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. 2024 Sep;12(6):1272-1279.
doi: 10.1111/andr.13574. Epub 2023 Dec 22.

Causal relationship between worry, tension, insomnia, sensitivity to environmental stress and adversity, and erectile dysfunction: a study using Mendelian randomization

Hao Zhang  1 , Shiqi Wang  2 , Sicheng Ma  3 , Chenming Zhang  4 , Zulong Wang  2 , Peiyu Yan  1   5
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Free article

Causal relationship between worry, tension, insomnia, sensitivity to environmental stress and adversity, and erectile dysfunction: a study using Mendelian randomization

Hao Zhang et al. Andrology. 2024 Sep.
Free article

Abstract

Background: This study aims to investigate the causal relationship between erectile dysfunction (ED) and psychological states including worry, tension, insomnia, sensitivity to environmental stress and adversity (SESA).

Method: This study the used two-sample bi-directional Mendelian randomization (MR) method. The study data was obtained from a pooled dataset of genome-wide association studies (GWAS). The bi-directional MR analysis was performed using inverse variance weighting, weighted median method, and MR-Egger regression analysis to assess the causality between ED and psychological states including worry, tension, insomnia, SESA in terms of odd ratios (OR). The study tested for heterogeneity using the Cochran Q method and for multiple validity using the MR-Egger and MR-PRESSO methods.

Results: In forward MR analysis correlating worry, tension, insomnia, and SESA as exposures, no causal relationship was found between worry or tension and ED (p < 0.05). However, insomnia (p = 0.001, OR = 3.441, 95%CI = 1.593-7.435) and SESA (p = 0.004, OR = 1.804, 95%CI = 1.203-2.701) were found to have a significant causal effect on ED risk. The reverse MR analysis with ED as the exposure did not show any significant correlation (all p > 0.05).

Conclusion: Individuals with insomnia and SESA are at higher risk for developing ED. Clinical evaluation should be more thorough for these individuals. Insomnia can be treated simultaneously with psychological counseling to reduce the risk of ED. In addition, there is no evidence to suggest that worry and tension increase the risk of ED.

Keywords: Mendelian randomization; environmental stress; erectile dysfunction; insomnia; tension; worry.

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References

REFERENCES

    1. Shamloul R, Ghanem H. Erectile dysfunction. Lancet North Am Ed. 2013;381(9861):153‐165. doi:10.1016/S0140‐6736(12)60520‐0
    1. Salonia A, Bettocchi C, Boeri L, et al. European Association of Urology Guidelines on Sexual and Reproductive Health—2021 Update: male sexual dysfunction. Eur Urol. 2021;80(3):333‐357. doi:10.1016/j.eururo.2021.06.007
    1. Chu NV, Edelman SV. Erectile dysfunction and diabetes. Curr Diab Rep. 2002;2(1):60‐66. doi:10.1007/s11892‐002‐0059‐5
    1. Li M‐K, Garcia LA, Rosen R. Lower urinary tract symptoms and male sexual dysfunction in Asia: a survey of ageing men from five Asian countries. BJU Int. 2005;96(9):1339‐1354. doi:10.1111/j.1464‐410X.2005.05831.x
    1. Tan HM, Tong SF, Ho CCK. Men's health: sexual dysfunction, physical, and psychological health—is there a link? J Sex Med. 2012;9(3):663‐671. doi:10.1111/j.1743‐6109.2011.02582.x

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