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NSAIDs include several widely used drugs, such as ibuprofen or naproxen.

In trying to determine if a particular drug causes erectile dysfunction, it is difficult to sort out the effects of the drug from those of the disease for which the drug is taken, Dr. R. Shiri and colleagues note in the Journal of Urology.

Previous reports have linked arthritis to erectile dysfunction, but whether NSAIDs, which are often used to treat arthritis, caused erectile dysfunction is unclear.

"To our knowledge, there are no previous studies on the incidence of erectile dysfunction in relation to NSAID use, i.e. studies on the use of NSAIDs recorded before the occurrence of erectile dysfunction," Shiri's team, from the University of Tampere in Finland, points out.

Their study involved 1126 men, between 50 and 70 years of age, without erectile dysfunction in 1994 when they completed a questionnaire that included, among other things, questions about erectile function and medication usage. The questionnaire was then re-administered five years later.

The investigators found that the erectile dysfunction rate was 93 cases per 1000 persons per year among NSAID users compared with just 35 cases among nonusers.

Arthritis was the most common reason for NSAID use, and for men with arthritis the corresponding rates of erectile disorder were 97 and 52 per 1000 person-years.

For whatever reason they were taken, NSAIDs roughly doubled the risk of erectile dysfunction compared with non-use. The presence of arthritis without NSAID use increased the risk of erection difficulty by only 30 percent, the researchers explain, and they therefore conclude that NSAIDs were largely to blame for the link between arthritis and erectile dysfunction.

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