Chronic alcoholism and male sexual function.

OBJECTIVE: The relation between chronic alcohol abuse and male sexuality remains uncertain. This study assessed the effect of chronic alcoholism on sexual function, marital adjustment, sleep-related erections, sleep disorders, and hormone levels during abstinence from alcohol. METHOD: Twenty chronically alcoholic men, aged 28-59 years, without evidence of severe hepatic disease and free from unrelated medical illnesses, were assessed 2-36 months after achieving sobriety and compared to a group of 20 nonalcoholic volunteers. Each subject and his sexual partner underwent semistructured interviews and completed several questionnaires; the men had medical and psychiatric evaluations and polygraphic assessment of sleep parameters and nocturnal penile tumescence during 4 nights, with the last night devoted to sequential blood sampling for evaluation of hormone levels. RESULTS: The alcoholic men did not differ from the comparison group in any sexual dimension or in the prevalence of sexual problems despite the significant marital dissatisfaction reported by their sexual partners. In addition, there were no differences between groups in sleep and nocturnal penile tumescence measures. The alcoholic group had a greater prevalence of periodic leg movement disorders but no respiratory abnormalities during sleep. Except for a significant overnight increase in plasma luteinizing hormone in the alcoholic men, there were no differences between groups in total and bioavailable testosterone, dihydrotestosterone, and prolactin or in the nocturnal circadian changes in testosterone and prolactin levels. CONCLUSIONS: These findings suggest that prolonged and severe alcohol abuse in men is compatible with normal sexual function during sobriety in the absence of substantial hepatic or gonadal failure.

Diabetes, psychological function and male sexuality.

The aim of the study was to assess psychological contributors or correlates of sexual dysfunction in diabetic men. The study was conducted on 40 diabetic men and 40 age-matched healthy volunteers. The subjects underwent a psychosexual interview with their sexual partners and had a comprehensive medical evaluation to rule out the confounding effects of other illnesses or medications. Psychiatric, psychological and marital information was obtained with the Schedule for Affective Disorders and Schizophrenia (SADS-L), the SCL-90-R, the Derogatis Sexual Function Inventory, the Locke-Wallace Marital Adjustment test and the Dyadic Adjustment Inventory. Compared to controls, diabetic patients had significantly lower levels of erotic drive, sexual arousal, enjoyment and satisfaction. Problems in these areas coexisted with alterations in sexual attitudes and body image but were not related to group differences in marital adjustment as reported separately by the patients and their partners. There was no evidence that psychological distress or psychiatric disorders are associated with diabetes or with its effects on sexual function.

Diabetes mellitus and male sexual function: a controlled study.

There is an extensive clinical literature on the erectile disorders of diabetic men but a paucity of controlled studies that have taken into account the effects of age, concurrent illnesses and medication on sexual function. This investigation was carried out on 40 diabetic men free from other illness or drugs that could affect sexual capacity and 40 age-matched healthy control subjects. Each subject and his female partner underwent semistructured interviews and the men had comprehensive medical evaluations and polygraphic assessment of sleep and nocturnal penile tumescence in the sleep laboratory during three nights. In comparison to control subjects, diabetic patients reported significant decreases in sexual desire, subjective arousal, erectile capacity, coital frequency and sexual satisfaction. The diabetic group also had significant decrements in duration of rapid eye movement sleep and in frequency, duration and degree of nocturnal penile tumescent episodes. There were no differences between Type 1 (insulin-dependent) and Type 2 (non-insulin dependent) diabetic patients in prevalence of sexual problems or in nocturnal tumescent measures. Significant relations were observed between lack of metabolic control, diabetic complications and impaired nocturnal tumescence. Sexually non-dysfunctional diabetic men had significant nocturnal penile tumescence abnormalities. Diabetic men without coital failures may have a subclinical impairment in erectile function which, although of not significant magnitude to interfere with penetration, is reflected in nocturnal penile tumescent measures. This result raises a note of caution in the interpretation of the nocturnal penile tumescence test for the differential diagnosis of diabetic erectile impotence.

Diabetes, sleep disorders, and male sexual function.

The prevalence and role of sleep disorders in the sexual problems of diabetic patients remain unexplored. This study was conducted on 40 diabetic men carefully screened to exclude the confounding effects of other medical illnesses or drugs likely to impair sexual function and 40 age-matched healthy volunteers. They underwent an extensive psychosexual interview, medical and psychiatric evaluations, and three recorded nights in a sleep laboratory. Electroencephalogram, eye movements, muscle tone, and nocturnal penile tumescence were monitored continuously. Respiratory airflow and bilateral anterior tibialis recordings were obtained during the first sleep session. Diabetic men had significantly higher prevalences of respiratory and periodic leg movement disturbances during sleep. There was clinical, although not nocturnal penile tumescence, evidence suggesting that respiratory abnormalities during sleep are associated with erectile difficulties in diabetic men. Future studies should include blood oxygenation and respiratory effort measures to clarify the significance of sleep-related airflow disturbances in diabetic patients.