title: Correlates of erectile dysfunction in moderate-to-severe chronic obstructive pulmonary disease patients.
abstract: OBJECTIVE
  Erectile dysfunction (ED) has important negative effects on male quality of life and self-esteem. The aim of this study was to acquire an insight into the sexual status of COPD patients.
  
  
  METHODS
  Ninety-five male patients aged 48-75 years, with moderate-to-severe stable COPD, and 30 age-matched subjects with normal pulmonary function were included. After clinical evaluation and measurement of serum sex hormones and TNF-alpha concentration, subjects were asked to answer the International Index of Erectile Function (IIEF) questionnaire as a method to diagnose and classify ED.
  
  
  RESULTS
  Varying degrees of ED were detected in 87% of COPD patients and 83% of controls. Although the total percentages of subjects with various severities of ED seemed similar, moderate and severe ED was 57% in COPD group and 20% in control subjects, suggesting a more severe course of ED in COPD patients. ED score of COPD patients was not correlated with age, smoking burden, duration of COPD, FEV1%, PaO2, PaCO2, serum dehydroepiandrosterone-sulphate, testosterone or estradiol levels. When patients were subgrouped according to severity of ED, serum TNF-alpha concentration, used as a marker of systemic inflammatory status in COPD, was significantly higher in patients with moderate-to-severe ED compared with mild-moderate ED.
  
  
  CONCLUSIONS
  The present study showed that ED is frequent and more severe in COPD patients than age-matched controls. Chronic systemic inflammation is likely to play a role in ED in COPD; the role of TNF-alpha should be evaluated further. Patients with COPD need comprehensive management including a detailed sexual evaluation.
authors.affiliation: Department of Chest Diseases, School of Medicine, Adnan Menderes University, Aydin, Turkey. fisunkaradag@yahoo.com
authors.forename: Fisun
authors.initials: F
authors.lastname: Karadag
authors.forename: Hatice
authors.initials: H
authors.lastname: Ozcan
authors.forename: Aslihan B
authors.initials: AB
authors.lastname: Karul
authors.forename: Emel
authors.initials: E
authors.lastname: Ceylan
authors.forename: Orhan
authors.initials: O
authors.lastname: Cildag
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D007172:Erectile Dysfunction / Q000097:blood / Q000209:etiology* / Q000523:psychology; D005541:Forced Expiratory Volume; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D011788:Quality of Life; D012649:Self Concept; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D012739:Gonadal Steroid Hormones; D014409:Tumor Necrosis Factor-alpha