Is It All in My Head? Self-Reported Psychogenic Erectile Dysfunction and Depression Are Common Among Young Men Seeking Advice on Social Media

It has been estimated that between 25–30% of men who suffer from erectile dysfunction (ED) are under the age of 40, a statistic that stands sharply in contrast with the breadth of current literature, understanding, and treatments for ED that have largely been characterized in men over the age of 60. Cardiovascular disease, hypertension, diabetes, hypogonadism, and vasculogenic etiologies are typically the top differential diagnoses for a man presenting with ED; however, it is unclear whether these etiologies can be generalized to a younger demographic.

Young men generally see a healthcare provider at lower rates than any other demographic and therefore are a difficult cohort to study. However, this demographic tends to gravitate towards social media platforms, particularly with regards to discussions about health-related topics. Therefore, social media platforms are a rich and untapped resource for this study of this unique population. Using quantitative Natural Language Processing and qualitative analysis methods, we analyzed a social media forum focused on ED. We found that younger men commonly experience depression, anxiety, and other psychogenic comorbidities in association with ED. Additionally, we found that many of these men do not visit a health care provider for their ED and may turn to social media for their health-related needs. A limitation of this study was all data were anonymous and self-reported, which may lead to biases in our conclusions. Additional validation studies would be helpful to support our findings.

Our work utilized honest and raw discussion of ED in a demographic that has been understudied while highlighting the important conclusion that younger men may suffer from a different set of comorbidities for ED compared to their older counterparts. Historically, cardiovascular disease has been a much-discussed comorbidity for ED; however, our study suggests that psychological distress is a key comorbidity that should not be neglected by providers in the evaluation and treatment of ED. Furthermore, this project also highlights the bigger role that social media is playing in our medical setting either as a source of information or as a source of shared decision making. Making better use of validated discussions will be an important consideration going forward in this new digital landscape.

Written by: Tommy Jiang, Vadim Osadchiy MD, Jesse N. Mills MD, Sriram V. Eleswarapu MD, PhD, Twitter: @eleswarapu, Department of Urology, University of California Los Angeles Health, Los Angeles, California

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