A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

Mi Wook Lee; Hyojung Park

doi:10.7475/KJAN.2013.25.5.483

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A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

Mi Wook Lee¹, Hyojung Park²

Korean Journal of Adult Nursing 2013;25(5):483-493.
Published online: October 18, 2013

DOI: https://doi.org/10.7475/KJAN.2013.25.5.483

Graduate School, Ewha Womans University, Seoul

Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Park, Hyojung Division of Nursing Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-2824, Fax: +82-2-3277-2850, E-mail: hyojungp@ewha.ac.kr

• Received: February 26, 2013 • Accepted: October 22, 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
The purpose of this study was to examine late-onset hypogonadism, erectile dysfunction, depression, and quality of life among middle-aged male workers.
Methods
The subjects included 343 men aged between 40 and 64, responded to self-report questionnaires on general characteristics, late-onset hypogonadism, erectile dysfunction, depression, and quality of life. Data were collected from May 16, 2012 to October 9, 2012 and analyzed using t-test, ANOVA, x²-test, hierarchical multiple regression.
Result
The prevalence rate of late-onset hypogonadism was 63.8% with high points in reduction of libido, energy, physical strength and endurance, and erectile function. There were significant differences in late-onset hypogonadism according to age(x²=8.98, p=.048) and in erectile dysfunction according to age(F=11.03, p<.001), monthly income(F=2.84, p=.024) and smoking(t=2.96, p=.018). Significant differences were also found in depression according to educational level(F=8.12, p<.001) and in quality of life according to monthly income(F=7.21, p<.001). The factors which influenced quality of life were late-onset hypogonadism, erectile dysfunction, depression, marital status and religion.
Conclusion
Symptoms of erectile dysfunction can be improved by smoking cessation education program. In order to improve the life quality of middle-aged men, nursing intervention programs that would both provide proper knowledge on climacteric syndrome and alleviate symptoms should be designed while, at the same time, other programs to evaluate, prevent and control depression are developed.
Key Words: Late-onset hypogonadism; Erectile dysfunction; Depression; Quality of life

Table 1.

General Characteristics (N=343

Characteristics	Categories	n (%) or M±SD
Age (year)		51.4±5.98
	40~49	163 (47.5)
	50~59	150 (43.7)
	60~64	30 (8.8)
Marital status	Single	32 (9.3)
Marital status	Married	311 (90.7)
Education	Elementary school	14 (4.1)
	Middle school	52 (15.2)
	High school	68 (19.8)
	College graduate	188 (54.8)
	Graduate school	21 (6.1)
Religion	Yes	227 (66.2)
Religion	No	116 (33.8)
Occupation	Professional	68 (19.8)
	Manager	46 (13.4)
	Office worker	147 (42.9)
	Service	32 (9.3)
	Other	50 (14.6)
Monthly income	＜100	13 (3.8)
	100~200	111 (32.4)
	200~300	117 (34.1)
	＞300	102 (29.7)
Smoking	Yes	213 (62.1)
Smoking	No	130 (37.9)
Alcohol	Yes	268 (78.1)
Alcohol	No	75 (21.9)
Exercise	Yes	109 (31.8)
Exercise	No	234 (68.2)

Table 2.

Scores for Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life (N=343)

