Some headlines were sensational. “If your big toe looks like this you’re 31% more likely to have a penis issue,” noted the Daily Star (UK). Men’s Health added, “How Your Big Toe Can Signal Problems With Your Erection.” MedPage, as one would expect, was considerably more professional: “Gout Patients Face Increased Risk for Erectile Dysfunction.”
The coverage all centers on a recent study by UK researchers published in Arthritis Research & Therapy. Keele University (UK) epidemiology research fellow Alyshah Abdul Sultan and colleagues studied 9,653 men with gout and 38,218 controls, with an average of 10 follow-up years. They found a 31 percent increased risk — and an absolute increase of 0.6 percent — for erectile dysfunction (ED) among gout patients compared to those without gout. They also observed an increased ED risk during the year prior to gout diagnosis.
(Learn about the classic description of gout: that a bedsheet resting on the joint is “agonizing.”)
Gout is a form of arthritis afflicting more than 3 million Americans which particularly pains the big toe joint. It affects 2.4 percent of UK adults, while ED impacts 2 percent of UK men under the age of 40, and 86 percent of men older than 80, the researchers noted.
Several recent studies have suggested an association between ED and gout. One concluded that “patients with gout be routinely screened for ED,” but it was small: just 83 gout patients. Two southeast Asian studies were larger — one had 19,368 and the other 35,265 gout patients. But their results — that ED risk is higher among gout patients — “can only be generalised to Western countries with caution, given the large variation in the reporting of ED by region,” the UK researchers wrote.
Other previous studies failed to account for whether patients are obese or drink alcohol, which are gout risk factors, they added.
(Read 10 facts about gout.)
“To our knowledge, no previous study has quantified the incidence of ED warranting pharmacological intervention or assessed ED reporting both before and after gout diagnosis, which may be important in understanding disease mechanisms,” noted the authors. “We have conducted one of the largest studies to precisely determine the risk of ED among men with gout.”
In 2014, the lead author of the study — with the 83 gout patients — that found common and severe ED in men with gout said that the results “strongly support the proposal to screen all men with gout for the presence of ED,” reported Medscape. “Men don’t usually volunteer sexual complaints,” she added. “The gout patients in our study were generally delighted and grateful that someone finally asked them about ED.”