Exploring the Relationship Between Depression and Erectile Dysfunction in Aging Men

Normal sexual function is a biopsychosocial process; sexual dysfunction almost always has organicand psychological components and requires multidisciplinary, goal-directed evaluation andtreatment. Factors such as aging, declining testosterone levels, medical illness, certain medications,and comorbid depressive illness can contribute to sexual dysfunction. Erectile dysfunction is one ofthe more common male sexual dysfunctions encountered in the clinical setting. Comorbidity betweenerectile dysfunction and depressive illness is high, but the causal relationship is unclear. The psychosocialdistress that often accompanies erectile dysfunction might stimulate the development of depressiveillness, or, as some data suggest, depression might cause erectile dysfunction. This article reviewsthe literature on the relationship between depression and erectile dysfunction, as well as the design ofa new study that may provide some answers, and concludes that erectile dysfunction is a common,treatable condition that may cause or be the result of depression. Recent data suggest that sildenafil isan effective treatment for erectile dysfunction in men with comorbid depression. Erectile dysfunctionshould be considered a multifactorial condition that may require a multidisciplinary approach to treatment,especially when depression is present.