Variable	Late-onset hypogonadism (Patients, n=219)		Late-onset hypogonadism (Controls, n=124)		Range	M±SD
	Yes	No	Yes	No
	n (%)	n (%)	n (%)	n (%)
Decrease in libido	148 (67.6)	71 (32.4)	38 (30.6)	86 (69.4)
Lack of energy	144 (65.8)	75 (34.2)	45 (36.3)	79 (63.7)
Decrease in strength and endurance	138 (63.0)	81 (37.0)	64 (51.6)	60 (47.4)
Lost height	21 (9.6)	198 (90.4)	3 (8.9)	121 (97.6)
Decrease enjoyment of life	59 (27.0)	160 (73.0)	11 (8.9)	113 (91.1)
Sad and grumpy	78 (35.6)	141 (64.4)	20 (16.1)	104 (83.9)
Erections less strong	129 (58.9)	90 (41.1)	35 (28.2)	89 (71.8)
Deterioration in your ability to play sports	60 (27.4)	159 (72.6)	14 (11.3)	110 (88.7)
Falling asleep after dinner	51 (23.3)	168 (76.7)	5 (4.0)	119 (96.0)
Deterioration in your work performance	57 (26.0)	162 (74.0)	10 (8.1)	114 (91.9)
Erectile dysfunction					5~75	44.28±11.39
Depression					0~60	18.02±5.75
Quality of life					0~130	84.48±12.25

Table 3.

Differences in Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life according to Characteristics (N=343)

Variable	Categories	Late-onset hypogonadism				Erectile dysfunction			Depression			Quality of life
Variable	Categories	Patients	Controls	x²	p	M±SD	t or F	p	M±SD	t or F	p	M±SD	t or F	p
Age (year)	40~49^a	94 (57.7)	69 (42.3)	8.98	.048	48.15±9.00	11.03	＜.001	16.80±2.16	1.79	.187	82.60±10.14	2.68	.032
	50~59^b	112 (74.7)	38 (25.3)			44.55±10.80		a, b＞c^†	18.00±2.48			83.46±11.44
	60~64^c	24 (80.0)	6 (20.0)			33.60±10.05			17.20±2.40			78.10±13.00
Marital status	Single	20 (62.5)	12 (37.5)	1.18	.341	45.15±9.45	2.28	.107	16.80±2.32	1.31	.271	83.46±5.46	2.09	.127
Marital status	Married	202 (65.0)	109 (35.0)			44.55±11.85			17.00±2.40			83.20±11.96
Education	Elementary school^a	11 (78.6)	3 (21.4)	4.89	.212	35.55±9.30	7.01	.011	14.80±2.48	8.12	＜.001	81.74±12.74	1.27	.281
	Middle school^b	41 (78.8)	11 (21.2)			41.70±11.55			16.20±2.56		a＞d, e^†	80.08±12.22
	High school^c	49 (72.1)	19 (27.9)			40.35±11.40			17.80±2.40			83.12±10.14
	College graduate^d	151 (80.3)	37 (19.7)			45.15±11.10			18.40±2.32			85.72±16.90
	Graduate school^e	16 (76.2)	5 (23.8)			50.55±9.00			20.80±2.40			83.20±12.74
Religion	Yes	179 (78.9)	48 (21.1)	0.93	.346	45.15±12.30	1.22	.320	17.00±2.48	-1.02	.393	82.42±11.70	1.01	.392
Religion	No	92 (79.3)	24 (20.7)			44.10±11.85			17.20±2.56			81.38±12.22
Occupation	Professional	42 (61.8)	26 (38.2)	6.41	.198	49.20±8.70	1.69	.199	17.00±2.48	2.01	.158	83.46±9.10	0.30	.801
	Manager	34 (73.9)	12 (26.1)			44.25±6.90			16.20±2.32			85.54±11.70
	Office worker	113 (76.9)	34 (23.1)			47.25±11.70			15.80±2.64			79.74±12.74
	Service	22 (68.8)	10 (31.2)			41.10±11.70			17.60±3.04			84.26±13.00
	Other	37 (74.0)	13 (26.0)			44.85±10.65			18.20±3.28			82.30±13.26
Monthly income	＜100^a	9 (69.2)	4 (30.8)	7.01	.051	40.35±14.10	2.84	.024	19.40±2.80	2.88	.023	79.30±13.26	7.21	＜.001
	100~200^b	84 (75.7)	27 (24.3)			42.00±12.15		a＜c, d^†	18.20±3.12			81.90±11.44		a＜d^†
	200~300^c	82 (70.1)	35 (29.9)			45.15±11.70			16.80±2.88			83.90±12.04
	＞300^d	62 (60.8)	40 (39.2)			46.05±12.00			15.80±2.40			85.68±12.74
Smoking	Yes	161 (75.6)	52 (24.4)	1.51	.327	43.95±11.85	2.96	.018	17.00±2.32	2.44	.099	84.68±13.00	-1.05	.377
Smoking	No	99 (76.2)	31 (23.8)			50.85±10.20			16.40±2.40			83.69±12.22
Alcohol	Yes	210 (78.4)	58 (21.6)	0.83	.361	44.25±12.45	0.33	.741	16.80±2.32	-1.11	.373	84.90±12.48	0.11	.908
Alcohol	No	60 (80.0)	15 (20.0)			43.10±12.10			17.40±2.72			84.64±12.74
Exercise	Yes	88 (80.7)	21 (19.3)	0.18	.690	44.10±12.15	-1.61	.201	16.80±2.40	0.12	.907	83.90±11.44	-0.38	.681
Exercise	No	181 (77.4)	53 (22.6)			45.15±12.00			17.10±2.48			84.16±11.96

