title: The contribution of common medical conditions and drug exposures to erectile dysfunction in adult males.
abstract: OBJECTIVE
  We examined the association of prevalent erectile dysfunction and coexisting medical conditions in United States men taking into account age and drug exposures.
  
  
  METHODS
  Men older than 40 years who participated in the 2001 to 2002 National Health and Nutrition Examination Survey were asked to report on erectile function. Men who were never able to achieve an erection sufficient for intercourse were defined as having complete erectile dysfunction. Adjusted odds ratios for complete erectile dysfunction prevalence in men with a coexisting condition compared to those without the condition were calculated. Age, race/ethnicity, urinary symptoms, cardiovascular disease, diabetes, hypertension with and without selected antihypertensive therapy (mainly beta blockers and thiazide diuretics), selected antidepressant therapy (mainly, tricyclics and selective serotonin reuptake inhibitors), smoking and alcohol were included in all statistical models.
  
  
  RESULTS
  Of United States men 8% (95% CI 6.0-10.2) reported complete erectile dysfunction. In multivariate analyses, obstructive urinary symptoms (OR 2.0, 95% CI 1.2-3.4), diabetes (OR 2.6, 95% CI 1.3-5.2), hypertension with selected antihypertensive therapy (OR 3.0, 95% CI 1.6-5.9), and selected antidepressant therapy (OR 5.2, 95% CI 1.7-15.9), increased the odds of complete erectile dysfunction prevalence, whereas presence of cardiovascular disease, urinary incontinence and hypertension without selected antihypertensive therapy did not.
  
  
  CONCLUSIONS
  Obstructive urinary symptoms, diabetes, hypertension treated with selected medications, and selected antidepressant drug use are independently associated with increased erectile dysfunction risk in United States men. Physicians should carefully consider the potential impact of these medications and comorbid conditions when discussing sexual function with their male patients.
authors.affiliation: Social & Scientific Systems Inc., Silver Spring, Maryland 20910, USA. mfrancis@s-3.com
authors.forename: Mildred E
authors.initials: ME
authors.lastname: Francis
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Leroy M
authors.initials: LM
authors.lastname: Nyberg
authors.forename: Paul W
authors.initials: PW
authors.lastname: Eggers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012907:Smoking / Q000009:adverse effects; D016055:Urinary Retention / Q000150:complications / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents; D000959:Antihypertensive Agents