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Original Research

Open Access

Evaluation of psychogenic erectile dysfunction and fibromyalgia syndrome with risk factors

  • Sevil Karagül1,*,
  • Işıl Fazilet Kartaloğlu2

1Department of Physiotherapy and Rehabilitation, Istanbul Kent University, 34000 Istanbul, Turkey

2Department of Physical Medicine and Rehabilitation, Acıbadem University, 34000 Istanbul, Turkey

DOI: 10.22514/jomh.2025.134 Vol.21,Issue 11,November 2025 pp.45-56

Submitted: 18 August 2025 Accepted: 30 September 2025

Published: 30 November 2025

*Corresponding Author(s): Sevil Karagül E-mail: sevil.karagul@kent.edu.tr

Abstract

Background: Fibromiyalgia syndrome (FMS) leads to disability and functional limitations in daily life, along with depression and anxiety. While sexual dysfunction has been reported in female patients with fibromyalgia (FM), there are limited studies on erectile dysfunction (ED) in male patients with FM. Our aim was to investigate the frequency of FMS in patients with psychogenic ED. Methods: In this single-center, cross-sectional, controlled study, 23 young men diagnosed with psychogenic erectile dysfunction (pED) and 24 age- and body mass index (BMI)-matched healthy controls were assessed multidimensionally. Participants were screened for pain prevalence (WPI), symptom severity (SSS), fibromyalgia impact (rFIQ), mood (Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI)), sleep quality (PSQI) and International Index of Erectile Function (IIEF) using eight Turkish validity-reliability validated scales; organic erectile dysfunction was excluded by penile Doppler ultrasound and hormonal panel. Results: The prevalence of fibromyalgia syndrome (FMS) was approximately five times higher in the pED group than in the control group, and WPI, SSS, and rFIQ values were significantly higher. Multiple linear regression explained 69% of the variance in the IIEF score, with depression, SSS, and sleep disturbance being the strongest negative predictors; waist circumference made an additional but weaker contribution. Conclusions: We demonstrated that FM could be a risk factor for the occurrence of ED. It has also been shown that sleep problems, depression and anxiety are observed more frequently in ED patients.


Keywords

Psychogenic erectile dysfunction; Fibromyalgia syndrome; Sleep quality and depression


Cite and Share

Sevil Karagül,Işıl Fazilet Kartaloğlu. Evaluation of psychogenic erectile dysfunction and fibromyalgia syndrome with risk factors. Journal of Men's Health. 2025. 21(11);45-56.

References

[1] Salonia A, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, et al. European association of urology guidelines on sexual and reproductive health—2021 update: male sexual dysfunction. European Urology. 2021; 80: 333–357.

[2] McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, et al. Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the fourth international consultation on sexual medicine 2015. The Journal of Sexual Medicine. 2016; 13: 144–152.

[3] Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU International. 1999; 84: 50–56.

[4] Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nature Reviews Disease Primers. 2016; 2: 16003.

[5] Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. The American Journal of Medicine. 2007; 120: 151–157.

[6] Akkus E, Kadioglu A, Esen A, Doran S, Ergen A, Anafarta K, et al.; Turkish Erectile Dysfunction Prevalence Study Group. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. European Urology. 2002; 41: 298–304.

[7] Wang CM, Wu BR, Xiang P, Xiao J, Hu XC. Management of male erectile dysfunction: from the past to the future. Frontiers in Endocrinology. 2023; 14: 1148834.

[8] Safaei M, Maasoumi R, Mahdavi SA, Ghadirian L, Gelehkolaee KS. Reaching consensus: a scoping review on erectile disorder guidelines. Journal of Medicine and Life. 2022; 15: 1074–1080.

[9] Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. Journal of Urology. 2018; 200: 633–641.

[10] Leslie SW, Sooriyamoorthy T. Erectile dysfunction. StatPearls: Treasure Island. 2025.

[11] He W, Yang Y, Liang H, Huang Z, Jiang J. Migraine is associated with high risk of erectile dysfunction: a systematic review and cumulative analysis. The Journal of Sexual Medicine. 2022; 19: 430–440.

[12] Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men—a review of the prevalence and risk factors. Sexual Medicine Reviews. 2017; 5: 508–520.

[13] Donatucci CF, Lue TF. Erectile dysfunction in men under 40: etiology and treatment choice. International Journal of Impotence Research. 1993; 5: 97–103.

[14] Ciaccio V, Di Giacomo D. Psychological factors related to impotence as a sexual dysfunction in young men: a literature scan for noteworthy research frameworks. Clinics and Practice. 2022; 12: 501–512.

[15] Allen MS, Walter EE. Erectile dysfunction: an umbrella review of meta-analyses of risk-factors, treatment, and prevalence outcomes. The Journal of Sexual Medicine. 2019; 16: 531–541.

