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In a comprehensive look at the association between medical conditions and erectile dysfunction (ED), researchers analyzed data from a representative sample of 1370 male participants (age range, 40–85) in the 2001–2002 National Health and Nutrition Examination Survey (NHANES). In this analysis, only complete ED (“never able to get and keep a complete erection”) was considered, to minimize ambiguity associated with definitions of less severe ED.
The overall prevalence of complete ED was 8%, but prevalence ranged from 1% in men in their 40s to 56% in men in their 80s. In multivariate analyses, complete ED was independently associated with age, obstructive urinary symptoms, diabetes, antidepressant medication, and former smoking. In hypertensive men, complete ED was associated with use of selected drugs (diuretics, β-blockers, clonidine, or methyldopa). However, complete ED was associated neither with cardiovascular disease generally nor with hypertension in men not taking the aforementioned drugs. Moderate alcohol intake (1–7 drinks/week) was associated with reduced risk for complete ED, and greater weekly alcohol intake was associated with neither increased nor decreased risk.
Francis ME et al. The contribution of common medical conditions and drug exposures to erectile dysfunction in adult males. J Urol 2007 Aug; 178:591-6.
Comment
This report supports usual thinking about some, but not all, factors thought to predispose men to ED. For example, the unexpected lack of association with cardiovascular disease or with hypertension (apart from use of certain antihypertensive drugs) perhaps reflects less severe vascular disease in this cohort compared with other cohorts. A link between obstructive urinary symptoms and ED has been described previously, but the mechanism mediating that link is unclear.