†Scheffé test.

Table 4.

Differences in Erectile Dysfunction, Depression, and Quality of Life according to Late-onset Hypogonadism (N=343)

Variable	Categories	Late-onset hypogonadism		t	p
		Patients (n=219)	Controls (n=124)
		M±SD	M±SD
Erectile dysfunction		43.65±11.85	46.65±12.60	2.13	.009
Depression		19.80±5.20	16.20±5.80	-4.05	.003
Quality of life	Overall domain	82.68±17.94	87.36±18.46	6.69	＜.001
	Physical domain	28.45±5.49	30.61±5.94	7.98	＜.001
	Psychological domain	18.78±3.54	20.52±4.20	3.21	＜.001
	Social relationships domain	8.97±1.83	9.60±1.89	2.45	.008
	Environmental domain	24.96±5.20	26.48±5.68	6.81	＜.001

Table 5.

Predictors of Quality of Life (N=343)

Variables		Model 1		Model 2
Variables		β	t (p)	β	t (p)
Control	Marital status^a	.27	3.11 (＜.001)	.08	1.29 (.210)
	Religion^b	.16	2.30 (.032)	.01	0.15 (.861)
Independent	Late-onset hypogonadism			-.64	-9.93 (＜.001)
	Erectile dysfunction			-.13	-1.89 (.059)
	Depression			-.30	-3.65 (.003)
		Adjusted R²=.161, F=4.49, p=.003		Adjusted R²=.409, F=9.53, p＜.001

a=dummy coded (married=1, single=0), b=dummy coded (yes=1, none=0).

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A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

Korean J Adult Nurs. 2013;25(5):483-493. Published online October 31, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.5.483

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A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

Korean J Adult Nurs. 2013;25(5):483-493. Published online October 31, 2013

DOI: https://doi.org/10.7475/kjan.2013.25.5.483

A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

Table 1.

General Characteristics (N=343

Characteristics	Categories	n (%) or M±SD
Age (year)		51.4±5.98
	40~49	163 (47.5)
	50~59	150 (43.7)
	60~64	30 (8.8)
Marital status	Single	32 (9.3)
Marital status	Married	311 (90.7)
Education	Elementary school	14 (4.1)
	Middle school	52 (15.2)
	High school	68 (19.8)
	College graduate	188 (54.8)
	Graduate school	21 (6.1)
Religion	Yes	227 (66.2)
Religion	No	116 (33.8)
Occupation	Professional	68 (19.8)
	Manager	46 (13.4)
	Office worker	147 (42.9)
	Service	32 (9.3)
	Other	50 (14.6)
Monthly income	＜100	13 (3.8)
	100~200	111 (32.4)
	200~300	117 (34.1)
	＞300	102 (29.7)
Smoking	Yes	213 (62.1)
Smoking	No	130 (37.9)
Alcohol	Yes	268 (78.1)
Alcohol	No	75 (21.9)
Exercise	Yes	109 (31.8)
Exercise	No	234 (68.2)

Table 2.

