This page about gout and sex was last reviewed or updated on 31 August 2014.
Erectile Dysfunction (ED) has been found to be quite common in gout patients, but is that so surprising? ED and gout can have similar causes. The message is – are you suffering from gout and suspect ED? Check for ED with your doctor, although it could well be caused by something else. Scientifically, more needs to be known about this sensitive topic.
Are sexuality and gout connected? In case you have wondered, and you probably have, sex is not a cause of gout, because gout’s immediate cause is an elevated uric acid level which itself is the product of many dietary and medical conditions, of which sexual intercourse is not known to be one. No one has demonstrated that sex raises uric acid.
But does the gouty condition in men allow them to have sex?
Given the similarity of some causes of erectile dysfunction and of gout, such as ageing, hypertension, obesity and diabetes, it would be surprising if a link between gout and sex, and a link between higher uric acid and the risk of ED, could not be found among gout patients. But the real puzzle to solve is - does the gouty condition alone cause erectile dysfunction?
So far the balance of studies points to there being a connection. And a connection between higher uric acid levels and the risk of erectile dysfunction.
This issue had been overlooked, until the last few years. But there have been recent studies about levels of uric acid and erectile dsfunction. And gout and sex came into focus in June at the European League against Rheumatism (EULAR) annual 2014 conference in Paris.
Dr Naomi Schlesinger, from the United States, spoke to conference delegates about erectile dysfunction and gout. She is a leading gout researcher. She was half of the research team who, in a study a few years ago, found that
Dr.Schlesinger became aware of ED and gout when she noticed how much Viagra she prescribed for gout patients
To find out more, Dr. Schlesinger and colleagues undertook a survey of 201 patients at a rheumatology clinic at an American medical school. Eighty three (83) patients had gout. Of those with gout, 76% had ED, compared to about half with ED among those who did not have gout (118). Of those with both ED and gout 43%, described their ED as severe. Those with gout were more likely to describe their ED as severe. And among the gout patients, more men with tophaceous gout, the kind of gout you often get when it becomes severe, had ED.
patients tend to be older, and older men tend to have ED more than men of
younger ages. So when confounding factors like this, as well as obesity and
hypertension, (also among ED causes) were included in the analysis, the
association between erectile dysfunction and gout was still significant.
WHAT DO OTHER STUDIES SAY?
In 2010 the journal Arthritis & Rheumatism reported on another U.S. study that also concluded ED is significantly associated with gout. Among 256 gout sufferers, 40% had ED compared to 29% of non-gout sufferers. As mentioned above, age is a common ED cause, and at older ages the percentage of gout sufferers rises. So when researchers statistically adjusted for age, they also found there was a significant association between erectile dysfunction and gout (1)
All this points to gout as a cause of ED. But on the other hand, a large British database investigation (1,292 men with gout) a few years ago concluded there was no association between ED and gout. (2)
The immediate cause of gout is high uric acid. Do gout patients with ED have high uric acid?
URIC ACID AND ERECTILE DYSFUNCTION – LEVEL PREDICTS E.D.
A Iranian study (3) looked at the link between erectile dysfunction and uric acid levels. Men with ED had higher uric acid. It also found that for every 1 mg/dl increase in serum (blood) uric acid, the risk for ED was doubled. And men with the highest uric acid were nearly 6 times more likely to get ED than men with the lowest. That was after major confounding factors were adjusted for. It concluded that higher uric acid itself is a predictor for ED.
In 2014 a Turkish study (4) came to a similar conclusion. Not only was higher uric acid a risk factor for ED, independent of other causes, that was also the case irrespective of blood pressure levels.
So there is some conflicting evidence, but the pendulum weighs heavily towards a connection between gout and erectile dysfunction. All these studies agree there needs to be more research into this subject to get to the real truths. For example, if high uric acid is a cause of ED, no one has yet found out whether it is possible to clear it up with lowered uric acid. And, does high uric acid cause mild or severe ED?
If doctors know their gout patient is more likely to have ED, especially if the patient is older, this knowledge would lead to quicker treatment for it. So Naomi Schlesinger called at EULAR for erectile dysfunction screening for gout patients.
What does this mean for readers? If you think you have gout don’t wait for screening to become common practice. Tell your GP (PCP) if you think you have ED too. But the ED may well have another cause of course. Shy or embarrassed ? Remember your doctor is there to help you and has heard regularly about ED before from others. You are not the first.
Gout news video Want to know more? Here is a ten minutes video of Dr.Schlesinger talking about ED and gout at EULAR
Gout and sex references
(1) W. Maynard, Janet, A. McAdams, Mara, N. Baer, Alan, Hoffman-Bolton, Judith, C. Gelber, Allan, Coresh, Josef; Erectile Dysfunction Is Associated with Gout in the Campaign Against Cancer and Heart Disease (CLUE II). Abstract. Arthritis Rheum 2010;62Suppl 10 :1544 DOI: 10.1002/art.29310
(2) E Roddy, S Muller, R Hayward, CD Mallen Gout, allopurinol and erectile dysfunction: an epidemiological study in a primary care consultation database. Presentation.Arthritis Research UK, Primary Care Centre.
(3) Salem S, Mehrsai A, Heydari R, Pourmand G. Serum uric acid as a risk predictor for erectile dysfunction. J Sex Med. 2014 May;11(5):1118-24. doi: 10.1111/jsm.12495. Epub 2014 Mar 13
(4) Aribas A1, Kayrak M, Ulucan S, Keser A, Demir K, Alibasic H, Akilli H, Solak Y, Avci A, Turan Y, Kaya Z, Katlandur H, Kanbay M. The relationship between uric acid and erectile dysfunction in hypertensive subjects. Blood Press. 2014 Jul 16:1-7. [Epub]
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