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Authors Mialon A, Berchtold A, Michaud PA, et al.
Review Date November 2012
Citation Journal of Adolescent Health 2012;51:25-31
There is a paucity of studies of sexual and reproductive health focusing specifically on young men. The prevalence of erectile dysfunction (ED) increases with age and is known to be associated with other health conditions and health behaviours in older men. On the other hand premature ejaculation (PE) is more common in younger men and may be associated with depression and stress. This Swiss study aimed to address part of the gap in research related to ED and PE in younger men by surveying men aged 18-25 years attending a medical screening day to assess suitability for military service.
The aims of the study were to 1) assess the prevalence of PE and ED among young Swiss men and 2) assess factors associated with PE and ED in this age group.
Men aged 18-25 who were attending a clinic for military service in two districts in Switzerland (n=9,761) were invited to complete a questionnaire on substance abuse and sexual function. For this analysis on PE and ED only sexually active men were included. Men were considered to have PE if they considered their ejaculatory control to be fair or poor and it was a problem for the man, his partner or both. ED was assessed by the IIEF-5 and men scoring <22 (mild ED or worse) were included in the ED group.
Separate analyses were done for each condition (PE and ED), comparing young men with the condition to those without. Groups were compared for substance use (tobacco, alcohol, cannabis, other illegal drugs, and medication without a prescription), self-reported body mass index, sexual orientation, physical activity, employment status, sexual experience (years since first sexual intercourse and age at first intercourse), depression status, mental and physical health (SF12) in a bivariable analysis. Multivariable log-linear analysis used to consider all variables significant in bivariable analysis simultaneously.
Two thousand, five hundred and seven men aged 18-25 years completed the questionnaire. Prevalence of PE was 11% and prevalence of ED was 30% (noting that 25% was mild ED). Poor mental health was the only variable to have a direct association with both conditions after controlling for potential confounders. In addition, PE was directly associated with tobacco, illegal drugs, employment status and physical activity, whereas ED was directly linked with medication without a prescription, years since first intercourse and physical health.
One-third of young men in this study had a problem with sexual dysfunction. The factors associated with these problems should act as signs for health professionals to take the opportunity to speak with their young male patients about their sexual and reproductive health.
Points to Note
- Mental health was the only variable to be directly associated with both PE and ED. However, the direction of the association cannot be ascertained from this cross-sectional study. It is likely to be bi-directional suggesting that mental health issues may be a sign that sexual function should be assessed and vice versa.
- Substance misuse and physical inactivity were also associated with PE suggesting opportunities for intervention.
- Although non-significant for PE, sexual inexperience was associated with both sexual problems.
- Physical health (measured by SF-12) was associated with ED which has been shown in older populations.
- Limitations of the study include the low response rate and potential bias; cross sectional design; and all self-reported data.
- The study has gone some way to alert health professionals to the need to include sexual and reproductive health, apart from just sexually transmitted infection, in consultations with young men.