Gout Associated with Higher Risk of Erectile Dysfunction

Erectile dysfunction may be a more common comorbidity than previously thought among patients with gout.

The authors of “Erectile Dysfunction Is Common among Patients with Gout,” published in The Journal of Rheumatology, conducted a cross-sectional study of men age 18-89 who presented at a rheumatology clinic to determine “whether men with gout may have an increased prevalence of erectile dysfunction (ED) as compared with men without gout.”

The Sexual Health Inventory in Men (SHIM) is a commonly used instrument for screening and diagnosing erectile dysfunction. It consists of the following 5 questions:

• How do you rate your confidence that you could get and keep an erection?
• When you had erections with sexual stimulation, how often were your erections hard enough for penetration (entering your partner)?
• During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) you partner?
• During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
• When you attempted sexual intercourse, how often was it satisfactory for you?

Patients’ responses to each question are rated from 0 to 5 (from 1 to 5 for a couple of the questions), with the total score added up at the end. Higher scores generally indicate better sexual health. Patients who score 21 or less may possibly have erectile dysfunction, and should be evaluated further by a physician.

SHIM scores for erectile dysfunction screening are grouped into 5 severity grades: no erectile dysfunction (SHIM score of 22-25), mild ED (17-21), mild to moderate ED (12-16), moderate ED (8-11), and severe ED (1-7).

For the current study, researchers used the SHIM questionnaire, medical and family history, physical examinations, and recent laboratory studies to evaluate participants’ for erectile dysfunction.

Out of 201 participants, 83 had gout, and a control group of 118 men did not. The researchers reported that “a significantly greater proportion of patients with gout (63, 76%) had ED versus patients without gout (60, 51%, p = 0.0003).”

The presence of gout was also associated with severity of erectile dysfunction: 22 men (26%) with gout had severe ED compared with only 17 (15%) of patients without gout (p = .04). Patients with gout had an average SHIM score of 14.4 vs. 18.48 in patients without gout (p < .0001).

“There was a statistically significant association between gout and ED. The association remained significant after adjustment for age, hypertension, diabetes, and obesity,” the authors wrote.

Based on these findings, the authors concluded that erectile dysfunction “is present in most men with gout and is frequently severe,” and proposed that patients with gout be routinely screened for this potential comorbidity.