Shift Work Sleep Disorder and Night Shift Work Significantly Impair Erectile Function
Open accessAbstract
Objectives: Here we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers. Methods: Men presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5 inhibitor use, age, and comorbidities to determine the effect of SWSD on ED as assessed using the IIEF. Results: Of the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P < .01). When assessing for the type of shift work performed, men who worked night shifts had IIEF-EF scores 7.6 points lower than men who worked during the day or evening (P < .01). Testosterone use improved IIEF-EF scores for men with SWSD by 2.9 points, ameliorating the effect of SWSD on ED. However, baseline testosterone levels were not associated with worse erectile function in this cohort. Conclusion: Men with SWSD have worse erectile function, with men who work night shifts having even poorer erectile function. These findings suggest that circadian rhythm disturbance may significantly impact erectile function. While testosterone therapy may partly reverse the effects of SWSD, shift work is a potential risk factor for ED and should be assessed for as part of the evaluation of men with ED.
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Symptoms consistent with hypogonadism are common in night shiftworkers, particularly those with shiftwork sleep disorder.
“symptoms consistent with hypogonadism are common in night shiftworkers, particularly those with shiftwork sleep disorder [99–101]”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [100]
The Discussion (page unavailable) reports increased hypogonadism in people with disordered sleep and suggests that workers with shift work sleep disorder (SWSD) may be at higher risk of low testosterone. It does not establish that hypogonadal symptoms are common among night-shift workers or measure whether those symptoms are particularly common in workers with SWSD; the study’s reported outcome is erectile function. (LLM, conf=0.83)
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Cited by
Sorted by citations
Sleep, testosterone and cortisol balance, and ageing men
Liu, P. Y., & Reddy, R. T. (2022) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-022-09755-4 · Cited by 80 · see citing works
- Authors
- Rodriguez, K. M., Kohn, T. P., Kohn, J. R., Sigalos, J. T., Kirby, E. W., Pickett, S. M., Pastuszak, A. W., & Lipshultz, L. I.
- Affiliations
- Baylor College of Medicine , Houston, TX , USA
- Johns Hopkins University (US)
- University of California, Los Angeles (US)
- Baylor College of Medicine (US)
- Rice University (US)
- University of Utah (US)
- Corresponding author
- Lipshultz, Larry I.
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-07-28
- Volume
- 17
- Issue
- 9
- Pages
- 1687-1693
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- PMC
- PMC7484090
- OpenAlex
- W3046046069
- Cited by
- 54
- References
- 5
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 8 · 2023: 9 · 2022: 17 · 2021: 1 · 2020: 1
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (K08DK115835-01)
- National Institute of Diabetes and Digestive and Kidney Diseases
- Urology Care Foundation Rising Stars
- American Urological Association Urology Care Foundation
- Urology Care Foundation
- American Urological Association
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- shift work disorder, erectile dysfunction, night shift work, circadian rhythm disruption, testosterone replacement therapy, International Index of Erectile Function, male sexual health
- MeSH terms
- Shift Work Schedule, Humans, Erectile Dysfunction, Male, Penile Erection, Testosterone, Sleep Disorders, Circadian Rhythm
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