Erectile dysfunction (ED) is increasing among men, even in the absence of known systemic risk factors. This study investigates the potential link between non-urological conditions, including temporomandibular disorders (TMD), multiple chemical sensitivity (MCS), tension, migraine headache (TH&MH), localized myofascial pain disorder (LMP), irritable bowel syndrome (IBS), and fibromyalgia (FM), with ED in young Taiwanese men aged under 65.

We recruited participants under 65 via an online questionnaire for our cross-sectional study. The questionnaire gathered data on various ED risk factors, such as age, body mass index (BMI), education level, comorbidities, smoking status, and regular exercise habits. Non-urological conditions were assessed with validated questionnaires. Erectile function was evaluated with the International Index of Erectile Function Score (IIEF-5), with a score < 22 indicating ED. Statistical tests, including Student's t-test and Pearson's chi-square test, compared participants with and without ED. Univariate and multivariate logistic regression analyses identified potential ED risk factors.

Out of 3,704 Taiwanese men surveyed, 58.94% had ED. Those with ED were older and more obese and had lower education, fewer regular exercise habits, more comorbidities, and more non-urological conditions such as TH&MH, LMP, IBS, and FM (Table 1). Univariate logistic regression revealed that age ≥ 40 years, obesity, lower education level, hypertension, diabetes mellitus, psychiatric diseases, HIV infection, lack of regular exercise, TH&MH, LMP, IBS, and FM correlated with ED. On multivariate analysis, age ≥ 40 years (OR 1.619, 95%CI 1.382 – 1.895, p < 0.001), BMI ≥ 30 kg/m2 (OR 1.538, 95%CI 1.217 – 1.942, p < 0.001), psychiatric diseases (OR 1.542, 95%CI 1.240 – 1.927, p < 0.001), BPH (OR 2.218, 95%CI 1.322 – 3.722, p = 0.003), HIV infection (OR 1.842, 95%CI 1.413 – 2.401, p < 0.001), and lack of regular exercise (OR 1.177, 95%CI 1.026 – 1.351, p = 0.020) remained significantly associated with ED. Moreover, IBS was the only non-urological condition independently associated with ED (OR: 1.473; 95% CI: 1.077 – 2.015, p = 0.015) (Table 2).

IBS emerged as an independent risk factor for ED after adjusting for other confounding risk factors such as age, BMI, psychiatric disease, BPH, HIV infection, and lack of regular exercise. The results indicate a correlation between lower abdominal diseases. Further research in this area is crucial. Limitations included retrospective study design and the use of online self-reported questionnaires.

In Taiwanese men aged under 65, besides older age, obesity, psychiatric conditions, BPH, HIV infection, and lack of regular exercise, IBS is an independent predictor of ED. Further study is needed to clarify the pathophysiology between ED and IBS.