Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido

Kazuyoshi Shigehara; Yuki Kato; Masashi Iijima; Shohei Kawaguchi; Takahiro Nohara; Kouji Izumi; Yoshifumi Kadono; Mikio Namiki; Atsushi Mizokami

doi:10.1016/j.esxm.2021.100426

Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido

Sex Med. 2021 Oct;9(5):100426. doi: 10.1016/j.esxm.2021.100426. Epub 2021 Sep 10.

Authors

Kazuyoshi Shigehara¹, Yuki Kato², Masashi Iijima², Shohei Kawaguchi², Takahiro Nohara², Kouji Izumi², Yoshifumi Kadono², Mikio Namiki³, Atsushi Mizokami²

Affiliations

¹ Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan. Electronic address: kshigehara0415@yahoo.co.jp.
² Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
³ Department of Urology, Hasegawa Hospital, Toyama, Toyama, Japan.

Abstract

Introduction: Decreased libido in middle-aged and elderly men is often difficult to treat, and identifying the risk factors affecting decreased libido is important for the clinical management of decreased libido. However, limited information is available regarding specific risk factors in this population.

Aim: The present study investigated the risk factors for decreased libido among middle-aged and elderly men.

Methods: Patients who attended our male andropausal outpatient clinic between 2009 and 2015 were enrolled. All patients completed a self-administered questionnaire, which included the Aging Male Symptoms (AMS) scale, International Prostate Symptom Score (IPSS), and Sexual Health Inventory for Men (SHIM). Information on waist size, body mass index, present illness, present use of any medication, and lifestyle habits were collected by each attending physician. Blood biochemical data such as free testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-Chol), and hemoglobin A1c values were assessed. Libido was assessed based on AMS scale question 17, and a score of 4 or higher was defined as severely decreased libido (severe group).

Main outcome measure: The clinical factors associated with severely decreased libido were analyzed based on multiple regression analysis.

Results: A total of 292 subjects were included in the analysis, 111 (38%) of which belonged to the severe group. The mean age of study subjects was 66.2 years, and the mean FT value was 7.1 ± 2.2. Comparisons of each variable among the severe and not severe groups showed significant differences in older age, current cigarette smoking, AMS scale, IPSS, frequency of nocturnal voiding, SHIM score, and HDL-Chol value. Multivariate regression analysis revealed that current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for severely decreased libido. Furthermore, the frequency of nocturnal voiding significantly increased with severity of decreased libido.

Conclusion: Current cigarette smoking, frequent nocturnal voiding, and a low SHIM score were the independent risk factors for a severely low libido. K Shigehara, Y Kato, M Iijima, et al. Risk Factors Affecting Decreased Libido Among Middle-Aged to Elderly Men; Nocturnal Voiding is an Independent Risk Factor of Decreased Libido. Sex Med 2021;9:100426.

Keywords: Erectile Dysfunction; Libido; Nocturia; Smoking.