ED tied to impaired work productivity, QoL

Erectile dysfunction (ED) has a significant impact on work productivity and health-related quality-of-life (HRQoL), an observational study shows.

“[Our findings] highlighted the strong association of ED with work productivity loss and its potential negative association with HRQoL globally … [suggesting that] ED remains a prevalent concern and a consistent unmet need … [T]he global coverage … also suggests that this issue is pervasive across geographies,” said the researchers.

Men from eight countries* (n=52,697; mean age 55 years) self-reported difficulties in achieving or maintaining an erection over the past 6 months, rating it on a scale of 1–5. A score of ≥2 signified some degree of ED; based on this, nearly 50 percent were classified as having ED. [Int J Clin Pract 2019;doi:10.1111/ijcp.13384]

Compared with men without ED, more men with ED stayed home from work (7.1 percent vs 3.2 percent), worked while sick (22.5 percent vs 10.1 percent), and had higher rates of impairment (24.8 percent vs 11.2 percent [overall work productivity] and 28.6 percent vs 14.4 percent [activity]; p<0.001 for all).

In terms of HRQoL, men with vs without ED had lower Mental Component Summary (46.7 vs 51.2), Physical Component Summary (48.3 vs 53.0), and health state utility scores (0.69 vs 0.78; p<0.001 for all).

The poor HRQoL could be due to low testosterone levels secondary to comorbidities (ie, obesity, type 2 diabetes [T2D], and cardiovascular disease) that generally occur during midlife and could adversely affect men’s sexual health and relationships, noted the researchers. [Sex Med Rev 2018;6:384‐395] “Although the extent of this burden subtly varied within each country … the collective results suggest that discrepancies in HRQoL between men with ED and those with no ED are clinically meaningful.”

As the outcomes were comparable to those reported in studies on treatment-resistant depression, obesity, and T2D, the researchers noted that ED may have a burden profile similar to common ED risk factors and comorbidities. [BMC Psychiatry 2018;18:352; Diabetes Metab Syndr Obes Targets Ther 2015;8:327-328; J Occup Environ Med 2016;58:1121‐1126] “[This] not only underscores the link between ED and these conditions but also emphasizes the considerable negative impact of ED on work productivity and HRQoL among men globally … The burden may prove to be a significant, underrecognized concern for patients and employers alike.” With the average age of men with ED becoming younger in recent years, the implications of ED in the workplace are important, they said. [Nat Rev Dis Prim 2016;2:16003]

The results add a fresh perspective on the burden of ED and underline the need for earlier detection for better management and appropriate treatment to help reduce this burden, noted the researchers. “[S]uccessful ED treatment requires a systems medicine‐based multifaceted approach, as well as a couple‐oriented intervention to enhance sexual satisfaction and intimacy.”

Nonetheless, as the study did not include men who were unable to participate in online surveys, the findings may not be applicable to those who are severely ill/disabled or those who lack access to (or adequate knowledge of) the internet. The retrospective design and self‐reported response may have also influenced the results, hence the need to interpret the results with caution, noted the researchers.