Functional anorectal pain ups incidence of ED, depression, anxiety in men

Men with functional anorectal pain (FARP) are more vulnerable to erectile dysfunction (ED), depression, and anxiety, a study has shown. Moreover, the incidence of these conditions increases with pain severity.

“Factors such as alcohol intake, work pressure, prolonged sitting, and longer defecation times are significantly correlated with FARP pain severity,” the investigators said.

A total of 406 male participants were divided into FARP (n=323) and healthy control (n=73) groups in this case-control study. The investigators collected demographic and disease characteristics from the patients. They then assessed ED, depression, and anxiety symptoms using the 5-item International Index of Erectile Function, Patient Health Questionnaire–9, and Generalized Anxiety Disorder 7, respectively.

Descriptive statistics was used to describe baseline characteristics and logistic regression analysis to identify factors influencing FARP. The association of FARP with ED, depression and anxiety was assessed using linear and ordinal logistic regression analyses. Finally, the investigators ensured validity through subgroup and sensitivity analyses.

Men with FARP, compared with unaffected participants, had a higher incidence of serious ED (59.8 percent vs 32.9 percent), depression (20.7 percent vs 4.1 percent), and anxiety (31.5 percent vs 12.3 percent); had lower 5-item International Index of Erectile Function scores; or had higher Patient Health Questionnaire–9 and Generalized Anxiety Disorder 7 scores.

FARP severity significantly correlated with alcohol intake, family relationship, high work pressure, and prolonged bowel movements. The association of FARP with ED, depression, and anxiety was statistically significant in both crude and adjusted models.

Specifically, FARP correlated with 2.47 times higher risk for ED, 2.73 times higher for depression, and 2.67 times higher for anxiety. Increasing pain severity also increased the incidence of ED (moderate pain: 4.80 times; p<0.0001; severe pain: 3.49 times; p<0.004), depression (moderate pain: 1.85 times; p<0.017; severe pain: 2.04 times; p<0.037), and anxiety (moderate pain: 1.86 times; p<0.014).

“Changes in lifestyle and work habits can help prevent pain symptom exacerbation,” the investigators said. “Attention to erection and psychological issues in patients with FARP and interdisciplinary comprehensive treatment may improve the efficacy.”