Mechanism of Sexual Dysfunction in Alcohol Dependence: A Pudendal Somatosensory Evoked Potential Study

Cheon, Jin Sook

Abstract

Sexual disturbances had been experienced in 8-63% of male alcoholics. The possible etiologies of the sexual problems hi alcoholics had been known to be hormonal rather than, neuropathic or psychosocial. The aims of this study were to identify the prevalence and the mechanism of sexual disorders in alcohol dependence. The sexual complaints were found in male inpatients with alcohol dependence(n=28) using the screening and diagnostic questionnaires for sexual problems, and then took blood samples to test for liver function, lipid metabolism, anemia and diabetes, and questionnaires for depression. We also measured serum testosterone levels by radioimmunoassay. The pudendal SEPs were measured by the following procedures, in which we stimulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity ; three tomes of threshold, stimulus rate 1-4.7Hz, stimulus duration 0.1 or 0.2msec), and recorded at the scalp(active electrode ; 2cm behind Cz, reference electrode ; Fz) . The results were as follows : 1) Subjective complaints of sexual dysfunction were low desire 53.6%, disorders of excitement or orgasm 42.9%(impotence 25.0%, premature ejaculation 17.9%). 2) Serum testosterone concentrations were not changed, even though reduced in 40% of alcoholics. 3) P1 and N1 latencies of pudendal SEPs in alcoholics were significantly delayed(p<0.05), and showed no response(39.3%) or delayed response(60.7%). 4) Otherwise, vascular or hepatic factors should be considered. In conclusion, chronic alcoholics might be suffered from subclinical sexual problems. The mechanism of sexual dysfunctions seemed to be originated from the neuropathic factors rather than hormonal or psychosocial ones.