Introduction

The risk of erectile dysfunction (ED) increases with age and typically occurs in middle and older aged men. Recently, we have experienced an increase in young men referred to our practice for ED, with many of these men also complaining of symptoms of low testosterone. Given the paucity of data on this subject, we sought to describe the hormonal profiles of young men with the chief complaint of ED. We hypothesize that the majority of young men with ED will have normal hormonal evaluations. _x000D_

Methods

Institutional Review Board (IRB) approval was obtained for a retrospective chart review of men aged 18-40 years who presented with the complaint of ED and had a hormonal evaluation from January 2002-October 2016 at a tertiary care institution. We obtained data on demographics, co-morbidities, medications, and hormonal evaluations. Hypogonadism was defined as a testosterone level <200 ng/dL and hyperprolactinemia as a prolactin level >13.1 ng/mL.

Results

A total of 2,292 men were identified. The median age was 32.7 years with more men complaining of ED as they neared age 40 compared to younger ages. 42.9% of men were White, 8.6% Black or African American, 4% Asian, 0.9% Hispanic, and 43.6% other or unknown. Median BMI was 26.8. The most common comorbidities are listed in Table 1. Men were being actively treated for these medical conditions. Additionally, 9% of men were taking antihistamines, 6.10% using H2-receptor antagonists, and 9.9% taking muscle relaxants. _x000D_ _x000D_ The average total testosterone level was 368 ± 160 ng/dL. 10.6% of men had hypogonadism. Abnormalities of LH and FSH were noted in 10% and 9.1% of men, respectively. 8.5% of men had hyperprolactinemia. _x000D_ _x000D_ For treatment of ED, 68.7% of men were given a phosphodiesterase type 5 inhibitor (PDE5i) and 2.4% were given alprostadil. 12.9% of men were started on testosterone therapy. _x000D_ _x000D_ _x000D_

Conclusions

The majority of men under age 40 with ED exhibit a normal hormonal milieu. Men of this cohort that endorsed symptoms of low testosterone may in fact be experiencing symptoms which could be attributed to life stressors or associated comorbidities such as depression, anxiety, or diabetes. Additionally, many men were using medications that have been linked to ED including antihypertensives, antihistamines, and H2-receptor antagonists. A majority of these men with ED were treated with a PDE5i.

Funding

None