Scores for Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life (N=343)

Variable	Late-onset hypogonadism (Patients, n=219)		Late-onset hypogonadism (Controls, n=124)		Range	M±SD
	Yes	No	Yes	No
	n (%)	n (%)	n (%)	n (%)
Decrease in libido	148 (67.6)	71 (32.4)	38 (30.6)	86 (69.4)
Lack of energy	144 (65.8)	75 (34.2)	45 (36.3)	79 (63.7)
Decrease in strength and endurance	138 (63.0)	81 (37.0)	64 (51.6)	60 (47.4)
Lost height	21 (9.6)	198 (90.4)	3 (8.9)	121 (97.6)
Decrease enjoyment of life	59 (27.0)	160 (73.0)	11 (8.9)	113 (91.1)
Sad and grumpy	78 (35.6)	141 (64.4)	20 (16.1)	104 (83.9)
Erections less strong	129 (58.9)	90 (41.1)	35 (28.2)	89 (71.8)
Deterioration in your ability to play sports	60 (27.4)	159 (72.6)	14 (11.3)	110 (88.7)
Falling asleep after dinner	51 (23.3)	168 (76.7)	5 (4.0)	119 (96.0)
Deterioration in your work performance	57 (26.0)	162 (74.0)	10 (8.1)	114 (91.9)
Erectile dysfunction					5~75	44.28±11.39
Depression					0~60	18.02±5.75
Quality of life					0~130	84.48±12.25

Table 3.

Differences in Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life according to Characteristics (N=343)

Variable	Categories	Late-onset hypogonadism				Erectile dysfunction			Depression			Quality of life
Variable	Categories	Patients	Controls	x²	p	M±SD	t or F	p	M±SD	t or F	p	M±SD	t or F	p
Age (year)	40~49^a	94 (57.7)	69 (42.3)	8.98	.048	48.15±9.00	11.03	＜.001	16.80±2.16	1.79	.187	82.60±10.14	2.68	.032
	50~59^b	112 (74.7)	38 (25.3)			44.55±10.80		a, b＞c^†	18.00±2.48			83.46±11.44
	60~64^c	24 (80.0)	6 (20.0)			33.60±10.05			17.20±2.40			78.10±13.00
Marital status	Single	20 (62.5)	12 (37.5)	1.18	.341	45.15±9.45	2.28	.107	16.80±2.32	1.31	.271	83.46±5.46	2.09	.127
Marital status	Married	202 (65.0)	109 (35.0)			44.55±11.85			17.00±2.40			83.20±11.96
Education	Elementary school^a	11 (78.6)	3 (21.4)	4.89	.212	35.55±9.30	7.01	.011	14.80±2.48	8.12	＜.001	81.74±12.74	1.27	.281
	Middle school^b	41 (78.8)	11 (21.2)			41.70±11.55			16.20±2.56		a＞d, e^†	80.08±12.22
	High school^c	49 (72.1)	19 (27.9)			40.35±11.40			17.80±2.40			83.12±10.14
	College graduate^d	151 (80.3)	37 (19.7)			45.15±11.10			18.40±2.32			85.72±16.90
	Graduate school^e	16 (76.2)	5 (23.8)			50.55±9.00			20.80±2.40			83.20±12.74
Religion	Yes	179 (78.9)	48 (21.1)	0.93	.346	45.15±12.30	1.22	.320	17.00±2.48	-1.02	.393	82.42±11.70	1.01	.392
Religion	No	92 (79.3)	24 (20.7)			44.10±11.85			17.20±2.56			81.38±12.22
Occupation	Professional	42 (61.8)	26 (38.2)	6.41	.198	49.20±8.70	1.69	.199	17.00±2.48	2.01	.158	83.46±9.10	0.30	.801
	Manager	34 (73.9)	12 (26.1)			44.25±6.90			16.20±2.32			85.54±11.70
	Office worker	113 (76.9)	34 (23.1)			47.25±11.70			15.80±2.64			79.74±12.74
	Service	22 (68.8)	10 (31.2)			41.10±11.70			17.60±3.04			84.26±13.00
	Other	37 (74.0)	13 (26.0)			44.85±10.65			18.20±3.28			82.30±13.26
Monthly income	＜100^a	9 (69.2)	4 (30.8)	7.01	.051	40.35±14.10	2.84	.024	19.40±2.80	2.88	.023	79.30±13.26	7.21	＜.001
	100~200^b	84 (75.7)	27 (24.3)			42.00±12.15		a＜c, d^†	18.20±3.12			81.90±11.44		a＜d^†
	200~300^c	82 (70.1)	35 (29.9)			45.15±11.70			16.80±2.88			83.90±12.04
	＞300^d	62 (60.8)	40 (39.2)			46.05±12.00			15.80±2.40			85.68±12.74
Smoking	Yes	161 (75.6)	52 (24.4)	1.51	.327	43.95±11.85	2.96	.018	17.00±2.32	2.44	.099	84.68±13.00	-1.05	.377
Smoking	No	99 (76.2)	31 (23.8)			50.85±10.20			16.40±2.40			83.69±12.22
Alcohol	Yes	210 (78.4)	58 (21.6)	0.83	.361	44.25±12.45	0.33	.741	16.80±2.32	-1.11	.373	84.90±12.48	0.11	.908
Alcohol	No	60 (80.0)	15 (20.0)			43.10±12.10			17.40±2.72			84.64±12.74
Exercise	Yes	88 (80.7)	21 (19.3)	0.18	.690	44.10±12.15	-1.61	.201	16.80±2.40	0.12	.907	83.90±11.44	-0.38	.681
Exercise	No	181 (77.4)	53 (22.6)			45.15±12.00			17.10±2.48			84.16±11.96

