title: The association between erectile dysfunction, depressive symptoms and testosterone levels among middle-aged men.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between erectile dysfunction and depressive symptoms and testosterone levels among middle-aged men at the community level.
  
  
  METHODS
  The study population consisted of 614 men born in 1945 and living in the city of Oulu, Finland. Erectile dysfunction was assessed by the erectile function domain of the International Index of Erectile Function questionnaire and depressive symptoms by the Beck Depression Inventory. Blood samples were collected to measure testosterone and sex hormone-binding globulin level.
  
  
  RESULTS
  After adjusting for confounders, erectile dysfunction was statistically significantly associated with depressive symptoms (risk ratio (RR) 1.66, 95% confidence interval (95% CI) 1.29-2.15), as well as with obesity (RR 1.72, 95% CI 1.12-2.62). Neither total nor free testosterone level was associated with erectile dysfunction among our study group.
  
  
  CONCLUSIONS
  Depressive symptoms rather than testosterone levels should be taken into consideration while treating middle-aged men with erectile problems at the community level.
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Oulu Mentalcare Oy, Oulu, Finland kadri.suija@ut.ee.
authors.forename: Kadri
authors.initials: K
authors.lastname: Suija
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Kerkelä
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Rajala
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Jokelainen
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Mauri
authors.initials: M
authors.lastname: Laakso
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Oulu Mentalcare Oy, Oulu, Finland.
authors.forename: Pirjo
authors.initials: P
authors.lastname: Härkönen
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland.
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.affiliation: Institute of Health Sciences, University of Oulu, Oulu, Finland Oulu Mentalcare Oy, Oulu, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Timonen
mesh_terms: D003863:Depression / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone
keywords: Depressive symptoms; erectile dysfunction; male; obesity; testosterone