Research Finds Direct Connection Between Sexual Dysfunction and Depression

Sexual dysfunction (SD) can best be described as disruptions in the sexual response cycle to include desire, arousal, and orgasm that cause distress. Mental health disorders, such as depression, can contribute directly toward experiences of SD in patients. However, not much research exists about whether sexual dysfunction can contribute to mental health issues, except maybe through an indirect connection. We know that SD often affects an individual’s quality of life, but what is known about a potential direct connection to mental health?

The Study

A research group in China released surveys to explore exactly this question and received responses from 5,259 male and 5,502 female respondents. The survey included general demographic questions related to family planning and general health histories. Researchers also included several sexual function- and mental health-related questionnaires:

• Patient health questionnaire-9 (PHQ-9) includes 9 questions related to the diagnostic criteria for depression according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-4). With lower scores linked to? (You list this in all other surveys so include here as well)
• International index of erectile function (IIEF-5) is used to assess erectile dysfunction and satisfaction with sexual activity. Higher scores are linked to better erectile function.
• Premature ejaculation diagnostic tool (PEDT) includes 5 questions related to ejaculation capabilities, with higher scores being linked to worse premature ejaculation symptoms.
• Female sexual function index (FSFI) consists of questions related to six domains of sexual activity (list the six domains here), with lower scores being linked to worse sexual function.

Are SD and Depression Connected?

Results of the study revealed a clear two-way connection between SD and depression. Those that scored lower on the IIEF and FSFI scales also answered higher on the PHQ-9 pointing to higher rates of depression, and this was consistent when comparing effects of depression on SD to effects of SD on depression. Researchers concluded that SD may influence depression, and vice versa. Internationally, these correlations are supported. It was also found that factors such as age, number of children, and fertility desire also influence the relationship between SD and depression, although more data is needed to understand the relationship between how and why this impacts SD and depression.  

Other Factors in Play

The research team also looked into whether an individual’s “knowledge of the effects of SD on fertility (KSDF)” influenced either depression or SD. This was because the Chinese population included in the study were less likely to have the same sexual health education opportunities as other populations might, due to cultural and social expectations. Researchers found that having less KSDF played a small role in the way men’s SD affects depression. They believe this may be because more women receive better information and resources earlier on in their reproductive age.

Men, on the other hand, were less likely to see that same support. Additionally, cultural norms may prevent men from sharing with their providers about SD and other sexual health issues they may be having.

Conclusion

Despite the sample consisting of only Chinese individuals, and the potential for self-reporting bias, researchers believe clinicians globally may be able to use this information to create shorter form educational materials geared toward men, potentially encouraging more open conversations about sexual dysfunction.

Those who believe they have SD or depression should speak with a sexual health or mental health professional.

Resources:

Ruan, L., Zhang, Y., Sheng, Y., Wu, B., Yu, H., Huang, Z., Jiang, H., Zhang, X., & Tang, D. (2025). The mediating role of sexual dysfunction knowledge in the association between sexual function and depression: A large-scale national cross-sectional study in reproductive-aged population. The Journal of Sexual Medicine, 22(6), 1053–1061. https://doi.org/10.1093/jsxmed/qdaf070