Hysterical traits are not from the uterus but from the testis: a study in men with sexual dysfunction.
BACKGROUND
The relationship between testosterone (T) and psychopathology in subjects with sexual dysfunction has not been completely clarified.


OBJECTIVE
To evaluate the association between T levels and different psychopathological symptoms and traits in men seeking treatment for sexual dysfunction.


METHODS
A consecutive series of 2,042 heterosexual male patients (mean age 51.8 +/- 13) consulting an outpatient clinic for sexual dysfunction was retrospectively studied.


METHODS
Several hormonal, biochemical, and instrumental parameters were investigated, including testis volume (Prader orchidometr) and penile blood flow (penile Doppler ultrasound). Patients were interviewed, prior to the beginning of any treatment, with the previously validated Structured Interview on Erectile Dysfunction (SIEDY), and ANDROTEST (a structured interview for the screening of hypogonadism in patients with sexual dysfunction). They also completed the Middlesex Hospital Questionnaire (MHQ) a brief self-reported questionnaire for the screening of the symptoms of mental disorders in nonpsychiatric setting.


RESULTS
T levels showed a negative correlation with depressive and anxiety (somatized and phobic) symptoms. Conversely, histrionic/hysterical traits were strongly and positively associated with elevated T. Men with histrionic/hysterical traits had higher androgenization, as suggested by both higher total and free T, higher testis volume and a lower ANDROTEST score. They were also characterized by better self-reported sexual functioning and penile blood flow. Accordingly, when SIEDY scales were considered, SIEDY scale 2 (relational domain) was significantly lower in subjects with histrionic/hysterical traits further indicating a more satisfying sexual relationship.


CONCLUSIONS
In men consulting for sexual dysfunction, histrionic/hysterical personality is associated with higher androgenization and better sexual functioning. Hysteria, previously considered as a typically feminine psychopathological trait (the uterine theory), should now be considered as an index of better masculine sexual well-being.
Bandini
Elisa
E
University of Florence, Department of Clinical Physiopathology, Florence, Italy.
Corona
Giovanni
G
Ricca
Valdo
V
Fisher
Alessandra D
AD
Lotti
Francesco
F
Sforza
Alessandra
A
Faravelli
Carlo
C
Forti
Gianni
G
Mannucci
Edoardo
E
Maggi
Mario
M
D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology; D007046:Hysteria / Q000453:epidemiology* / Q000209:etiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013737:Testis; D013739:Testosterone / Q000097:blood*; D014599:Uterus
D013739:Testosterone