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Risk factors for erectile dysfunction among young men – findings of a real-life cross-sectional study

Pozzi, E1; Capogrosso, P1; Ventimiglia, E1; Pederzoli, F1; Boeri, L2; Cazzaniga, W1; Chierigo, F1; Frego, N1; Moretti, D1; Dehò, F1; Montanari, E2; Gaboardi, F1; Mirone, V3; Montorsi, F1Salonia, A1

1: San Raffaele Hospital, Italy; 2: University of Milan, Italy; 3: University of Naples Federico II, Italy

Objectives: Erectile dysfunction (ED) is an increasingly common complaint among young men aged less than 40 years. We aimed to assess the factors associated with an impaired erectile function (EF) in a cohort of young men seeking medical help for sexual dysfunction at a single academic center.

Materials and Methods: Complete clinical and sociodemographic data were available for 307 consecutive patients <40 yrs old referring to the andrology clinic of a single academic center for sexual dysfunction. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). All patients completed the International Index of Erectile Function (IIEF), the Beck’s Inventory for Depression (BDI) and the International Prostatic Symptom Score questionnaire (IPSS). ED severity was classified according to Cappelleri’s criteria. We compared patients with impaired EF (defined as IIEF-EF domain <26) with those reporting normal IIEF-EF scores. Mann-Whitney and Fisher’s exact tests were applied to test the differences between the two groups.

Results: Overall, 229 (75%) and 78 (25%) patients had normal and impaired EF; among patients with ED, 90 (29%) had an IIEF-EF score suggestive for severe ED (IIEF-EF<11). Patients with and without ED did not differ significantly in terms of median [IQR] age (32.0 [27.0-36.0] vs. 31.0 [24.0-36.0]), BMI (23.7 [21.9-26.1] vs. 23.4 [22.2-24.6]), prevalence of hypertension (7.5% vs. 2.6%), general health status (CCI≥1: 4.8 vs. 2.6%), smoking history (29% vs. 31%), alcohol use (88% vs. 88%) and median IPSS score (5 [2-10] vs. 4 [2-8.5]) (all p>0.2). Similarly, no differences were reported in terms of serum sex hormones and lipid profile between the two groups (all p>0.05). Of note, patients with ED reported lower median IIEF-Sexual Desire domain scores (7 [6-9] vs. 9 [8-9], p<0.01) and higher BDI scores (7.0 [3.0–13.0] vs. 5.0 [1.0 – 9.5], p=0.01) as compared with those with normal EF.

Conclusions: These findings showed that young men with ED do not differ in terms of baseline clinical characteristics from a comparable-age group with normal EF, but depicted lower sexual desire scores, clinically suggesting a more probable psychogenic cause of ED. Physicians should take this into account when assessing young men complaining of ED.


Work supported by industry: no.

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