A new study indicates a high prevalence of erectile dysfunction (ED) and evidence of recreational use of erectile dysfunction medications (EDM) among adolescents and young men.

Researchers at Children’s Memorial Hospital and Northwestern University’s Feinberg School of Medicine conducted an anonymous survey of 234 sexually active males between the ages of 18-25 on the campuses of three national universities in Chicago. This survey -  the first of its kind -  found that a significant number of surveyed young men had used erectile dysfunction medications (EDM) such as Viagra™  -  many in conjunction with other recreational drugs, and most without consulting their physician.

Often associated with sexual dissatisfaction, decreased quality of life, depression and anxiety, ED has rarely been studied in adolescent males. This first study to gauge ED occurring with condom use (EDwC) indicates that men who have experienced ED while putting on a condom are four times more likely to use condoms inconsistently.

Thirteen percent of the respondents reported ED, defined as “ever had difficulty getting or keeping an erection,” but rarely discussed this with their medical providers. Twenty-five percent reported ED occurring with condom use. “Our exploratory study examines the prevalence and correlates of ED, EDwC and EDM use in a community-based sample of college-age males,” said Najah Musacchio, MD, fellow in General Academic Pediatrics and lead investigator. “Participants with EDwC were 4 times more likely to use condoms inconsistently, and 5 times more likely to have multiple sex partners in the last year, suggesting that EDwC may represent a barrier to safer sex and play a role in STI transmission,” said Robert Garofalo, Director of Adolescent HIV Services.

A total of 302 college-age males completed a self-administered survey. Oral consent was obtained before survey administration. Sixty-eight participants (23%) reported no anal/vaginal sex in the past year and were excluded from analysis. Participants were predominantly white (66%), ages 18-20 (64%) and heterosexual (95%). Most (83%) had one to five sexual partners in the past year and 47% reported 100% condom use for anal/vaginal sex. Six participants (3%) had a prior STI, five of whom were men who have sex with men (MSM).

Six percent of surveyed men used EDM. Fifty-seven percent of participants who took EDM used them to treat ED; 29% used them to enhance sexual performance. Sixty-four percent of EDM users mixed EDM with alcohol or illicit drugs; 36% with multiple other drugs. “Particularly concerning is mixing Viagra™ and other EDM with alcohol and drugs, such as ecstasy or methamphetamine,” said Musacchio. “Such drugs boost sex drive and reduce inhibitions, yet impair sexual performance. EDM use may permit men in altered mental and physical states to engage in unsafe sexual behaviors, creating concern for unwanted pregnancy and sexually transmitted infections (STI).”

Survey participants rarely obtained their EDM from a medical provider: most (54%) got EDM from their friends or other non-medical sources (39%) such as the Internet.

In studies with adult men who have sex with men (MSM), Viagra™ use has similarly been associated with risky sex (increased number of sex partners, higher rates of STIs, and unprotected sex with HIV-positive partners). “Although small in number, the young MSM in our sample reported disproportionate EDM use and STIs, possibly warranting exploration of these issues in this adolescent subpopulation,” said Musacchio.

Survey findings suggest that ED and EDwC occur with some frequency in adolescents, and that these issues are rarely discussed with medical providers. Given the association between ED and negative health outcomes such as depression and sexual dissatisfaction, medical providers should ask adolescent males about ED and counsel them on potential health risks of EDM and substance use, they advised. Providers should specifically inquire about EDwC, stressing the importance of using condoms with all sexual encounters.

“The topic must be addressed,” Musacchio said. “Data indicates that ED and EDM use is not uncommon in young males. It should be openly discussed in the medical community and between provider and patient -  especially since it can lead to unsafe sex and other health risks.”

Najah Senno Musacchio, MD, is a Fellow in General Academic Pediatrics at Children’s Memorial Hospital in Chicago, Ill.

Robert Garofalo, MD, MPH, is the Director of Adolescent HIV Services at Children’s Memorial Hospital in Chicago, Illinois. He is also an Attending in Adolescent Medicine in the Department of General Academic Pediatrics at Children’s Memorial Hospital.

The largest pediatric hospital in Illinois, Children’s Memorial Hospital provides specialists in every known pediatric specialty. As the educational facility for Northwestern University’s Feinberg School of Medicine, these physicians see more than 102,000 patients a year.

US News & World Report ranks Children’s Memorial among the nation’s top pediatric hospitals, and Chicago magazine lists the hospital among the top ten places to work in the city. The American Nurses Association also recognized Children’s Memorial as the first hospital in the state - and the first pediatric hospital in the nation - to receive its prestigious Nursing Excellence Magnet Award.

The Pediatric Academic Societies (PAS) Annual Meeting is the largest international meeting that focuses on research in child health. The PAS consists of the American Academy of Pediatrics, Ambulatory Pediatric Association, American Pediatric Society, and Society for Pediatric Research.

###

SOURCE: Archives of Pediatrics & Adolescent Medicine