UNEMPLOYMENT, AGE AND DEPRESSION AS

RISK FACTORS FOR ERECTILE DYSFUNCTION

AND FEMALE LACK OF SEXUAL DESIRE

Carmita H. N. ABDO
Waldemar M. de OLIVEIRA JR.
Edson D. MOREIRA JR.
João A. S. FITTIPALDI

Project of Sexuality (ProSex)

Department and Institute of Psychiatry
Medical School of the University of São
Paulo
 INTRODUCTION

Sexual problems are very common generally occur in

industrialized western countries in the world (Lindal &
Stefansson, 1993)

About 30 million men in the United States present some

erectile dysfunction (ED) causing suffering and interpersonal
difficulties

According to Massachusetts Studies (MMAS), 52% of men

between 40 and 70 years old present some type of ED
(Araujo et al, 1998)
 INTRODUCTION

34% of Japanese men, 22% of Malaysians, 17% of Italians

and 15% of Brazilians present some moderate or severe ED
(Nicolosi et al, 2003)

The increasing risk for ED related to diabetes mellitus,

heart diseases, urinary tract infections, smoking and age

The risk for ED is also found in depressed and unemployed

patients (Morillo et al, 2002; May & Bobele, 1988)
 INTRODUCTION

Lack of sexual desire (LSD), defined as the absence or a

severe decrease in fantasies and desires related to any
sexual activity, is the most frequent sexual dysfunction
among women (Laumann et al, 1999; Rosen, 2000)

The prevalences change between 5% and 49%.

Depression and age are the most common factors for the
development of LSD (Kadri et al, 2002)
 OBJECTIVE

In this study we`re trying to show the prevalences of

depression, ED and LSD in relevant sample of
Brazilian population, trying to evaluate the risk for
erectile difficulties and lack of sexual desire facing
depression, unemployment and aging.
 MATERIAL AND METHODS

The Brazilian Study of Sexual Behaviour (BSSB) was

conducted between February and April 2000, and was
performed using a sample of 2,835 subjects (53% of women
and 47% of men), from ten cities of seven Brazilian states

The subjects` age was 18 years-old or above

They were weekend visitors on beaches, parks and

shopping centers, and they were invited to answer an
anonymous and self-applicable questionnaire
 MATERIAL AND METHODS

Following the adequacy the questionnaire was

composed of 38 sections distributed in four groups:
identification questions (1 to 11), habits and tendencies
(13 to 27), sexual practices and dysfunctions (28 to 38)
and general health (question 12) (Abdo et al, 2000)

Chi-square and multivariated logistic regression tests

were used. Values of p < 0.05 were considered statiscally
significant
 RESULTS

The prevalence of feminine LSD was 34.6% and 14.7%

of moderate/severe ED – 41% of women and 22.5% of
men were unemployed

Depression was mentioned by 29.7% of women and

16.8% of men

Unemployed women and men present higher frequency

of depression, as well as higher frequency of LSD in
women and ED in men as shown in charts 1 and 2
 RESULTS

Chart 1. Percentage of depression and lack of sexual

desire (LSD) among women according to their
working status
Working status Depression (%) LSD (%)
Unemployed 33.3 35.9
Employed 26.7 27.1

Chart 2. Percentage of depression and

moderate/severe erectile dysfunction (ED) among
men according to their working status
Working status Depression (%) ED (%)
Unemployed 20.0 17.9
Employed 15.6 11.3
 RESULTS

Prevalence of ED is straightly related to aging. As charts 3 and

show, the older the individuals, the higher the prevalence of these
dysfunctions

Chart 3. Frequency of LSD in women according to age (n=1,474)

Age (years) LSD n(%)
Up to 25 90 (23.4)
26 to 40 145 (25.8)
41 to 60 214 (47.0)
61 or more 54 (73.0)
p<0.001
 RESULTS

Chart 4. Frequency of moderate/severe erectite dysfunction

(ED) in men according to age (n=1,161)

Age (years) LSD n(%)

Up to 25 19 (10.0)
26 to 40 47 (9.5)
41 to 60 71 (18.0)
61 or more 32 (38.6)

p<0.001
 RESULTS

Women
Results of multivariated logistic regression have shown
that, among women, being unemployed and getting older
increase te chance for LSD
Unemployment increased the chance for LSD in 1.66
times (95% CI; 1.29 – 2.14; p<0.001)
Compared to women up to 25, those ages vary from 41
to 60 years old present 2.92 times (95% CI; 2.01 – 4.07;
p<0.001) more chances for LSD. Those who are 61 or
more have their chance increased in 7.59 times (95% CI;
3.11 – 18.52; p<0.001)
In this model, depression hasn`t increased the chance
for LSD
 RESULTS

Men
Being unemployed, depressed and getting older
increase the chance for moderate or severe ED according
to the multivariated logistic regression model
Unemployment increases 1.83 times (95% CI; 1.22 –
2.77; p<0.01) the chance for moderate/severe ED,
whereas depression increases it in 1.93 times
Men between 41 and 60 and men who are 61 or more
present higher chance for moderate/severe ED.
Compared to individuals up to 25 years old, the chance
for moderate/severe ED increases in 1.86 times (95% CI;
1.06 – 3.28; p<0.05) for individuals between 41 and 60
and 4.31 times (95% CI; 1.93 – 9.62; p<0.001) for those
who are 60 or more
 DISCUSSION

The prevalence of ED and LSD in our sample was

similar to the one found in other studies

In medical literature, different prevalences for sexual

dysfunctions are found

This variation in due partly to the type of sample

(community versus sexuality clinics) studied, the type of
trial preformed (self-applicable questionnaires or
interview), and the clinical definition used for each
dysfunction
 DISCUSSION

The same tendency for the increasing of ED and LSD

with age noticed in previous studies was found in this
sample

Studies indicate the relationship between depressive

symptoms and erectile dysfunction (Shabsigh et al, 1998;
Ducrocq, 1999; Intili & Nier, 1998). It is verified that
depression and ED are commonly associated, mutually
maintaining or enchancing each other

Unemployment as a worldwide increasing tendency has

contributed to the higher number of sexual difficulties
 CONCLUSION

2. Age and unemployment incresed the risk for LSD in

women and ED in men independently from each other
3. Depression increased the risk for ED, but not for
feminine LSD
4. It`s essencial for the successful treatment of these
dysfunctions, to distinguish physical, psychological and
relational problems. Older patients` own
characteristics should also be taken into consideration
5. The treatment of depression as well as the
improvement of socio-economical conditions can also
contribute to decrease the risks of sexual dysfunctions
among men and women
6. Sexual performance shows quality of life as well as
quality of life leads to a better sexual performance