Men with erectile dysfunction (ED) are over three times more likely to develop osteoporosis than men with normal erections, according to researchers from Taiwan.
Osteoporosis is a disorder that causes bones to lose their density, making them weak. As a result, people with osteoporosis are at higher risk for breaks and fractures.
Osteoporosis and ED share many risk factors, such as heart disease, diabetes, and high blood pressure. Past research has suggested a link between the two conditions, but those studies were small. The current study aimed to examine this relationship in a larger group of men.
The researchers analyzed data from the Taiwan National Health Insurance Research Database, which includes encrypted medical records for patients in Taiwan’s largest health insurance program. They identified 4,460 men over age 40 (average age 58) who had been diagnosed with ED between 1996 and 2010.
As a comparison group, the researchers also identified 17,480 men around the same age who did not have ED.
Overall, 5.92% of the men with ED eventually developed osteoporosis. Among the men without ED, the rate was 3.65%.
Men with ED tended to develop osteoporosis more quickly, too, with a median time of 3.7 years compared to 8.6 years for the men without ED. While risk increased with age, younger men with ED were at higher risk than older men.
Other medical conditions, including high blood pressure, high levels of lipids, hyperthyroidism, stroke, and chronic pulmonary disease, were also more common in the ED group.
The researchers were not certain what, exactly, linked ED with osteoporosis and called for more research in this area. However, they considered several possibilities. For example, men with ED often have low levels of testosterone, a hormone that is important for bone health as well as sexual function.
Similarly, low levels of vitamin D have been associated with both conditions. This vitamin helps maintain healthy bones. Some experts believe that vitamin D deficiency may contribute to damage to the endothelium – the tissue that lines blood vessels. Such damage could impair blood flow to the penis.
They acknowledged that their data did not include information about the men’s diet, smoking status, and exercise habits, which might have affected the results. They also noted that many men are reluctant to discuss ED and might seek treatment elsewhere, so the actual incidence rate might be higher. They added that their findings might not apply to men outside Taiwan.
Still, clinicians should be aware of the connection, they said.
“Because of the easy and noninvasive evaluation of osteoporosis, patients with ED should be examined for bone mineral density, and men with osteoporosis should be evaluated for ED,” they wrote.
The study was published in June in the journal Medicine.
Wu, Chieh-Hsin MD, et al.
“Increased risk of osteoporosis in patients with erectile dysfunction: A nationwide population-based cohort study”
(Full-text. June 2016)
National Osteoporosis Foundation
“What is Osteoporosis and What Causes It?”