Karlovac, Croatia
4th International Consultation on Sexual Medicine (ICSM), June 19-21, 2015, Madrid, Spain
Objective
Methods
Posttraumatic stress disorder (PTSD) is a mental disorder that develops after a person experiences an extremely stressful event (exposure to death, serious injury or sexual violence). The four symptom clusters are: intrusion symptoms, avoidance of stimuli associated with the traumatic event, negative alterations in cognitions and mood, and alterations in arousal and reactivity.
Patients with PTSD have a higher prevalence of erectile disorder (ED) due to several reasons: PTSD affects intimate relationships, drugs used for the treatment of PTSD can adversely affect sexuality, and PTSD itself can have a negative influence on sexuality.
The aim of this study was to determine biological and psychological factors related to ED in PTSD patients.
Participants: 195 patients with PTSD
average age 48.3 (range 35-74)
Measures of metabolic syndrome: blood pressure, height, weight, abdominal circumference, triglyceride level, cholesterol level
Measures of psychological factors:
Beck's Depression Inventory (BDI)
Beck’s Anxiety Inventory (BAI)
PTSD Checklist
Measures of erectile (dys)function:
Arizona Sexual Experience Scale (ASEX)
International Index of Erectile Function (IIEF)
Results
Between 50-75% of patients with PTSD have ED, according to different instruments (50% according to IIEF, and 77% according to ASEX).
Patients with ED have more intensive PTSD symptoms, and especially arousal and avoidance symptoms. ED patients had higher levels of depression and anxiety. Logistic regression showed that avoidance symptoms and depression were the most important.
There were no differences in lipid levels, glucose, BMI and smoking in patients with and without ED.
There was no difference in age of those patients with ED and without ED.
Conclusion
In PTSD, age and elements of metabolic syndrome are not important factors that influence the development of ED.
Psychological factors are more important for the development of ED in PTSD patients, especially depression, anxiety and avoidance symptoms of PTSD.
We would like to thank all the patients who participated in the study.