Self-concept and erectile dysfunction in 45-year-old men : Results of acorollary study of the PROBASE trial

Abstract

Self-concept consists of self-perceptions and is influenced by the life course of the person. This study investigated associations between self-concept and erectile dysfunction (ED) in 45-year-old German men. Forty-five-year-old, heterosexual men who had participated in the PROBASE-study were included. Erectile Function was evaluated using the International Index of Erectile Function (IIEF-6). The presence of ED was defined by IIEF-6 score ≤25. Self-concept was assessed using the facets "body image" (threeitems from the Dresden Body Image Inventory, DKB-35), "perception of masculinity" (threeitems from the Male Role Norms Scale, MRNS), "perceived social pressure with regard to sexual performance" (fournewly constructed items), and "sexual self-esteem" (threenewly constructed items). Scores for these facets of self-concept can range from1 to5. Higher scores indicate amore positive body image, higher sexual self-esteem, amore modern understanding of masculinity, and greater perceived social pressure. Differences in self-concept between men with ED and without ED were analyzed using the Mann-Whitney-U-test. Furthermore, Cohen'sd effect sizes (ESd) were calculated. The responses of 3143 men were analyzed. Men with ED (16.2 %) have significantly lower scores regarding body image (mean3.6 ±0.6 vs 3.8 ±0.5; p <0.001; ESd= -0.5), perception of masculinity (mean3.4 ±0.7 vs 3.7 ±0.6; p <0.001; ESd= -0.4), and sexual self-esteem (mean3.6 ±0.6 vs 3.9 ±0.5; p <0.001, ESd= -0.4) than men without ED. Furthermore, they had significantly higher scores for perceived social pressure (mean2.1 ±0.7 vs 1.5 ±0.5; p <0.001; ESd= 1.2). Self-concept and ED are associated in 45-year-old men. Men with ED have a more negative body image, a more traditional understanding of masculinity, more negative sexual self-esteem, and greater perceived social pressure with regard to sexual performance than men without ED.