Non-steroidal anti-inflammatory drugs linked to increased risk of erectile dysfunction

Men who take non-steroidal anti-inflammatory drugs three times a day for more than three months are 2.4 times more likely to have erectile dysfunction compared to men who do not take those drugs regularly, according to a Kaiser Permanente study published online in The Journal of Urology.

While previous research showed a trend toward this same finding, this observational study used electronic health records, an automated pharmacy database and self-reported questionnaire data to examine NSAID use and ED in an ethnically diverse population of 80,966 men aged 45 to 69 years throughout California.

After controlling for age, race, ethnicity, smoking status, diabetes, hypertension, heart disease, high cholesterol and body mass index, the researchers found that ED was 1.4 times more likely -- a modest risk -- among regular NSAID users compared to men who did not take the drugs regularly. This association was consistent across all age groups.

"This study is a great example of how we work to understand the safety and effectiveness of what we recommend for our patients. We went into this study thinking we would find the opposite effect: that NSAIDs would have a protective effect because they protect against heart disease, which is also linked to ED," said study senior author Steven J. Jacobsen, MD, PhD, an epidemiologist and director of research for Kaiser Permanente Southern California. "The next step is to dive a bit deeper to understand the underlying physiology of what might be happening with these drugs."

Erectile dysfunction is a common problem in many middle-aged and elderly men. According to the National Institutes of Health, approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED on a long-term basis.

However, the researchers caution that men should not stop taking NSAIDs based on this study.

"There are many proven benefits of non steroidals in preventing heart disease and for other conditions. People shouldn't stop taking them based on this observational study. However, if a man is taking this class of drugs and has ED, it's worth a discussion with his doctor," Jacobsen said.

Study authors included: Joseph M. Gleason, MD, and Howard Jung, MD, from the Kaiser Permanente Los Angeles Medical Center; Jeffrey M. Slezak, MS; Kristi Reynolds, PhD, MPH, Reina Haque, PhD, MPH, Virginia P. Quinn, PhD, MPH, and Steven J. Jacobsen, MD, PhD, with the Kaiser Permanente Southern California Department of Research & Evaluation; Ronald K. Loo, MD, Kaiser Permanente Downey Medical Center; and Stephen K. Van Den Eeden, PhD with the Kaiser Permanente Northern California Division of Research.

The Department of Research & Evaluation (R & E) conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences, and behavioral research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women's and children's health, quality and safety, and pharmacoepidemiology. Located in Pasadena, Calif., the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit www.kp.org/research.

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.7 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.