To date it is not clear to which extent a clinical, sexual dysfunction in the female partner might associate with erectile dysfunction (ED) in the male partner. The present study is aimed at the assessment of clinical features of ED associated with relational disturbances.

In a consecutive series of 1140 male subjects reporting a stable couple relationship we evaluated the impact of relational factors, as assessed by SIEDY Scale 2 (exploring, as reported by the patient, menopausal symptoms, partnerʼs medical illness interfering with sexual activity and reduced partner desire and climax). Several hormonal, bio-chemical and instrumental parameters were also studied.

We found that SIEDY Scale 2 is significantly and independently from other factors (as the organic ones) associated with ED, delayed ejaculation, hypoactive sexual desire and decreased number of intercourses. In particular, the chance of being affected by severe ED increased by 10 [1-10] % for each increment of SIEDY Scale 2 score (p<0.05). SIEDY Scale 2 scores are assoced with an advanced age of the partner and a long couple relationship (<10 years), independently from patientʼs age. In addition, an increased relational factor significantly (p<0.0001) correlates with increased extra-marital affairs (r=0.111), conflicts in the couple (r=0.279), alcohol abuse (r=0.155) and presence of depressive symptoms (r=0.182).

Our result should encourage the clinicians to consider the context in which the sexual symptom develops, analysing the relationship and partnerʼs behaviour and diseases. Ameliorating the relational background and the sexual framework might help in treating male sexual dysfunction.