J Sex Med. 2025 May 5:qdaf070. doi: 10.1093/jsxmed/qdaf070. Online ahead of print.
ABSTRACT
BACKGROUND: Sexual dysfunction (SD) and depression are prevalent issues that significantly affect both physical and mental health.
AIM: This study aimed to explore the association between sexual function (SF) and depression in reproductive-aged population and further examine the mediating role of knowledge regarding the effect of sexual dysfunction on fertility (KSDF).
METHODS: This study enrolled a total of 10 761 participants aged 20-40 from 31 regions, including 5259 males and 5502 females, with a median age of 29.0 years. Basic demographic data were collected initially, followed by clinical data acquisition.
OUTCOMES: The International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Female Sexual Function Index-19 (FSFI-19), the Patient Health Questionnaire-9, and the Disease Knowledge Questionnaire.
RESULTS: The study revealed a significant bidirectional association between SF and depression among the population. Specifically, poorer SF was correlated with higher severity of depressive (IIEF5 [β = -0.155, P < .001], PEDT [β = 0.311, P < .001], and FSFI-19 [β = -0.059, P < .001]). Conversely, higher severity of depressive was associated with poorer SF (IIEF5 [β = -0.202, P < .001], PEDT [β = 0.249, P < .001], and FSFI-19 [β = -0.191, P < 0.001]). Furthermore, in males, the KSDF mediated the bidirectional associations between SF and depression. Specifically, the mediating proportions were as follows: KSDF mediated 3.00% of the association between IIEF5 and depression, and 2.20% of the association between PEDT and depression; similarly, for the association between depression and SF, KSDF mediated 2.50% of the association between depression and IIEF5 and 2.20% between depression and PEDT. However, no such mediation was observed in females.
CLINICAL IMPLICATIONS: This provides new insights for the clinical management of these issues in the male reproductive-aged population.
STRENGTHS AND LIMITATIONS: These findings suggest that enhancing this knowledge could interrupt bidirectional association between impaired SF and depression in this demographic, potentially alleviating both conditions without requiring additional interventions. However, cross-sectional study design does not allow us to draw corresponding causal conclusions.
CONCLUSION: The current study further demonstrated a significant bidirectional association between SF and depression among the reproductive-aged population, and importantly, the KSDF was found to mediate this association in males.
PMID:40324178 | DOI:10.1093/jsxmed/qdaf070
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