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Objective

Assess the association between vitamin D (vitD) levels, sexual functioning and depressive symptoms in a cohort of men seeking medical help for erectile dysfunction (ED) as their primary compliant, without any known psychiatric disorders.

Methods

Data from 171 men were analyzed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients completed the IIEF and the Beck Depression Inventory (BDI). Circulating hormones and VitD were measured in every patient [deficiency for vitD levels <20 ng/mL (group A); vitD insufficiency for vitD levels between 20 and 30 ng/mL (group B); normal level for vitD >30 ng/ml (Group C)].

Results

Overall, 68 (39.8%), 62 (36.3%) and 41 (24.0%) patients were in group A, B and C, respectively. Groups were comparable for age, BMI, CCI, smoking and alcohol habits and sex steroids. IIEF-EF domain score was lower in group A than in group B (p=0.04) and group C (p<0.001). EF domain was also lower in group B than group C (p=0.03). Severe ED was found in 59.3% vs. 25.9% vs. 14.8%, in group A, B and C, respectively (p<0.001). Group A patients reported lower scores of IIEF-sexual desire (p<0.01) and IIEF-orgasmic function (0.03) than those in group C. Similarly, patients in group A and B had lower BDI scores than men in group C (all p≤0.03). vitD was inversely correlated with BDI scores (p<0.01) and positively correlated with IIEF-EF scores (p<0.001). At MV linear regression analysis age, BDI, group A and group B (all p≤0.04) vs. group C, were significantly associated with IIEF-EF severity, after accounting for BMI, CCI, total testosterone, smoking and alcohol status. Conversely, only IIEF-EF (p=0.03) was associated with BDI score after accounting for age, BMI, CCI, testosterone levels and vitD status.

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