Ruan Lewen, Zhang Yuyang, Sheng Yuying, Wu Baoyan, Yu Hui, Huang Zhenyu, Jiang Hui, Zhang Xiansheng, Tang Dongdong
Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230000, China.
NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), Hefei, 230000, China.
J Sex Med. 2025 Jun 3;22(6):1053-1061. doi: 10.1093/jsxmed/qdaf070.
Sexual dysfunction (SD) and depression are prevalent issues that significantly affect both physical and mental health.
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).
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.
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.
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.
This provides new insights for the clinical management of these issues in the male reproductive-aged population.
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.
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.
性功能障碍（SD）和抑郁症是普遍存在的问题，对身心健康均有显著影响。
本研究旨在探讨生殖年龄人群性功能（SF）与抑郁症之间的关联，并进一步检验性功能障碍对生育影响的知识（KSDF）的中介作用。
本研究共纳入来自31个地区的10761名20 - 40岁的参与者，其中男性5259名，女性5502名，中位年龄为29.0岁。首先收集基本人口统计学数据，随后获取临床数据。
国际勃起功能指数5（IIEF5）、早泄诊断工具（PEDT）、女性性功能指数 - 19（FSFI - 19）、患者健康问卷 - 9和疾病知识问卷。
研究揭示了该人群中SF与抑郁症之间存在显著的双向关联。具体而言，较差的SF与更高的抑郁严重程度相关（IIEF5[β = -0.155，P <.001]，PEDT[β = 0.311，P <.001]，FSFI - 19[β = -0.059，P <.001]）。相反，更高的抑郁严重程度与较差的SF相关（IIEF5[β = -0.202，P <.001]，PEDT[β = 0.249，P <.001]，FSFI - 19[β = -0.191，P < 0.001]）。此外在男性中，KSDF介导了SF与抑郁症之间的双向关联。具体而言，中介比例如下：KSDF介导了IIEF5与抑郁症之间关联的3.00%，以及PEDT与抑郁症之间关联的2.20%；同样，对于抑郁症与SF之间的关联，KSDF介导了抑郁症与IIEF5之间关联的2.50%，以及抑郁症与PEDT之间关联的2.20%。然而，在女性中未观察到这种中介作用。
这为男性生殖年龄人群中这些问题的临床管理提供了新的见解。
这些发现表明，增强这方面的知识可能会中断该人群中受损的SF与抑郁症之间的双向关联，有可能在无需额外干预的情况下缓解这两种情况。然而，横断面研究设计不允许我们得出相应的因果结论。
当前研究进一步证明了生殖年龄人群中SF与抑郁症之间存在显著的双向关联，重要的是，发现KSDF在男性中介导了这种关联。
