ArticleSexual medicine2026
Erectile dysfunction and subsequent substance abuse: a retrospective cohort study of US non-academic hospitals.
Article in Sexual medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
Background: Erectile dysfunction (ED) affects millions and is associated with cardiovascular disease, diabetes, and depression-conditions that share risk factors with substance use disorders. Aim: This study investigates the temporal relationship between ED diagnosis and subsequent substance abuse/dependence diagnoses across different age groups. Methods: This retrospective cohort study used the TriNetX database to identify adult males from US hospitals with ED diagnoses (ICD-10: N52) with at least 3 years of follow-up. Controls were propensity-matched 1:1 on age and race. Patients were stratified into three age groups (20-39, 40-64, and ≥ 65 years). Cox proportional hazards models assessed risk over a 3-year follow-up period. Outcomes: Primary outcome was any substance abuse/dependence diagnosis (ICD-10: F10-F19 categories); secondary outcomes examined individual substance categories. Results: The study included 323 838 patients (161 919 with ED, 161919 controls) across three age strata. In men ≥65 years ( Clinical Implications: Clinicians should maintain heightened awareness for substance abuse risk, particularly sedative misuse, when evaluating and treating elderly men with ED. Age-specific screening and counseling may be warranted. Strengths and Limitations: Strengths include large sample size and propensity matching. Limitations include potential selection bias, inability to assess treatment adherence, and database-specific coding variations. Conclusion: Elderly men with ED demonstrate significantly elevated risk for sedative, opioid, and cocaine abuse in the 3 years following ED diagnosis, while younger men show protective associations. These findings suggest a bidirectional relationship that warrants further investigation.
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