Purpose: Increasing age has been associated with decreasing male sexual function. We evaluated the association of urogenital pain with sexual function in a community based cohort of older men.
Materials and methods: In 2000, 1,764 white men with a median age of 60 years residing in Olmsted County, Minnesota completed a questionnaire that included questions from the National Institutes of Health Chronic Prostatitis Symptom Index to evaluate urogenital pain that is ejaculatory, penile, perineal, suprapubic and testicular pain, and pain on urination. Questions from the Brief Male Sexual Function Inventory were used to evaluate 5 domains of sexual function, including sexual drive, erectile function, ejaculatory function, assessment of sexual problems and overall sexual satisfaction.
Results: Of 1,248 men who reported a regular sexual partner there were significant associations of testicular pain with impaired sexual drive (OR 2.5, 95% CI 1.4 to 4.4) and sexual satisfaction (OR 1.8, 95% CI 1.1 to 3.2) after adjustment for age. A pain score of 4 or greater was associated with impaired sexual drive (OR 1.6, 95% CI 1.0 to 2.6) and impaired ejaculatory function (OR 1.7, 95% CI 1.0 to 2.7). Men with impaired mental health and penile pain were less likely to report impaired sexual drive (OR 0.4, 95% CI 0.04 to 3.2) than men without impaired mental health and penile pain (OR 5.2, 95% CI 1.3 to 20.8, interaction p = 0.03).
Conclusions: Urogenital pain may be associated with impaired sexual function in older men. Furthermore, men with impaired mental health may be less likely to report pain associated impairment of sexual function, while the reverse may be true in the presence of comorbidity.