Erectile dysfunction (ED) is estimated to affect 18 million men in the U.S., and factors like advancing age, hypertension, diabetes, cardiovascular diseases, and such, are generally thought to be responsible for it. But a new study suggests that gout may also cause ED in most men suffering from it. The study was presented Thursday at the European League Against Rheumatism Annual Congress (EULAR 2014), according to a press release.

Gout, a severe form of arthritis, is characterized by sudden, sharp pain in the joints accompanied by redness and tenderness. It generally affects middle-aged men and is caused due to too much uric acid in the bloodstream. Although high levels of uric acid may not always predispose men to developing gout, sometimes factors like obesity, alcoholism, certain types of food, and even genetics may cause the uric acid to form needle-like monosodium urate crystals in the joints, which leads to gout.

It is estimated that one to four percent of the Western population will develop gout at some point in their lives. Although the exact connection between gout and ED has not been established, previous research has suggested that medication such as allopurinol, used to treat gout, may be causing ED. The current study surveyed 201 men, of whom 83 had gout. Seventy-six percent of these men with gout reported ED as compared to 52 percent without gout.

Severe ED was seen in 43 percent of men with gout compared to 30 percent without gout. According to lead author Dr. Naomi Schlesinger, chief, Division of Rheumatology and professor of medicine, Rutgers-Robert Wood Johnson Medical School, "these results strongly support the proposal to screen all men with gout for the presence of ED. Increasing awareness of the presence of ED in gout patients should in turn lead to earlier medical attention and treatment for this distressing condition."

Clogged Arteries, ED, and Vascular Diseases

ED occurs when the arteries that supply blood to the penis get clogged due to plaque build-up. The choking of these small arteries is a sign that larger arteries, such as those supplying blood to the heart may also be clogged. So ED may be a sign of an underlying vascular disease and, according to Schlesinger, "patients who present with ED also have an increased rate of CVD risk factors and concomitant silent CAD, all these patients should also be evaluated for possible silent CAD."

Statistical Relation Between Gout and ED

For the study, men aged 18 to 89 went to a rheumatology clinic between August 2010 and May 2013. The men were asked to fill out a Sexual Health Inventory in Men (SHIM) survey to determine the prevalence of ED. The SHIM classified ED into one of five categories: absent (26), mild (22), mild to moderate (17), moderate (11) and severe (1). Researchers reviewed the patient's history, physical examination, and recent laboratory studies. They then summarized data using descriptive statistics and subgroup analyses. They also used chi-square tests for independence to compare categorical variables.

The statistics clearly indicated that most men with gout have ED, as they had an SHIM score of 14.38 as compared to 18.53 in patients without gout. Gout patients who were older than 65 years of age also reported ED and often more severe than men without gout. ED was also higher in men with tophaceous gout, a chronic gout condition where nodules appear in soft tissues of the body than those without it. In a multivariate analysis, the association between gout and ED remained statistically higher even after adjusting for age, hypertension, LDL-cholesterol, glomerular filtration rate (a measure of renal function), obesity, depression, and diabetes.

Source: Schlesinger N. European League Against Rheumatism Annual Congress. 2014.