A large, ethnically diverse study has linked the regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) with erectile dysfunction (ED) beyond what would be expected due to age and comorbidity.

Researchers set out to investigate whether the potential relationship between inflammation and ED suggested by previous research is causal. They launched a prospective cohort study of 80,966 male members of Kaiser Permanente managed care plans. The men, who were aged 45 to 69 years old at study enrollment in 2002, responded to a questionnaire designed to assess ED; NSAID exposure was calculated based on automated pharmacy data and self-reports.

Ultimately, 29.3% of the men reported moderate or severe ED (being sometimes or never able to achieve and maintain an erection) and 47.4% were considered NSAID users, defined as receiving more than a 100-day supply of at least one NSAID, using NSAIDs at least five days per week, or having prescriptions for three or more NSAID doses per day.

The investigators expected NSAIDs to show a protective effect against ED because of the protective effect these agents have against heart disease. However, after controlling for age, race, ethnicity, smoking status, diabetes, hypertension, hyperlipidemia, peripheral vascular disease, coronary artery disease, and BMI, they found ED to be 1.4 times more likely to occur among regular NSAID users compared with non-regular users, across all age groups (J Urol. 2011;185:1388-1393). The association persisted even when a stricter definition of NSAID drug exposure was used.