title: Predictors of sexual bother in a population of male North American medical students.
abstract: BACKGROUND
  The prevalence and associations of sexual bother in male medical students has not been extensively studied.
  
  
  OBJECTIVE
  The aim of this study is to analyze predictors of sexual bother in a survey of male North American medical students.
  
  
  METHODS
  Students enrolled in allopathic and osteopathic medical schools in North America between February 2008 and July 2008 were invited to participate in an internet-based survey of sexuality and sexual function.
  
  
  METHODS
  The principle outcome measure was a single-item question inquiring about global satisfaction with sexual function. The survey also consisted of a questionnaire that included ethnodemographic factors, student status, sexual history, and a validated scale for the assessment of depression. Respondents completed the International Index of Erectile Function, the premature ejaculation diagnostic tool, and the Self-Esteem and Relationship Quality survey (SEAR). Descriptive statistics, analysis of variance, and multivariable logistic regression were utilized to analyze responses.
  
  
  RESULTS
  There were 480 male subjects (mean age 26.3 years) with data sufficient for analysis. Forty-three (9%) reported sexual bother. Sexual bother was significantly more common in men with erectile dysfunction (ED), high risk of premature ejaculation (HRPE), depressive symptoms, and lower sexual frequency. However, after multivariate analysis including SEAR scores, ED, and HRPE were no longer independently predictive of sexual bother. Higher scores for all domains of the SEAR were associated with lower odds of sexual bother.
  
  
  CONCLUSIONS
  ED and HRPE are associated with sexual bother in this young and presumably healthy population. However, after controlling for relationship factors neither ED nor HRPE independently predicted sexual bother. It is plausible to hypothesize that sexual dysfunction from organic causes is rare in this population and is seldom encountered outside of relationship perturbations. Attention to relationship and psychological factors is likely of key importance in addressing sexual concerns in this population.
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Smith
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D003863:Depression; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology; D006240:Happiness; D006801:Humans; D007989:Libido; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D016017:Odds Ratio; D010549:Personal Satisfaction; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012649:Self Concept; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000523:psychology; D019529:Sexuality / Q000523:psychology*; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult