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Original Research

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

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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

© 2013 Korean Society of Adult Nursing

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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  • 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)
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)
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)
No 130 (37.9)
Alcohol Yes 268 (78.1)
No 75 (21.9)
Exercise Yes 109 (31.8)
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
Patients Controls x2 p M±SD t or F p M±SD t or F p M±SD t or F p
Age (year) 40~49a 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
50~59b 112 (74.7) 38 (25.3)     44.55±10.80   a, b＞c† 18.00±2.48     83.46±11.44    
60~64c 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
Married 202 (65.0) 109 (35.0)     44.55±11.85     17.00±2.40     83.20±11.96    
Education Elementary schoola 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 schoolb 41 (78.8) 11 (21.2)     41.70±11.55     16.20±2.56   a＞d, e† 80.08±12.22    
High schoolc 49 (72.1) 19 (27.9)     40.35±11.40     17.80±2.40     83.12±10.14    
College graduated 151 (80.3) 37 (19.7)     45.15±11.10     18.40±2.32     85.72±16.90    
Graduate schoole 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
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 ＜100a 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
100~200b 84 (75.7) 27 (24.3)     42.00±12.15   a＜c, d† 18.20±3.12     81.90±11.44   a＜d†
200~300c 82 (70.1) 35 (29.9)     45.15±11.70     16.80±2.88     83.90±12.04    
＞300d 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
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
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
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
β t (p) β t (p)
Control Marital statusa .27 3.11 (＜.001) .08 1.29 (.210)
  Religionb .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
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    A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker
    A Study on Late-onset of Hypogonadism, Erectile Dysfunction, Depression, and Quality of Life among Middle-aged Male Worker

    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)
    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)
    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)
    No 130 (37.9)
    Alcohol Yes 268 (78.1)
    No 75 (21.9)
    Exercise Yes 109 (31.8)
    No 234 (68.2)

    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

    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
    Patients Controls x2 p M±SD t or F p M±SD t or F p M±SD t or F p
    Age (year) 40~49a 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
    50~59b 112 (74.7) 38 (25.3)     44.55±10.80   a, b＞c† 18.00±2.48     83.46±11.44    
    60~64c 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
    Married 202 (65.0) 109 (35.0)     44.55±11.85     17.00±2.40     83.20±11.96    
    Education Elementary schoola 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 schoolb 41 (78.8) 11 (21.2)     41.70±11.55     16.20±2.56   a＞d, e† 80.08±12.22    
    High schoolc 49 (72.1) 19 (27.9)     40.35±11.40     17.80±2.40     83.12±10.14    
    College graduated 151 (80.3) 37 (19.7)     45.15±11.10     18.40±2.32     85.72±16.90    
    Graduate schoole 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
    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 ＜100a 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
    100~200b 84 (75.7) 27 (24.3)     42.00±12.15   a＜c, d† 18.20±3.12     81.90±11.44   a＜d†
    200~300c 82 (70.1) 35 (29.9)     45.15±11.70     16.80±2.88     83.90±12.04    
    ＞300d 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
    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
    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
    No 181 (77.4) 53 (22.6)     45.15±12.00     17.10±2.48     84.16±11.96    

    †Scheffé test.

    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

    Predictors of Quality of Life (N=343)

    Variables   Model 1 Model 2
    β t (p) β t (p)
    Control Marital statusa .27 3.11 (＜.001) .08 1.29 (.210)
      Religionb .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)

    Table 5. Predictors of Quality of Life (N=343)

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

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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