Science shows erectile dysfunction is common and linked to other diseases
Recently, a group of researchers studied the prevalence of erectile dysfunction. They also assessed the evidence related to heart disease and vascular mortality.
Erectile dysfunction (ED) is the inability to maintain an erection that is firm enough to have sex. In some cases, it can be a sign of an underlying medical problem, such as high blood pressure or even obesity. In other cases, it may be linked to psychological problems, that is, low self-esteem, depression and anxiety.
Although ED is relatively common, its prevalence has been difficult to determine. As a result, the studies produce a range of very varied results. This is due to a number of reasons, mainly because the definition of erectile dysfunction is subjective for some.
A growing problem?
According to the authors, ED is a growing concern and the increase is due to several reasons, such as age is a risk factor, and the world population is continuously growing and living longer. In addition, obesity and related conditions like diabetes, which are also on the rise, are risk factors for developing erection problems.
Understanding the magnitude and scope of the condition is more important than ever. To investigate, the scientists took data from previous studies. In all, they identified 41 relevant studies that examined the prevalence and role of dysfunction in other conditions. The researchers found that prevalence rates ranged from 3% to 76.5%.
Why this difference?
The research also investigated how different methods of assessing erectile dysfunction affect outcomes. The International Index of Erectile Function is a questionnaire-based tool. Studies using this specific method found prevalence rates of 13.1 to 71.2%.
Another standard measure is a questionnaire that was originally designed for the Massachusetts Study of Aging. Articles that used this method produced a variation of 15.5 - 69.2%.
While the above two methods are the most common, some studies have used other, less common tools. Studies that used such tools produced results with the highest variance, providing lower and higher prevalence rates (3% and 76.5%).
This shows that the method researchers use can strongly influence the results. It also shows that no matter how erectile dysfunction is measured, studies come to dramatically different conclusions.
The authors further reported the results according to geographic regions:
- Europe: 10 - 76.5%
- Asia: 8 - 71.2%
- Oceania: 40.3 - 60.69%
- Africa: 24 - 58.9%
- North America: 20.7 - 57.8%
- South America: 14 - 55.2%
This disparity between regions is likely due to a wide range of influences, including environmental, genetic and lifestyle factors. In addition, cultural norms can influence whether or not an individual is comfortable reporting their erection problem.
Overall, researchers have found that the most important risk factors for ED include age, obesity, and conditions such as diabetes and depression. In addition to excessive consumption of alcohol and tobacco.
Erectile dysfunction and cardiovascular disease
When scientists looked for links between erectile dysfunction, heart and blood vessel disease, they found an abundance of evidence.
An increased prevalence and incidence of a number of conditions such as myocardial infarction and ischemic heart, high blood pressure, angina pectoris, arteriosclerosis and peripheral vascular disease have been observed.
They also found an association between ED and mortality. They said:
Men with erectile dysfunction also have an increased risk of all-cause mortality [...] as well as cardiovascular disease.
However, as the authors noted, most studies investigated were cross-sectional population, so data were taken from participants only. This means that it is not possible to eliminate cause and effect - cardiovascular disease can increase the risk of erectile dysfunction or vice versa.
The study concluded that: The global prevalence of erectile dysfunction is high and poses a significant burden on the quality of life of men and their partners. They also believe that clinicians should think about this condition in at-risk patients, as patients themselves may not provide information voluntarily.
Relationship with vascular diseases
Globally, erectile dysfunction affects around 150 million men. Of this large number of individuals, the majority have vasculogenic ED, which is thought to represent a distinct manifestation of the same systemic disease that leads to clinical cardiovascular disease (CVD).
The shared risk factors between ED and CVD, their strong association with subclinical and clinical CVD, the biological plausibility of the "artery size hypothesis" (a pathobiological basis for the predictive value of ED for CVD), and the strength of the epidemiological evidence demonstrating the value of ED for predicting CVD, makes a compelling case for its potential utility in predicting clinical CVD risk and for guiding the initiation and intensity of preventive therapy.
The plausible utility of ED in predicting risk and guiding preventive therapy has encouraged a significant push in certain clinical and research circles to systematically assess ED symptoms as part of standard clinical assessment of cardiovascular risk.
References:
- VAN HEMELRIJCK, Mieke et al. The global prevalence of erectile dysfunction: a review. BJU international, v. 124, no. 4, p. 587-599, 2019.
- ORIMOLOYE, Olusola A.; FELDMAN, David I.; BLAHA, Michael J. Erectile dysfunction links to cardiovascular disease—defining the clinical value. Trends in cardiovascular medicine, v. 29, no. 8, p. 458-465, 2019.