76: Erectile dysfunction and Viagra™ use:

Article Outline

• Purpose
• Methods
• Results
• Conclusions
• Copyright

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Purpose 

Despite a NIH call for epidemiologic investigation, there are limited data on erectile dysfunction (ED) in adolescent males. ED is associated with sexual dissatisfaction, decreased quality of life, depression, and anxiety. There are no published data on ED associated with condom use (EDwC). Anecdotal evidence suggests that teenagers use erectile dysfunction medications (EDM) recreationally, mixed with drugs or alcohol. Our study examines the prevalence and correlates of ED, EDwC, and EDM use in college-age males.

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Methods 

We distributed an anonymous, self-administered survey to a convenience sample of 302 males age 18-25 at 3 Chicago-area university campuses. Sixty-eight participants (23%) who reported no sexual activity in the last year (defined as “anal or vaginal sex”) were excluded from further analysis. We used logistic regression to conduct age-adjusted correlates of ED, EDwC, and EDM use. Effects were considered significant if p<0.05.

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Results 

Participants (N=234) were 66% white, 95% heterosexual, and had a mean age of 20.1 years (SD=1.5). Eighty-three percent had 1-5 sexual partners in the last year, 47% reported 100% condom use, and 3% had a history of a sexually transmitted infection (STI). Thirteen percent reported ED, defined as “ever had difficulty getting or keeping an erection.” Twenty-five percent reported EDwC, defined as “ever lost an erection while putting on a condom.” Only 1/29 discussed their ED with a medical provider. Participants with ED were more likely to have had a prior STI (AOR=6.4; 95% CI=1.2-34.9) and to have had more than 5 sex partners in the last year (AOR=2.7; 95%CI=1.1-6.8). Males with EDwC were more likely to use condoms inconsistently (AOR=4.3; 95% CI=2.2-8.6) and to have had more than 5 sex partners in the last year (AOR=5.3; 95% CI=2.4-11.6), making EDwC a potential barrier to safer sexual activity. Six percent (N=14) reported EDM use. Most obtained EDM from a friend (7) or other non-medical source such as the Internet (5); only 1 participant obtained EDM from a medical provider. EDM was used by 57% to treat ED and by 29% to enhance sexual performance. EDM users were more likely to have had an STI (AOR=7.0; 95%CI=1.1-45.4) and to have ED (AOR=4.5; 95% CI=1.2-13.4). Sixty-four percent of EDM users mixed these medications with other substances, including alcohol, marijuana, GHB, methamphetamine, and cocaine. These substances augment sex drive, reduce inhibitions, and diminish the ability to perform sexually. Therefore, EDM use when combined with other drugs or alcohol may permit males in altered mental/physical states to have risky sex, potentially contributing to the spread of STIs and unwanted pregnancies.

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Conclusions 

ED and EDwC are under-studied in adolescents, and our findings suggest they are rarely discussed with a medical provider. Given the association with negative health outcomes such as depression and anxiety, medical providers should ask adolescents about ED and counsel them on potential health risks involved in EDM and substance use. Providers should inquire about EDwC, stressing the importance of using condoms with all sexual encounters.