Erectile dysfunction, low testosterone influence life satisfaction in men with spinal cord injuries

Erectile dysfunction (ED) and low testosterone levels are tied to life dissatisfaction in men with spinal cord injury (SCI), a recent study has shown.

A hundred men (mean age, 49±17 years) receiving rehabilitation for chronic SCI were enrolled. The Life-Satisfaction Questionnaire-9 (LiSat-9) was used to evaluate sexual and life satisfaction, while the International Index of Erectile Function-5 (IIEF-5) assessed erectile function. Participants also underwent biochemical analysis for the measurement of total testosterone (TT).

Majority of the men (89 percent) were in a stable relationship, but almost half had LiSat-9 scores <4, suggesting dissatisfaction with their lives. These participants had greater sexual dissatisfaction and ED, as well as lower TT and free testosterone, than their more satisfied counterparts. Demography and comorbidities were comparable between the satisfied and dissatisfied subgroups.

Spearman’s correlation test further showed that life satisfaction was significantly and positively correlated with sexual satisfaction (r, 0.64; p<0.00001), IIEF-5 scores (r, 0.25; p=0.01), TT (r, 0.40; p=0.0003) and free testosterone (r, 0.35; p=0.0003).

Logistic regression analysis confirmed these results. Poor erectile function significantly increased the likelihood of life dissatisfaction (odds ratio [OR], 0.93, 95 percent confidence interval [CI], 0.88–0.98; p=0.01), as did low free testosterone (OR, 0.98, 95 percent CI, 0.98–0.99; p=0.008).

“ED and low testosterone levels exhibit a significant independent association with life dissatisfaction. As they are modifiable risk factors, prospective studies could explore possible effects of their treatment in improving sexual and life satisfaction,” researchers said.