During the 10-year surveillance period, there were 100,248 incident cases of erectile dysfunction diagnosed in active component servicemen, according to the report released today and published in the September issue of the Medical Surveillance Monthly Report (MSMR) from the Armed Forces Health Surveillance Center (AFHSC). The overall crude incidence rate was 8.4 per 1,000 person-years (p-yrs). Erectile dysfunction cases classified as psychogenic – related predominantly or exclusively to psychological factors – comprised almost half of all erectile dysfunction cases (48 percent) during the surveillance period (Table 2).
The report described the counts and rates of newly diagnosed erectile dysfunction diagnoses for all males who had served at least one day in the active component of the Army, Navy, Air Force, Marine Corps, or Coast Guard.
During the surveillance period, crude incidence rates of erectile dysfunction more than doubled from 5.8 cases per 1,000 p-yrs in 2004 to 12.6 cases per 1,000 p-yrs in 2013. Incidence rates of psychogenic erectile dysfunction demonstrated a greater increase than rates of organic erectile dysfunction (Figure 1). Organic erectile dysfunction is attributable to underlying physical factors such as obesity, smoking, diabetes, cardiovascular disease or medication use.
“Since the advent of effective oral therapy for erectile dysfunction, this condition has been better recognized as a common medical disorder and as the most common sexual complaint reported by men to healthcare providers,” said Navy Captain Kevin Russell, the director of AFHSC. “This report is unique in its ability to clarify the epidemiology of this condition in a large population of men, namely active component U.S. servicemen.”
The study also reported that about half of servicemen who are newly diagnosed with erectile dysfunction do not seek medical care for the condition more than once during a two-year period; this may indicate that many servicemen are successfully treated in a single visit although it could also indicate that subsequent care for erectile dysfunction is sought outside the military health system.
As expected, incidence rates were higher in the older age groups, and the highest rates were observed in those aged 60 years or older. The incidence rates were sharply higher in service members aged 40 years or older (Table 2). Except for servicemen aged 20 years or younger, incidence rates in all age groups showed a slight increasing trend over the course of the surveillance period (Figure 2).
For the entire surveillance period, the crude incidence rate of erectile dysfunction was higher among black, non-Hispanic servicemen compared to servicemen of other race/ethnicity groups. Separated, divorced, and widowed servicemen had an almost four-fold higher crude incidence rate of erectile dysfunction than servicemen who had never married. The crude incidence rate of erectile dysfunction was lowest in servicemen with an education level of high school or lower (Table 2). Over the entire surveillance period, servicemen who had never deployed had the highest crude incidence rate of erectile dysfunction (10.1 per 1,000 p-yrs).
A cross-sectional study examining prevalence rates by race and ethnicity in U.S. civilian men aged 40 years or older reported the highest prevalence rates in blacks.7 Additionally, black, non-Hispanic service members have higher incidence rates of several conditions known to be risk factors for erectile dysfunction (i.e., hypertension, obesity, and diabetes).8,9
Some findings differed from those seen in the civilian literature. For example, Selvin et al. reported that lower levels of education were associated with higher prevalence of erectile dysfunction, whereas the report published in the September MSMR indicated that those with higher levels of education were more likely to be diagnosed with erectile dysfunction.4
These study findings suggest several avenues for additional analyses. For example, further studies could examine the comorbid and co-occurring medical conditions to look for possible reasons for erectile dysfunction in servicemen, and might provide insight into the reasons that the incidence rates of this condition are increasing. Several studies in veterans have examined the association between mental health diagnoses, especially post-traumatic stress disorder, and the occurrence of erectile dysfunction.
Click here to read entire study. The MSMR is the flagship publication for the AFHSC, featuring articles on evidence-based estimates of the incidence, distribution, impact and trends of illness in service members and associated populations.
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