Erectile dysfunction is the most frequently diagnosed sexual dysfunction among older men. A new meta-analysis investigating the association between alcohol consumption and erectile dysfunction is published in the International Journal of Impotence Research.Results show that moderate alcohol consumption is associated with a lower risk of erectile dysfunction. Underlying mechanisms might be related to mechanisms in cardiovascular disease.
What is already known? Previous studies suggest that moderate alcohol consumption is associated with a lower risk of erectile dysfunction. But the evidence is still inconclusive.
What does this study add? This study is a first meta-analysis of cross-sectional studies on the association between alcohol consumption and erectile dysfunction. Also a dose-response analysis is performed.
This meta-analysis1includes 24 cross-sectional studies from across the world with in total almost 155,000 men. When the researchers looked at ever-drinkers compared to never-drinkers, no association was found. This might be due to the heterogeneity between the individual studies. However, when looking at the dose-response analysis, results show that the risk for erectile dysfunction is lower for light-to-moderate alcohol consumption compared to non-drinkers. For heavy drinking (>25 drinks/week), no clear association was found. The lowest risk is found for 14.5 drinks/week, which is associated with a 34% lower risk for erectile dysfunction. Different studies also show that ex-drinkers are at increased risk of erectile dysfunction.
The researchers did not study the underlying mechanism but describe several possible mechanisms that could explain the association between alcohol consumption and erectile dysfunction. They argue that the beneficial effects of moderate alcohol consumption on cardiovascular disease might also apply for erectile dysfunction. Both have a similar pathophysiological basis which includes endothelial dysfunction, inflammation and low levels of testosterone. On the other hand, the adverse effects of mainly heavy alcohol consumption of erectile dysfunction might be related to damage of blood vessel endothelial cells and increased risk of developing insulin resistance. Next to that, alcohol can affect testosterone synthesis and therefore libido and sexual potency.
Erectile dysfunction or impotence is the inability to attain and/or maintain a satisfactory erection for sexual intercourse. Erectile dysfunction is the most frequently diagnosed sexual dysfunction in older men. Prevalence is about 5% in men of 40 years old and 15% in men 75 years old. Age is related to an increase in both prevalence and severity of erectile dysfunction. Other risk factors include obesity, smoking and a sedentary lifestyle1.
- 24 studies included based on large populations
- Categorical and dose-response analysis performed
- No evidence of publication bias
- Underlying mechanism is unknown, therefore limited evidence for causal relationship
- Residual confounding cannot be ruled out
- No data to assess effect of duration of drinking or very high alcohol consumption on erectile dysfunction.