Introduction: Erectile dysfunction (ED) has been demonstrated to be reasonably prevalent among young men (=40 yr). We aimed to i) assess changes in patterns of reported ED in men = 40 yr, and ii) compare the sociodemographic and clinical characteristics of ED men = 40 yr vs. > 40 yr of age over a 8-yr period at a single academic centre.
Methods: Data of 1179 patients seeking first medical help for ED and assessed by a single Sexual Medicine expert between 2013 and 2021 were analysed. All patients completed the IIEF at baseline. Descriptive statistics tested the sociodemographic and clinical characteristics of ED men = 40 yr vs. > 40 yr of age. Within the two groups, multivariable linear regression models tested the association between advancing age and IIEF scores. Local polynomial regression models were applied to explore and graphically display = 40 yr patients’ likelihood to report ED over the analysed time frame and to display changes of the IIEF-EF scores over increasing age between the two groups.
Results: Overall, median (IQR) age was 52 (41-62) yr. Median (IQR) IIEF-EF was 18 (15-22) at baseline. Of all, 268 (22.7%) were = 40 yr whereas 911 (77.3%) were > 40 yr at baseline. Rates of severe ED according to IIEF-EF did not differ between men = 40 yr and >40yr (60 (22.4%) vs. 155 (17%)). No significant differences were found for the IIEF domains (-IS, -OS, -SD) but IIEF-OF domains, which scored higher in younger men (9 () vs. 8 (), p=0.002). At baseline, younger patients reported less comorbidities, less active smoking, lower BMI, higher total testosterone (tT) levels than older patients (all p<0.005). At linear regression models, within the = 40 yr group, increasing age was not associated with changes across all IIEF domains. In contrast, in men > 40 yr, increasing age was linearly correlated with decreasing IIE-EF (all p<0.001), after adjusting for tT, BMI, CCI, smoking and arterial hypertension. Figure 1 graphically displays a stable 8-yr temporal trend of = 40 yr ED patients
Conclusions: One out of five men seeking first medical help for ED at a single academic centre were younger than 40 yr. This trend has remained stable over the last 8-years. Increasing age among younger patients is not associated with worse erectile function as oppositely occurs among patients > 40 yr.