Association of Type and Duration of Diabetes With Erectile Dysfunction in a Large Cohort of Men
- Constance G. Bacon, SCD12,
- Frank B. Hu, MD, PHD1,
- Edward Giovannucci, MD, SCD134,
- Dale B. Glasser, PHD5,
- Murray A. Mittleman, MD, DRPH36 and
- Eric B. Rimm, SCD134
- 1Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
- 2Department of Health and Social Behavior, Harvard School of Public Health, Boston, Massachusetts
- 3Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- 4Channing Laboratory, Department of Medicine, Brigham and Woman’s Hospital and Harvard Medical School, Boston, Massachusetts
- 5Sexual Health Team, Pfizer, New York, New York
- 6Institute for Prevention of Cardiovascular Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Abstract
OBJECTIVE—Differences in risk of erectile dysfunction (ED) by characteristics of diabetes among older men are not well understood. We examined the association of type and duration of diabetes with erectile function in men >50 years of age in a large prospective cohort study.
RESEARCH DESIGN AND METHODS—Subjects included 31,027 men aged 53–90 years in the Health Professionals Follow-Up Study cohort. On a questionnaire mailed in 2000, participants rated their ability (without treatment) in the past 5 years to have and maintain an erection sufficient for intercourse. Men who reported poor or very poor function were considered to have ED. Diabetes information was ascertained via self-report and documented with supplementary medical data.
RESULTS—Men with diabetes had an age-adjusted relative risk (RR) of 1.32 (95% CI 1.3–1.4) for having ED compared with men without diabetes. In multivariable regression analyses, men with type 1 and type 2 diabetes were at a significantly higher risk for ED (type 1 diabetes RR = 3.0, 95% CI 1.5–5.9; type 2 diabetes RR = 1.3, 1.1–1.5) than nondiabetic men. Men with type 2 diabetes had an increasingly greater risk of ED with increased duration since diagnosis (trend test P value <0.0001) (RR = 1.7, 95% CI 1.1–2.7, for men diagnosed >20 years previously).
CONCLUSIONS—For men over age 50 years, increasing duration of diabetes was positively associated with increased risk of ED relative to nondiabetic subjects. This association persisted despite the higher prevalence of other comorbid conditions. ED prevention and diabetes management efforts are likely to go hand-in-hand.
Footnotes
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Address correspondence and reprint requests to Constance G. Bacon, Harvard School of Public Health, Department of Nutrition, 665 Huntington Ave., Boston, MA 02115. E-mail: cbacon{at}hsph.harvard.edu.
Received for publication 24 September 2001 and accepted in revised form 6 May 2002.
C.G.B. has received grant support from Pfizer; D.B.G. holds stock in Pfizer; and E.B.R. has received consulting fees and grant support from Pfizer.
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