Erectile Dysfunction and Treatment: An Analysis of Associated Chronic Health Conditions - Beyond the Abstract

Erectile dysfunction (ED) is a common health condition that has steadily increased in incidence within the United States. In addition to impacting a man’s quality of life and self-perception, it can be an important indication of other underlying health concerns. As chronic diseases such as diabetes, atherosclerosis, and hypertension often have similar pathophysiology to ED. Because ED often holds a social stigma, patients will delay in seeking treatment from healthcare professionals. This is concerning as ED diagnosis in the clinical setting could allow for earlier detection of comorbid conditions. Our study found that a diagnosis of ED was strongly associated with the concomitant diagnoses of depression, hypertension, diabetes, as indicated by prior studies. It was also associated with several autoimmune diseases, which is a lesser-known association.

The increase of ED in men with associated autoimmune disorders could hypothetically be due to common pathophysiology regarding an increase in systemic estrogens. Men diagnosed with ED often have increased serum estradiol when controlling for other factors such as serum testosterone, BMI, age, and smoking. Estrogen is known for its ability to regulate and class switch antibody expression, which is why women are typically predisposed to autoimmune disorders. Men receiving treatment for ED were also commonly associated with autoimmune disorders. A diagnosis of autoimmune disease and the required close follow-up with specialized healthcare providers could be a reason why men treated for ED were also found to have a related diagnosis of an autoimmune disorder. This subset of patients may be more likely to bring up ED symptoms to healthcare providers with a longitudinal relationship. Further prospective research is needed to identify causal relationships that may be contributing to the associations observed and treatment options that can be added or modified to improve treatments for men with ED.

Written by: 

  • Lindsey N. Wright, BS, University of Utah School of Medicine, Salt Lake City, UT
Senior Authors:

  • Jim Hotaling, MD, MS, FECSM, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT
  • Alexander W. Pastuszak, MD, PhD, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT

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