Endocrine Abstracts

Introduction: Hypoactive sexual desire is defined as a persistent or recurrent deficient or absent sexual fantasies or desire for sexual activity which should not be comorbid with other medical conditions or with the use of psychoactive medications. Reduced libido is a symptom referring more to a reduction in sexual drive for sexual activity. The aim of the present study is to investigate the risk factors of primary reduced libido (i.e. not associated with conditions causing loss of libido such as hypogonadism, hyperprolactinemia, psychopathology and/or psychoactive medications) or secondary reduced libido (i.e. with aforementioned conditions) in male patients with sexual dysfunction.

Methods: A consecutive series of 3714 men (mean age 53.2±12.5 years) was retrospectively studied. Patient’s reduced libido was evaluated using question #14 of SIEDY (‘Did you have more or less desire to make love in the last three months?’)

Results: Reduced libido was comorbid with erectile dysfunction, premature ejaculation and delayed ejaculation in 38, 28.2 and 50% respectively, whereas it was isolated in 5.1%. Reduced libido prevalence was substantially increased by hypogonadism, almost doubled by psychopathology and universally present in subjects with hyperprolactinemia (secondary reduced libido). Subjects with primary reduced libido are characterized by higher post-school qualification, more disturbances in domestic and dyadic relationships, and an overall healthy body (lower glycaemia and triglyceride levels). Accordingly, in patients with primary reduced libido the risk of major cardiovascular events as calculated with the Progetto Cuore algorithm was lower than in the rest of the sample. Features of hypogonadism- or psychopathology-associated reduced libido essentially reflect their underlying conditions. Comorbidity with other sexual dysfunctions did not affect the main characteristics of primary or secondary reduced libido.

Conclusions: Primary and secondary reduced libido have different risk factors and clinical characteristics. Recognizing primary or secondary reduced libido will help clinicians to identify comorbidities and to tailor appropriate treatments.