Men with erectile dysfunction (ED) should be screened for depression, and men with depression should likewise be screened for ED, a new study recommends.
Researchers have found associations between depression and ED, noting that each condition may be a risk factor for the other.
The findings are based on two meta-analyses of 49 studies published through October 2017.
In the past, some studies have suggested that depression increases ED risk, while other research has found no link. The reverse might also be possible: men with ED could be at higher risk for depression.
The authors of the current paper considered both directions in their review. Overall, the studies involved over 192,000 men. Forty-four studies focused on depression exposure and ED risk. Three studies analyzed ED exposure and depression risk. And two studies looked at both angles.
The researchers determined that ED risk increased by 39% for men with depression.
In turn, depression risk increased by 192% for men with ED, who were almost three times more likely to be depressed than men without ED.
The authors noted a high degree of heterogeneity among the studies, as the papers were not uniform in their study design. Men’s ages, comorbidities, and assessment tools for ED and depression also varied among the studies.
The reasons behind the link are still unclear. It’s possible that men with depression feel less sexually confident and are prone to performance anxiety, which can result in ED. Depression’s effects on the brain might interfere with muscle relaxation in the penis. And ED is a common side effect of medications used to treat depression, the authors explained. (Note: There are antidepressants that have few or no sexual side effects.)
They added that the high heterogeneity of the studies makes it difficult to generalize the findings. Also, the results show an association, but not a cause and effect relationship.
The review was published online in June in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
Qian Liu, MPH, et al.
“Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis”
(Full-text. Published online: June 27, 2018)