title: Regular nonsteroidal anti-inflammatory drug use and erectile dysfunction.
abstract: OBJECTIVE
  Previous data suggest a potential relationship between inflammation and erectile dysfunction. If it is causal, nonsteroidal anti-inflammatory drug use should be inversely associated with erectile dysfunction. To this end we examined the association between nonsteroidal anti-inflammatory drug use and erectile dysfunction in a large, ethnically diverse cohort of men enrolled in the California Men's Health Study.
  
  
  METHODS
  This prospective cohort study enrolled male members of the Kaiser Permanente managed care plans who were 45 to 69 years old beginning in 2002. Erectile dysfunction was assessed by questionnaire. Nonsteroidal anti-inflammatory drug exposure was determined by automated pharmacy data and self-reported use.
  
  
  RESULTS
  Of the 80,966 men in this study 47.4% were considered nonsteroidal anti-inflammatory drug users based on the definitions used and 29.3% reported moderate or severe erectile dysfunction. Nonsteroidal anti-inflammatory drug use and erectile dysfunction strongly correlated with age with regular drug use increasing from 34.5% in men at ages 45 to 49 years to 54.7% in men 60 to 69 years old with erectile dysfunction increasing from 13% to 42%. The unadjusted OR for the association of nonsteroidal anti-inflammatory drugs and erectile dysfunction was 2.40 (95% CI 2.27, 2.53). With adjustment for age, race/ethnicity, smoking status, diabetes mellitus, hypertension, hyperlipidemia, peripheral vascular disease, coronary artery disease and body mass index, a positive association persisted (adjusted OR 1.38). The association persisted when using a stricter definition of nonsteroidal anti-inflammatory drug exposure.
  
  
  CONCLUSIONS
  These data suggest that regular nonsteroidal anti-inflammatory drug use is associated with erectile dysfunction beyond what would be expected due to age and comorbidity.
authors.affiliation: Department of Urology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Gleason
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Slezak
authors.forename: Howard
authors.initials: H
authors.lastname: Jung
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van den Eeden
authors.forename: Reina
authors.initials: R
authors.lastname: Haque
authors.forename: Virginia P
authors.initials: VP
authors.lastname: Quinn
authors.forename: Ronald K
authors.initials: RK
authors.lastname: Loo
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal