Background/Purpose: Gout is the most prevalent inflammatory arthritis, affecting 2.4% of adults in the UK. Recently, a link has been suggested between gout and erectile dysfunction (ED), however studies quantifying ED reporting by gout patients are lacking. The aim of this study was to determine the population level absolute and relative rates of ED reporting by patients with gout over a decade in England. 

Methods: Utilising data from one of the largest English primary care consultation databases (Clinical Practice Research Datalink), we identified 9,653 men with incident gout and matched them to 38,218 controls (ratio 1:4) by age and practice.  Absolute and relative rate of incident ED was calculated using Cox regression models. Absolute rates within specific time periods before and after gout diagnosis were compared to controls using Poisson regression models.

Results: Overall, the absolute rate of ED post-gout diagnosis was 193 (95% Confidence interval (CI): 184-202) per 10,000 person-years. This corresponded to a 31% (Hazard Ratio (HR) = 1.31 95%CI: 1.24-1.40) increased relative risk and 0.6% excess absolute risk compared to those without gout (Table 1). Among those prescribed urate-lowering therapy, the risk of ED was similar for cases and controls (HR=1.10 95CI: 1.01-1.19). Compared to controls, the risk of ED was also high in the year before gout diagnosis (incidence rate ratio= 1.63 95%CI 1.27-2.08). Our relative risk estimates remained broadly similar when we restricted our analyses to those with ED treated with medication.

Conclusion: We have shown a statistically significant increased risk of ED among men with gout, however, the absolute risk difference is small indicating limited influence of disease on ED. Clinicians should be aware that higher reporting of ED before gout diagnosis suggests a possible influence of hyperuricemia on arterial vasculature warranting further investigations. Overall our finding are reassuring to patients and clinicians.

    Table 1: Absolute and relative rate of Erectile Dysfunction after gout diagnosis

¹Per 10,000 person-years ²Adjusted for smoking status, Alcohol consumption, Body Mass Index, age, Ischemic heart disease, chronic diseases, hypertension, diabetes and depression.