Clinical Profile of Young Patients with Erectile Dysfunction: Preliminary Findings of a Real-life Cross-sectional Study

Background: Erectile dysfunction (ED) is an increasingly common complaint among men aged <40 yr. Objective: To assess clinical factors potentially associated with impaired erectile function (EF) in a cohort of young men seeking first medical help for ED as their primary complaint. Design, setting, and participants: Complete sociodemographic and clinical data for 307 consecutive patients aged <40 yr were analysed. Health-significant comorbidities were scored using the Charlson comorbidity index. Patients completed the International Index of Erectile Function (IIEF) and Beck's Inventory for Depression (BDI) and were categorised into two groups: those with impaired EF (IIEF-EF <26) and those with normal IIEF-EF scores. Outcome measurements and statistical analysis: Descriptive statistics and logistic regression analyses were used to test the association between risk factors and impaired EF. Results and limitations: Overall, 78 patients (25%) had normal and 229 (75%) had impaired IIEF-EF scores. Among ED patients, 90 (29%) had IIEF-EF scores suggestive of severe ED. The two cohorts did not differ in terms of median age, body mass index, prevalence of hypertension, general health status, smoking history, or alcohol use. No differences were reported for serum sex hormones and lipid profiles. Patients with ED reported higher median BDI scores (7, interquartile range [IQR] 3–13) than those with normal EF (5, IQR 1–9). Overall, the higher the BDI score, the lower was the IIEF-EF domain score (odds ratio 1.08, 95% confidence interval 1.02–1.15; p = 0.01). The single-centre cohort is the main study limitation. Conclusions: Overall, young men with impaired EF showed comparable clinical characteristics to those with normal IIEF-EF; conversely, young individuals with worse EF had BDI scores suggestive of significant mood deflection. Patient summary: Young men complaining of erectile dysfunction show significant mood deflection in comparison to patients with normal erectile function. Conversely, the clinical characteristics are similar between the two groups. Young men with worse erectile function had scores suggestive of significant mood deflection. Overall, these real-life findings suggest that psychogenic factors may have a major role in sexual functioning at a younger age, with extremely important effects on young men's psychiatric profile.