Those ubiquitous Cialis commercials tend to depict only older men with erectile dysfunction (ED), but a new analysis suggests as many as one in four men seeking medical help for the condition are younger than 40 years — and nearly half have severe cases.
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The findings, reported in The Journal of Sexual Medicine, suggest ED in young men may be more prevalent and more serious than previously thought. They also indicate the presence of cardiovascular problems that should be addressed early.
"Erectile function, in general, is a marker for overall cardiovascular function — this is the first research showing evidence of severe erectile dysfunction in a population of men 40 years of age or younger," noted Irwin Goldstein, editor-in-chief of The Journal of Sexual Medicine. "Clinically, when younger patients have presented with erectile dysfunction, we have in the past had a bias that their ED was primarily psychologic-based and vascular testing was not needed.
"We now need to consider regularly assessing the integrity of arterial inflow in young patients — identifying arterial pathology in such patients may be very relevant to their overall long-term health."
The new study is based on an analysis of patients at one outpatient clinic who sought medical help for newly-developed ED, a common complaint in men over 40 years of age. Paolo Capogrosso, M.D., of the University Vita-Salute San Raffaele, in Milan, Italy, and his colleagues assessed 439 men seeking medical help for ED between January 2010 and June 2012.
The result showed 114 (26 percent) 40 years old or younger. Compared with older patients, younger patients had a lower average body mass index, a higher average level of testosterone in the blood, and a lower rate of other medical conditions. But younger ED patients smoked cigarettes and used illicit drugs more frequently than older patients. In addition, severe erectile dysfunction was found in 48.8 percent of younger patients, compared to 40 percent of older patients.
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"These findings, taken together with those of other studies showing the importance of erectile dysfunction as a potential sentinel marker of major diseases, outline the importance of taking a comprehensive medical and sexual history and to perform a thorough physical examination in all men with erectile dysfunction, irrespective of their age," said Dr. Capogrosso.
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