NSAID Use Tied to Men's Sexual Performance

Mar. 7, 2011— -- The regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with higher odds of erectile dysfunction, a cross-sectional study showed.

Over-the-counter NSAIDs include acetylsalicylic acid (Aspirin), ibuprofen (Advil) and naproxen (Aleve).

In a large healthcare system, the rate of erectile dysfunction was 35.2 percent among middle-age men who regularly took NSAIDs and 24 percent among those who did not (P<0.001), according to Dr. Steven Jacobsen, director of research at Kaiser Permanente Southern California in Los Angeles, and colleagues.

After adjustment for age, race, ethnicity, smoking, body mass index, and various comorbidities, that worked out to a 1.22-fold greater likelihood of erectile dysfunction in NSAID users, the researchers reported online in the Journal of Urology.

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"While this raises the question of the role of inflammation and COX pathways in erectile dysfunction etiology, we cannot exclude alternative explanations," they wrote.

Those alternatives included confounding by factors not captured in the study, like subclinical disease and the severity of various comorbid conditions, and the possibility that NSAID use was itself an indicator of other conditions causing erectile dysfunction.

"If it's a true association then I think that it needs to enter into discussions about the risks and benefits of using NSAIDs -- whether for prevention or treatment," Jacobsen told MedPage Today.

"But I think probably the more important thing is that [by] bringing this to men's attention, that it may actually stimulate some conversation with their care provider about, first, erectile dysfunction, and, second, about some of the other risk factors for erectile dysfunction," he said.

Jacobsen stressed that the study does not prove a cause-and-effect relationship between NSAIDs and erectile dysfunction.

"People should not stop taking these if it's been recommended by their provider," he said, "and if they are concerned about it, they really should have a discussion with their provider about those risks and benefits."