UPJ INSIGHT Associations between Race and Erectile Dysfunction Treatment Patterns

By: Tony Chen, MD; Shufeng Li, MS; Michael L. Eisenberg, MD | Posted on: 01 Oct 2022

Chen T, Li S, Eisenberg ML. Associations between race and erectile dysfunction treatment patterns. Urol Pract. 2022;9(5)423-430.

Study Need and Importance

Erectile dysfunction (ED) is a highly prevalent condition that affects over 50% of men over the age of 40. Fortunately, there are many effective and readily available treatments for ED that range from oral medications to surgical intervention. Previous studies have shown that racial differences exist for ED risk factors, incidence, as well as severity, but none have examined whether these differences influence how men might receive treatment for ED. In this study, we sought to investigate whether there are racial differences in the types of ED treatments men receive.

What We Found

We analyzed administrative clai­ms data from over 800,000 men in the United States between 2003 and 2018, out of which 3.1% of were Asian, 10.5% were African American, 11.5% were Hispanic and 74.9% were Caucasian. After controlling for certain patient comorbidity and sociodemographic factors, we found that compared to Caucasians, Asian and Hispanic men had a lower probability of receiving any ED treatment, while African Americans had a higher probability. Asian and Hispanic men also tended to have longer delays to receiving ED treatment after (see Figure).

Figure. Kaplan-Meier curves for time to receiving any ED treatment for erectile dysfunction treatment by race.


As with any administrative claims data research, our analysis is dependent on accurate coding of diagnoses and treatments, and doesn’t capture treatments not paid for by commercial or Medicare insurers. Available racial categories used in population-based research are imperfect embodiments of identity and will often lack granular variables like preferred language. Finally, causality cannot be inferred from the retrospective nature of this work.

Interpretations for Patient Care

The results of this study demonstrate that there exist racial differences in how men are receiving treatments for ED. This study may hopefully serve as an impetus to further investigate factors that may influence patient decision making regarding ED treatment, as well as potential barriers to seeking ED treatment.