Psychobiological correlates of extramarital affairs and differences between stable and occasional infidelity among men with sexual dysfunctions.

Introduction: The relationship between extramarital affairs and male sexual dysfunctions (SDs) has not been completely clarified.

Aim: The aim of the present study is to describe how the reported presence of extramarital affairs vs. no report differentiates men attending medical care for SDs.

Methods: A nonselected series of 2,592 heterosexual (mean age 55 +/- 12.5 years) male patients with SD was studied with Structured Interview on Erectile Dysfunction (SIEDY). Furthermore, a complete physical examination and a series of biochemical, hormonal, and penile vascular evaluations were performed.

Main Outcome Measures: Several hormonal, biochemical, and instrumental parameters were investigated along with items derived from SIEDY.

Results: Infidelity is associated with relational problems within the primary couple, particularly in those with a stable secondary relationship. Furthermore, a higher androgenization is present in men with infidelity. Patients with SD reporting extramarital affairs had higher stress at work, a longer primary relationship span, and higher risk of conflicts within the primal couple and within the family. In addition, infidel men showed a higher risk of partner's illness and partner's hypoactive sexual desire. Among organic factors, a lower prevalence of hypogonadism was observed in infidel men. These subjects showed a better sexual function than the rest of the sample. In addition, they reported a higher intercourse frequency in the previous 3 months (considering both the primary and secondary relationship), a lower prevalence of hypoactive sexual desire (HSD), and a lower feeling of discomfort or guilt about autoerotism. Finally, when SIEDY scales were considered, SIEDY Scale 2 (relational domain) and Scale 3 (intrapsychic domain) scores were significantly higher in infidel subjects when compared with the rest of the sample.

Conclusions: Infidelity is associated with relational problems within the primary couple, particularly in those with a stable secondary relationship. Furthermore, a higher androgenization is present in men who commit infidelity.