title: Sexual dysfunction in men with COPD: impact on quality of life and survival.
abstract: BACKGROUND
  Most patients with chronic obstructive pulmonary disease (COPD) are middle-aged or older, and by definition all have a chronic illness. Aging and chronic illness decrease sexual interest, sexual function, and testosterone levels. To date, researchers have not simultaneously explored prevalence, risk factors, and impact of sexual dysfunctions on quality of life and survival in men with COPD. We tested three hypotheses: First, sexual dysfunctions, including erectile dysfunction, are highly prevalent and impact negatively the quality of life of those with COPD. Second, gonadal state is a predictor of erectile dysfunction. Third, erectile dysfunction, a potential maker of systemic atherosclerosis, is a risk factor for mortality in men with COPD.
  
  
  METHODS
  In this prospective study, sexuality was assessed in 90 men with moderate-to-severe COPD (40 hypogonadal) by questionnaire. Testosterone levels, comorbidities, dyspnea, depressive symptoms, and survival (4.8 years median follow-up) were recorded.
  
  
  RESULTS
  Seventy-four percent of patients had at least one sexual dysfunction, with erectile dysfunction being the most common (72 %). Most were dissatisfied with their current and expected sexual function. Severity of COPD was equivalent in patients with and without erectile dysfunction. Low testosterone, depressive symptoms, and presence of partner were independently associated with erectile dysfunction. Severity of lung disease and comorbidities, but not erectile dysfunction, were independently associated with mortality (p = 0.006).
  
  
  CONCLUSIONS
  Sexual dysfunctions, including erectile dysfunction, were highly prevalent and had a negative impact on quality of life in men with COPD. In addition, gonadal state was an independent predictor of erectile dysfunction. Finally, erectile dysfunction was not associated with all-cause mortality.
authors: College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Eileen G
authors: EG
authors: Collins
authors: Sahar
authors: S
authors: Halabi
authors: Mathew
authors: M
authors: Langston
authors: Timothy
authors: T
authors: Schnell
authors: Martin J
authors: MJ
authors: Tobin
authors: Franco
authors: F
authors: Laghi
mesh_terms: D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D004417:Dyspnea / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone; D007986:Luteinizing Hormone