Up to half of men under 50 suffer from erectile dysfunction

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ErectileUp to half of men under the age of 50 are suffering from erectile dysfunction as impotence rates have more than doubled in the last 25 years, The Independent reports a study has found. Scientists have warned that the condition is becoming alarmingly common for men under 50 but said it could help identify those most at risk of heart attacks, strokes or premature death.

Erectile dysfunction can be an early warning sign of high blood pressure or cholesterol and diabetes. Impotence has also been linked with increased risks of cardiovascular disease (CVD), dementia and early death.

Anna Kessler, the first author of the study, is quoted in the report as saying physicians should consider screening for erectile dysfunction because men may not want to voluntary offer the information themselves. “Due to the sensitive nature of the topic, physicians should consider screening for erectile dysfunction in at-risk patients, as information may not be volunteered,” she said.

Kessler, a urologist at King’s College London, added that “young men aged under 40 years had an exceptionally high prevalence of erectile dysfunction.”

The report says her team pooled data from dozens of studies involving tens of thousands of participants, from teenagers to adults in their 80s, across the world. Up to 50% of under 50s were affected, with one study of under 40s in Brazil finding the condition was more common in 18 to 25 year olds (35.6%) than those aged 26 to 40 (30.7%).

The report says as erections depend on a healthy blood flow to the penis, erectile dysfunction can be linked to serious illnesses. The risk of death from CVD rose 43% among men with erectile dysfunction and those with the condition were 68% more likely to develop dementia.

It is estimated 322m men worldwide will be affected by 2025, an increase from 152m men in 1995.

The report says Kessler also noted the impact on quality of life for men with the condition and their partners. “Partners of men with erectile dysfunction experience lower sexual satisfaction, correlated to the degree of erectile dysfunction in their partner,” she said. “The global prevalence of erectile dysfunction is high and represents a significant burden on the quality of life of men and their partners.”

The report says the study follows a survey of young British men that found six in ten avoided sex because of “performance anxiety”. Around 11.7m men in the UK said they struggled with sex, with one in eight experiencing problems every time, according to the research.

In 2017, it was revealed the number of prescriptions for Viagra and other erectile dysfunction drugs containing the active ingredient sildenafil had tripled in Britain in a decade.

Abstract
Objective: To evaluate the global prevalence of erectile dysfunction (ED); as well as its association with physiological and pathological ageing by examining the relationship between ED and cardiovascular disease (CVD), benign prostatic hyperplasia (BPH), and dementia. We also aimed to characterise discrepancies caused by the use of different ED screening tools.
Methods: The Excerpta Medica dataBASE (EMBASE) and Medical Literature Analysis and Retrieval System Online (MEDLINE) were searched to find population‐based studies investigating the prevalence of ED and the association between ED and CVD, BPH, and dementia in the general population.
Results: The global prevalence of ED was 3–76.5%. ED was associated with increasing age. Use of the International Index of Erectile Function (IIEF) and Massachusetts Male Aging Study (MMAS)‐derived questionnaire identified a high prevalence of ED in young men. ED was positively associated with CVD. Men with ED have an increased risk of all‐cause mortality odds ratio (OR) 1.26 (95% confidence interval [CI] 1.01–1.57), as well as CVD mortality OR 1.43 (95% CI 1.00–2.05). Men with ED are 1.33–6.24‐times more likely to have BPH then men without ED, and 1.68‐times more likely to develop dementia than men without ED.
Conclusion: ED screening tools in population‐based studies are a major source of discrepancy. Non‐validated questionnaires may be less sensitive than the IIEF and MMAS‐derived questionnaire. ED constitutes a large burden on society given its high prevalence and impact on quality of life, and is also a risk factor for CVD, dementia, and all‐cause mortality.

Authors
Anna Kessler, Sam Sollie, Ben Challacombe, Karen Briggs, Mieke Van Hemelrijck

The Independent report
BJU International abstract


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