What is the link between gout and ED?

Having the painful condition of gout can be bad enough but for some men, they may also discover that even worse, they are having trouble with erectile dysfunction or ED.  Several past studies have shown a link between the two with one being a population-based study suggesting men who have gout may have an increased risk of ED.  This finding and others support a possible role for hyperuricemia and inflammation as independent risk factors for ED.

What is gout and how is it linked to ED?

Gout is the most common form of inflammatory arthritis affecting more than 8 million Americans and is far more common in men than women, at least until menopause. Estrogen, a female sex hormone, helps the kidneys process uric acid.  However, once women reach menopause, their risk for gout increases, as their estrogen levels drop. 

The underlying cause of gout is a buildup of excess uric acid in the body called hyperuricemia.  The excess uric acid crystals get deposited in the joint cartilage causing excruciatingly painful symptoms within the joints.

Uric acid is a substance formed when our bodies break down purines.  Purines are naturally found in all cells of the body and in certain foods such as liver, seafood, peas, and beer.  Uric acid is usually absorbed in the blood where it is transported to the kidneys to be processed and eliminated in the urine.  However, some people make too much uric acid to where kidneys can’t process it efficiently causing a buildup of uric acid in the body. Uric acid can also accumulate when a person eats too many foods that contain purines. Eventually, the buildup forms sharp crystals, leading to gout. Gout often starts in the feet, especially the big toe. But it can also form in the knees, wrists, fingers, and elbows.

The connection of gout with ED is believed to be caused by deposits of needle-like monosodium urate crystals in the joints which is associated with an abnormally high level of urate in the bloodstream.  These crystals lead to inflammation, swelling and pain in the affected joint.  Since gout is commonly associated with cardiovascular disease (CVD) risk factors, men with ED also have an increased rate of CVD risk factors. 

There might also be a possible connection between high levels of uric acid and endothelial dysfunction. The endothelium is tissue that lines all blood vessels, including those in the penis. Problems with the endothelium can restrict blood flow to the penis, which weakens erections. As men with gout have higher levels of uric acid, this link might account for their ED.

  Other causes of ED

Besides gout, there are other causes of ED which may include the following:

·      Diabetes – 50% of men who have diabetes also have ED.  The elevated blood glucose level and nerve damage leads to inadequate blood flow and nerve damage to the penis.

·      Obesity – Men carrying excess weight tend to have high cholesterol levels leading to clogged arteries preventing efficient blood flow. 

·      Alcohol, smoking and drugs – Any kind of substance abuse is tough on a man’s brain and heart, making it difficult for the heart to pump blood efficiently and the brain to send signals accurately, therefore leading to ED.

·      Certain medications – ED can be a side effect of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, and appetite suppressants.

Any man who has gout should also be evaluated for ED.   In doing so, this can help men to not only discover a possible underlying cause of his ED but also to help them learn how to better manage their health to prevent gout and other possible causes associated with ED such as heart disease. 

David B. Samadi, MD, Urologic Oncology Expert and Robotic Surgeon located at 485 Madison Avenue on the 21st floor, New York, NY – 212-365-5000.  Follow Dr. Samadi at www.samadimd.com,  www.prostatecancer911.com, and www.roboticoncology.com