†Scheffé test.

Table 4.

Differences in Erectile Dysfunction, Depression, and Quality of Life according to Late-onset Hypogonadism (N=343)

Variable	Categories	Late-onset hypogonadism		t	p
		Patients (n=219)	Controls (n=124)
		M±SD	M±SD
Erectile dysfunction		43.65±11.85	46.65±12.60	2.13	.009
Depression		19.80±5.20	16.20±5.80	-4.05	.003
Quality of life	Overall domain	82.68±17.94	87.36±18.46	6.69	＜.001
	Physical domain	28.45±5.49	30.61±5.94	7.98	＜.001
	Psychological domain	18.78±3.54	20.52±4.20	3.21	＜.001
	Social relationships domain	8.97±1.83	9.60±1.89	2.45	.008
	Environmental domain	24.96±5.20	26.48±5.68	6.81	＜.001

Table 5.

Predictors of Quality of Life (N=343)

Variables		Model 1		Model 2
Variables		β	t (p)	β	t (p)
Control	Marital status^a	.27	3.11 (＜.001)	.08	1.29 (.210)
	Religion^b	.16	2.30 (.032)	.01	0.15 (.861)
Independent	Late-onset hypogonadism			-.64	-9.93 (＜.001)
	Erectile dysfunction			-.13	-1.89 (.059)
	Depression			-.30	-3.65 (.003)
		Adjusted R²=.161, F=4.49, p=.003		Adjusted R²=.409, F=9.53, p＜.001

a=dummy coded (married=1, single=0), b=dummy coded (yes=1, none=0).

Table 1. General Characteristics (N=343

Table 2. Scores for Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life (N=343)

Table 3. Differences in Late-onset Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life according to Characteristics (N=343)

†Scheffé test.

Table 4. Differences in Erectile Dysfunction, Depression, and Quality of Life according to Late-onset Hypogonadism (N=343)

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A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

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