The more medications a man is on, the higher is his risk of developing erectile dysfunction, also known as impotence, researchers from Kaiser Permanente reported in the British Journal of Urology International. Not only is the risk of ED (erectile dysfunction) greater, but also the condition’s severity.

Lead author, Diana C. Londoño, MD., said that she and her team found that ED severity was more likely to be higher among the study participants on the most drugs. Their survey, part of the California Men’s Health Study, included 37,712 adult males aged from 46 to 69. They were from a wide range of ethnic and cultural backgrounds.

Londoño and team gathered data on medication usage from pharmacy records between 2002 and 2003. They concentrated on adult male patients who were on over three medications. They analyzed survey responses regarding ED to quantify severity and prevalence.

29% of the men surveyed reported moderate or severe erectile dysfunction. They linked ED to the number of medications used, as well as older age, higher BMI (body mass index), depression, smoking status, high blood pressure (hypertension), diabetes and high cholesterol. Even after taking these ED risk factors into account, the link between multiple drugs and ED prevailed.

Dr. Londoño said:

“Clinically, the findings from this study suggest that a crucial step in the evaluation of ED would be to review the current medications the patient is taking and their potential side effects. When appropriate, decreases or changes in the amount of or type of medication should be considered.”

As the number of medications increased, so did the prevalence of ED, the authors reported – across all age groups:

  • Medications taken: 0 to 2. Number of participants 16,126.
    Proportion with moderate ED – 15.9%
  • Medications taken: 3 to 5. Number of participants 10,046.
    Proportion with moderate ED – 19.7%
  • Medications taken: 6 to 9. Number of participants 6,870.
    Proportion with moderate ED – 25.5%
  • Medications taken: 10 or more. Number of participants 4,670.
    Proportion with moderate ED – 30.9%

The following drugs are most commonly linked to ED:

  • Antihypertensive drugs, such as thiazides, beta blockers, and clonidine.
  • Psychogenic drugs, such as SRRIs (selective serotonin reuptake inhibitors), tricyclic antidepressants, monoamine oxidase inhibitors, and lithium
  • Any medication that is able to interfere with testosterone pathways

57% of the men in the survey were on more than three different drugs. The older the participants, the more likely they were to be on over three medications.

Percentage of men on more than three medications according to age:

  • 50 to 59 years – 53%
  • 60 to 70 years – 66%

Of those on more than three medications, 73% had a BMI of over 35 (obese).

25% of the men were on at least ten drugs.

ED is a condition that affects a considerable number of adult males globally. According to prior studies, approximately 35% of males over 60 years of age live with ED.

The authors explained that ED can have many different causes, including:

In most of the causes, levels of nitric oxide drop. Nitric oxide is the main neurotransmitter that starts an erection, and maintains one.

Michael Kanter, medical director of Quality & Clinical Analysis for Kaiser Permanente Southern California, said:

“This study highlights that while physicians still need to treat patients with medications when indicated, they should be aware that erectile dysfunction may occur.”

In an Abstract in the journal, the authors concluded:

“These data suggest that the number of medications a man takes is associated with worse ED, even after comorbidities have been taken into account.”

Written by Christian Nordqvist