[16] Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, et al. AAPT diagnostic criteria for fibromyalgia. The Journal of Pain. 2019; 20: 611–628.

[17] Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nature Reviews Rheumatology. 2020; 16: 645–660.

[18] Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care & Research. 2013; 65: 786–792.

[19] Aitcheson N, Lin Z, Tynan K. Low-dose naltrexone in the treatment of fibromyalgia: a systematic review and narrative synthesis. Australian Journal of General Practice. 2023; 52: 189–195.

[20] Natalucci G, Faedda N, Baglioni V, Guidetti V. The relationship between parental care and pain in children with headache: a narrative review. Headache. 2020; 60: 1217–1224.

[21] Besiroglu H, Dursun M. The association between fibromyalgia and female sexual dysfunction: a systematic review and meta-analysis of observational studies. International Journal of Impotence Research. 2019; 31: 288–297.

[22] Ou SC, Lin MC, Lin HJ, Huang CP, Huang ST. Association between erectile dysfunction and fibromyalgia in male patients: a Taiwanese nationwide population-based cohort study. International Journal of Urology. 2020; 27: 1102–1108.

[23] Loh-Doyle JC, Stephens-Shields AJ, Rolston R, Newcomb C, Taple B, Sutcliffe S, et al. Predictors of male sexual dysfunction in urologic chronic pelvic pain syndrome (UCPPS), other chronic pain syndromes, and healthy controls in the multidisciplinary approach to the study of chronic pelvic pain (MAPP) research network. The Journal of Sexual Medicine. 2022; 19: 1804–1812.

[24] Batmaz I, Sarıyıldız MA, Dilek B, Inanır A, Demircan Z, Hatipoğlu N, et al. Sexuality of men with fibromyalgia: what are the factors that cause sexual dysfunction? Rheumatology International. 2013; 33: 1265–1270.

[25] Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL. The revised fibromyalgia impact questionnaire (FIQR): validation and psychometric properties. Arthritis Research & Therapy. 2009; 11: R120.

[26] Ediz L, Hiz O, Toprak M, Tekeoglu I, Ercan S. The validity and reliability of the Turkish version of the revised fibromyalgia impact questionnaire. Clinical Rheumatology. 2011; 30: 339–346.

[27] Beck AT, Steer RA, Garbin MG. Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clinical Psychology Review. 1988; 8: 77–100.

[28] Hisli, N. A reliability and validity study of beck depression inventory in a university. Psychology Journal. 1989; 23: 3–13. (In Turkish)

[29] Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology. 1988; 56: 893–897.

[30] Ulusoy M, Şahin N, Erkmen H. Turkish version of Beck anxiety inventory: psychometric properties. Journal of Cognitive Psychotherapy. 1998; 2: 163–172.

[31] Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989; 28: 193–213.

[32] Ağargün MY, Kara H, Anlar Ö. The validity and reliability of the pittsburgh sleep quality index. Turkish Journal of Psychology. 1996; 7: 107–115. (In Turkish)

[33] Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49: 822–830.

[34] Giurleo C, McIntyre A, Kras-Dupuis A, Wolfe DL. Addressing the elephant in the room: integrating sexual health practice in spinal cord injury rehabilitation. Disability and Rehabilitation. 2022; 44: 3245–3252.

[35] Harris RE, Sundgren PC, Craig AD, Kirshenbaum E, Sen A, Napadow V, et al. Elevated insular glutamate in fibromyalgia is associated with experimental pain. Arthritis Rheum. 2009; 60: 3146–3152.

[36] Hwang JHA, Fraser EE, Downing MG, Ponsford JL. A qualitative study on the attitudes and approaches of Australian clinicians in addressing sexuality after acquired brain injury. Disability and Rehabilitation. 2022; 44: 8294–8302.

[37] Hwang NK, Park JS, Shim SH. Occupational therapists views on addressing the sexuality of adult clients in rehabilitation settings: a qualitative focus group study. Medicine. 2023; 102: e34760.

[38] Josefsson KA, Almborg AH. Using ICF/ICHI to promote sexual health. Cogent Medicine. 2021; 8: 1911293.

[39] Kempapidis T, Heinze N, Green AK, Gomes RSM. Queer and disabled: exploring the experiences of people who identify as LGBT and live with disabilities. Disabilities. 2024; 4: 41–63.

[40] McGrath M, Low MA, Power E, McCluskey A, Lever S. Addressing sexuality among people living with chronic disease and disability: a systematic mixed methods review of knowledge, attitudes, and practices of health care professionals. Archives of Physical Medicine and Rehabilitation. 2021; 102: 999–1010.

[41] Maddox EK, Massoni SC, Hoffart CM, Takata Y. Dietary effects on pain symptoms in patients with fibromyalgia syndrome: systematic review and future directions. Nutrients. 2023; 15: 716.


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