The relationship between testosterone and sexual function in depressed and healthy men.
OBJECTIVE
Men with Major Depressive Disorder (MDD) report high rates of sexual dysfunction, as do healthy males with low levels of testosterone. The objective of this study is to evaluate the effects of depression and low testosterone across various domains of sexual function.


METHODS
Untreated depressed males (N = 44) and age-matched healthy controls (N = 50) had blood samples drawn to determine morning levels of total testosterone (TT) and bioavailable testosterone (BT). In addition, questionnaires regarding depressive symptoms as well as sexual function were administered.


METHODS
Sexual function outcomes were measured using the Sex Effects (SexFX) Scale and depression severity was assessed with the Hamilton Rating Scale for Depression-17 item (HAMD-17).


RESULTS
Using TT criteria, 27.9% of men were categorically defined as hypogonadal compared to 19.3% using BT criteria. Within both TT and BT hypogonadal groups, men with MDD had lower scores on all domains of sexual function compared to healthy controls with hypogonadism. Testosterone levels interacted with MDD status to affect orgasm and desire, although not arousal. Multiple linear regression analyses revealed that depression status was the main factor influencing sexual function. Hypogonadal status was not a predictor of sexual function in this sample, although age did play a minor role in the domain of arousal.


CONCLUSIONS
While testosterone levels appear to influence sexual function, specifically orgasm, the presence of MDD appears to be a stronger factor and has high predictive value for sexual outcomes.
University Health Network, Department of Psychiatry, Toronto, Canada.
Sakina J
SJ
Rizvi
Sidney H
SH
Kennedy
Lakshmi N
LN
Ravindran
Peter
P
Giacobbe
Beata S
BS
Eisfeld
Debra
D
Mancini
Roger S
RS
McIntyre
D000328:Adult; D001143:Arousal / Q000502:physiology; D001682:Biological Availability; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D007989:Libido / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009948:Orgasm / Q000502:physiology; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D012735:Sexual Dysfunction, Physiological / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood*
D012738:Sex Hormone-Binding Globulin; D013739:Testosterone