ED is dynamic, associated with modifiable risk factors that may precede other chronic diseases

Several modifiable risk factors for erectile dysfunction, including obesity, physical activity, and alcohol intake, were identified by a recent Australian study.

Researchers surveyed 810 Australian men ages 35 to 80 during clinic visits 5 years apart. Erectile function, sexual desire, and sociodemographic, lifestyle, and health-related factors were examined. Results were published in the May Journal of Sexual Medicine. At baseline, 23.2% of the men had erectile dysfunction (ED), 19.2% had low solitary sexual desire, and 6.0% had low dyadic sexual desire. All 3 issues were found to be dynamic: For example, by the end of follow-up, ED had occurred in 31.7% of studied men, but remission was observed in 29%.

The researchers found several predictors of incident ED, including older age, lower income, higher abdominal fat mass, low alcohol intake, higher obstructive sleep apnea risk, voiding lower urinary tract symptoms (LUTS), depression, and diabetes. Age is a particularly significant factor. For every 10.6-year increase in age, the risk of ED incidence increases more than 2-fold, the researchers noted. Predictors of remission included younger age, current employment, absence of voiding LUTS, depression, and diabetes.

Incidence of low sexual desire was predicted by insufficient physical activity and low alcohol intake, along with not being married and socioeconomic factors. Remission was more likely in patients who had lower abdominal fat and higher physical activity, among other factors, leading researchers to conclude that some risk factors for these problems are remediable with lifestyle changes.

The finding of an association between lower income and ED risk correlates with previous findings of more cardiovascular disease in patients of lower socioeconomic status, the researchers noted. Similarly, associations with angina and diabetes fit with current understandings of the effect of cardiovascular health on erectile function, the researchers wrote. The finding of a protective effect from moderate alcohol consumption also fits with prior research, they noted.

The study also shows that “ED and low sexual desire may precede the development of many of these abnormalities and should be considered sentinel markers of chronic disease,” the authors concluded.