Globally, erectile dysfunction affects a significant percentage of men. A recent industry-funded study takes data from eight countries and asks whether the condition might reduce productivity at work.
Doctors define erectile dysfunction (ED) as an inability to achieve or maintain an erection that is sufficient for sex.
Although calculating its prevalence is challenging, ED is estimated to impact more than half of men aged 40–70.
Worryingly, it appears to be growing more common. According to one study, in 1995, ED affected 152 million men, globally. By 2025, the study authors predict that this figure will more than double to 322 million.
As ED becomes more common, researchers are keen to understand how it might affect the population at large.
The authors of the most recent study to investigate this issue focused on "work productivity loss, activity impairment, and health‐related quality of life."
Their study took data from eight countries: Brazil, China, France, Germany, Italy, Spain, the United Kingdom, and the United States. The researchers recently published their findings in The International Journal of Clinical Practice.
ED beyond the bedroom
Earlier studies have shown that ED can negatively impact the quality of life, but few have addressed ED's effect on work productivity, globally.
Although scientists in various countries have looked at these questions, the studies are difficult to compare. This is primarily because researchers use different methods to assess ED and the quality of life. The authors of the current study set out to produce a more "robust, consistent approach."
To investigate, the authors used questionnaire data from 52,697 men aged 40–70. The questionnaires included questions about symptoms of ED over the past 6 months, impairment of work and other activities, and self-reported quality of life.
The surveys also recorded information about a range of factors, including age, household income, employment, marital status, level of education, general health, body mass index (BMI), tobacco and alcohol use, and other health issues.
Work productivity was assessed with a questionnaire that covered, among other things, absenteeism and presenteeism (working when impaired by ill health).
Across all countries, ED affected 49.7% of participants. Prevalence varied from 45.2% in the United Kingdom to 54.7% in Italy.
The demographics of ED
Men with ED were more likely to be obese, smoke tobacco, drink alcohol excessively, and not exercise; they were also more likely to have other medical conditions. All of these variables have the potential to reduce productivity at work, so the researchers accounted for them in their analysis.
As expected, even after taking the above variables into account, ED significantly impacted work productivity. The authors write:
"After controlling for covariates, men with ED (versus no ED) had significantly greater impairment in the U.S. (2.11 times as much overall work productivity impairment)."
They found the most considerable impairment in the U.K., with 2.66 times as much impairment to productivity than those without ED.
Across all regions, men with ED had lost more time at work due to illness over the past 7 days than men without ED (7.1% versus 3.2%). It was a similar story for presenteeism (22.5% versus 10.1%). The authors summarize:
"Absenteeism, presenteeism, overall work productivity loss, and activity impairment were more than twofold higher in men with ED than men with no ED."
Also, as previous studies have concluded, quality of life scores were lower for individuals with ED than those without it, across all regions.
"This study shows that ED remains a prevalent concern, one that impacts work productivity and absenteeism."
Co-author Wing Yu Tang
Senior author Tarek Hassan adds, "Stemming from eight countries, the global coverage of the data also suggests that this issue is pervasive across geographies."
Questioning the findings
The study does have significant limitations, though. Firstly, questionnaire data can be unreliable; for instance, people may misreport how much time they have taken off work, either accidentally or due to perceived cultural expectations.
Also, in this study, researchers evaluated ED with a 5-point scale, rather than a medical assessment. The scale gave a way to respond to questions about ED symptoms — it ran from 1 (not at all) to 5 (a great deal).
Individuals who scored themselves 2–5 were classed as having ED. It could be argued that individuals who scored a 2, for instance, might not meet the threshold for medical classification of ED.
Although the scientists accounted for a range of variables in their analysis, because their study is cross-sectional, they cannot conclude that ED caused a drop in work productivity.
Also, other variables that the researchers did not include in their analysis could have influenced the results.
It is worth noting that this study was supported by Pfizer, which produces the original ED drug — Viagra. The two authors quoted above are employees of Pfizer, and three other authors of the paper were paid consultants for Pfizer at the time of the study.
Despite the limitations, this is a vital area of study. As ED becomes more prevalent, it is important to understand its impact on all facets of an individual's life and society at large.