Aguiar · International journal of impotence research 2025 · cross-sectional survey · n=210

Beyond the prescription: trends and challenges in erectile dysfunction medications among young adult men.

Level 4 - case-series / case-control

Cross-sectional survey study

PubMed 38831015 · doi:10.1038/s41443-024-00902-w · record verified 2026-08-26

What was done

A cross-sectional survey was administered via Qualtrics and distributed through ResearchMatch between June and July 2023 to assess erectile dysfunction (ED) prevalence, medication use patterns, acquisition sources, and medication knowledge among males aged 18 to 40 years.

What was found

Among 210 respondents, 57.1% reported ED and 39.0% reported prior ED medication use. Increased medication use was significantly associated with Black or African American race (OR = 3.54, p < 0.001), Hispanic or Latino ethnicity (OR = 3.32, p = 0.01), Medicare or Medicaid insurance (OR = 6.07, p < 0.001), and greater ED severity. Income >$200,000 was associated with lower medication use (OR = 0.23, p = 0.04). Medication sources included primary care providers (47.6%), direct-to-consumer (DTC) platforms (31.7%), and personal connections (19.5%). Key drivers for procurement methods were privacy (62.2%, n = 51) and cost (54.9%, n = 45). Although 73.2% received risk/benefit counseling and 84.1% received usage instructions, only 28.0% correctly identified essential aspects of proper medication use.

Why it matters

This study highlights how young adult men increasingly use direct-to-consumer channels to obtain ED medications due to privacy concerns, while demonstrating a major gap between reported clinical counseling and actual comprehension of appropriate drug usage.

Limits

The study is limited by a small sample size (n = 210) recruited via an online research registry, introducing potential volunteer and selection bias. Reliance on self-reported survey data introduces recall bias, the cross-sectional design cannot assess longitudinal outcomes, and confidence intervals for odds ratios were not reported in the abstract.