Links between chronic health conditions and sexual dysfunction in men: insights from a German population-based study
- 1Institute of Sexology and Sexual Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
- 2Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
- 3Department of Urology, Charité – Universitätsmedizin Berlin, Berlin, Germany
Abstract
Background: Sexual dysfunction (SD) is common among men and significantly impacts quality of life. Chronic health conditions (CHC), particularly with comorbid mental health (MH) issues, may be associated with increased risk of SD, yet large-scale population data are limited.
Objective: This study examined the prevalence and associations of sexual problems (SP), ICD-11-defined SD, and sexual distress among men with and without CHC in a representative German sample.
Methods: From a cross-sectional online survey, data from N = 1742 cisgender men (unweighted sample size) were included in the analysis. Participants reported on CHC status (i.e., cardiovascular, urological, mental health, cancer), SP, SD, and sexual distress (SDS-DAO). Regression models assessed associations between CHC and SD. Network analyses explored interrelations between CHC subgroups and SD domains.
Results: CHC were reported by 50.8% of participants. Men with CHC had higher rates of SP (79.2%) and SD (23.2%) than those without CHC (66.7% SP, OR 1.90, 95% CI 1.52–2.37; 9.1% SD, OR 3.00, 95% CI 2.24–4.07). SD was most prevalent in men with urological disorders, cancer, pain-related, mental health and cardiovascular conditions. Among men with CHC, comorbid MH conditions were substantially associated with sexual distress (β = 3.4, 95% CI 1.3–5.4, p = .001). Regression models demonstrated strong associations between CHC, comorbid MH conditions, and SD, with network analysis revealing strong links between erectile dysfunction with hypoactive sexual desire dysfunction and delayed ejaculation dysfunction, and conditions such as urological disorders, mental health conditions, cancer and cardiovascular disease.
Conclusion: CHC, especially mental health conditions, urological disorders, cancer and cardiovascualr disease, are strongly associated with SD and sexual distress in men. Integrated care approaches that include routine sexual health screening and address mental wellbeing may thus be essential to improving outcomes for men with chronic illness.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12894-026-02416-7.
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BibTeX
@article{kronthaler2026links,
title = {{Links between chronic health conditions and sexual dysfunction in men: insights from a German population-based study}},
author = {Selina Marie Kronthaler and Carlotta Florentine Oesterling and Tatjana Tissen-Diabaté and Klaus Michael Beier and Thorsten Schlomm and Jörg Neymeyer and Laura Hatzler},
journal = {BMC Urology},
year = {2026},
month = nov,
doi = {10.1186/s12894-026-02416-7},
url = {https://doi.org/10.1186/s12894-026-02416-7},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Links between chronic health conditions and sexual dysfunction in men: insights from a German population-based study
AU - Selina Marie Kronthaler
AU - Carlotta Florentine Oesterling
AU - Tatjana Tissen-Diabaté
AU - Klaus Michael Beier
AU - Thorsten Schlomm
AU - Jörg Neymeyer
AU - Laura Hatzler
PY - 2026
DA - 2026/11/05
JO - BMC Urology
DO - 10.1186/s12894-026-02416-7
UR - https://doi.org/10.1186/s12894-026-02416-7
AB - Background: Sexual dysfunction (SD) is common among men and significantly impacts quality of life. Chronic health conditions (CHC), particularly with comorbid mental health (MH) issues, may be associated with increased risk of SD, yet large-scale population data are limited. Objective: This study examined the prevalence and associations of sexual problems (SP), ICD-11-defined SD, and sexual distress among men with and without CHC in a representative German sample. Methods: From a cross-sectional online survey, data from N = 1742 cisgender men (unweighted sample size) were included in the analysis. Participants reported on CHC status (i.e., cardiovascular, urological, mental health, cancer), SP, SD, and sexual distress (SDS-DAO). Regression models assessed associations between CHC and SD. Network analyses explored interrelations between CHC subgroups and SD domains. Results: CHC were reported by 50.8% of participants. Men with CHC had higher rates of SP (79.2%) and SD (23.2%) than those without CHC (66.7% SP, OR 1.90, 95% CI 1.52–2.37; 9.1% SD, OR 3.00, 95% CI 2.24–4.07). SD was most prevalent in men with urological disorders, cancer, pain-related, mental health and cardiovascular conditions. Among men with CHC, comorbid MH conditions were substantially associated with sexual distress (β = 3.4, 95% CI 1.3–5.4, p = .001). Regression models demonstrated strong associations between CHC, comorbid MH conditions, and SD, with network analysis revealing strong links between erectile dysfunction with hypoactive sexual desire dysfunction and delayed ejaculation dysfunction, and conditions such as urological disorders, mental health conditions, cancer and cardiovascular disease. Conclusion: CHC, especially mental health conditions, urological disorders, cancer and cardiovascualr disease, are strongly associated with SD and sexual distress in men. Integrated care approaches that include routine sexual health screening and address mental wellbeing may thus be essential to improving outcomes for men with chronic illness. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12894-026-02416-7.
SN - 1471-2490
ER -