NSAID use raises risk of erectile dysfunction

[unseennude]

Regardless of the indication, the use of non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of erectile dysfunction in middle-age and elderly men, according to a report in the Journal of Urology for May.

In determining if a particular drug causes erectile dysfunction, it is difficult to sort out the effects of the drug from those of the disease for which the drug is taken, a type of bias known as confounding by indication, lead author Dr. R. Shiri and colleagues note. Previous reports have linked arthritis to erectile dysfunction, but whether NSAIDs, which are often used to treat arthritis, caused erectile dysfunction is unclear.

"To our knowledge, there are no previous studies on the incidence of erectile dysfunction in relation to NSAID use, i.e. studies on the use of NSAIDs recorded before the occurrence of erectile dysfunction," Dr. Shiri's team, from the University of Tampere in Finland, points out.

Their study involved 1126 men, between 50 and 70 years of age, without erectile dysfunction in 1994 when they completed a questionnaire that included, among other things, questions about erectile function and medication usage. The questionnaire was then readministered 5 years later.

The erectile dysfunction rate per 1000 person-years was 93 cases among NSAID users compared with just 35 cases among nonusers. Arthritis was the most common indication for NSAID use and men with this disease the corresponding rates were 97 and 52 per 1000 person-years.

Regardless of the indication, NSAID use roughly doubled the risk of erectile dysfunction compared with nonuse. The presence of arthritis without NSAID use increased the risk by only 30%, suggesting that NSAIDs were largely to blame for the link between arthritis and erectile dysfunction.

The results suggest that "the effect of NSAIDs is not likely to be explained by confounding by indication, ie by arthritis as an indication of NSAID use," the authors conclude