title: Conflicts Within the Family and Within the Couple as Contextual Factors in the Determinism of Male Sexual Dysfunction.
abstract: BACKGROUND
  The deterioration of a couple's relationship has been previously associated with impairment in male sexual function. Besides a couple's dystonic relationship, other stressors can unfavorably influence dyadic intimacy. A largely neglected etiopathogenetic factor affecting couple sexuality is the frustration caused by conflicts within the family.
  
  
  OBJECTIVE
  To evaluate the possible associations between male sexual dysfunction (SD) and conflictual relationships within the couple or the family.
  
  
  METHODS
  A consecutive series of 3,975 men, attending the Outpatient Clinic for SD for the first time, was retrospectively studied. Conflicts within the family and within the couple were assessed using two standard questions: "Are there any conflicts at home," and "Do you have a difficult relationship with your partner?" respectively, rating 0 = normal relationships, 1 = occasional quarrels, and 2 = frequent quarrels or always.
  
  
  METHODS
  Several clinical, biochemical, and psychological (Middlesex Hospital Questionnaire) parameters were studied.
  
  
  RESULTS
  Among the 3,975 patients studied, we observed a high prevalence of conflicts within the family and within the couple (32% vs. 21.2%). When compared with the rest of the sample, subjects reporting both type of conflicts showed a higher prevalence of psychiatric comorbidities. Hence, all data were adjusted for this parameter and for age. Family and couple conflicts were significantly associated with free floating anxiety, depression symptoms, and with a higher risk of subjective (self-reported) and objective (peak systolic velocity at the penile color Doppler ultrasound <35 mm/sec2) erectile dysfunction and hypoactive sexual desire. Female sexual function parameters, as reported by the patient, retained a significant association with both type of conflicts.
  
  
  CONCLUSIONS
  This study indicates that the presence of often unexplored issues, like conflicts within the family or within the couple, can represent an important contextual factor in the determinism of male SD.
authors.affiliation: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Boddi
authors.affiliation: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Egidia
authors.initials: E
authors.lastname: Fanni
authors.affiliation: Psychiatry Unit, Department of Neurological and Psychiatric Sciences, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Castellini
authors.affiliation: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Alessandra Daphne
authors.initials: AD
authors.lastname: Fisher
authors.affiliation: Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.affiliation: Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000328:Adult; D000368:Aged; D003220:Conflict, Psychological; D007172:Erectile Dysfunction / Q000523:psychology*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007989:Libido; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D012747:Sexual Partners / Q000523:psychology*
keywords: Conflict; Family; Sexual Dysfunction