China: Migraine is associated with a significantly high erectile dysfunction (ED) risk, particularly in those aged < 40 years, states a recent study in The Journal of Sexual Medicine. However, the researchers add that there is a need for further studying the pathophysiological mechanisms of this action.
Migraine is a common chronic primary headache that is shown to be associated with high ED risk. Weicheng He, Department of Urology, Shawan People's Hospital, Panyu District, Guangzhou, Guangdong, China, and colleagues aimed to summarize all the evidence related to this topic and show a quantified result on the association between migraine and ED, which has not been reported in the literature.

For this purpose, the researchers systematically searched the MEDLINE, Excerpta Medica Database, and Cochrane Library for identifying the eligible studies (2000–2021). The combined effects were synthesized with the relative risks (RR) or standard mean differences (SMD).
The study included 6 trials with a total of 51,657 participants, of which 6,175 were men with migraine.
The findings of the study were as follows:
The pooled analysis indicated that migraine was associated with a significantly higher risk of ED as compared to the non-migraine general population (RR = 1.63).
Consistently, men with migraine have a significantly lower IIEF-5 score than healthy controls (SMD = -3.64).
Stratification analysis on the mean age indicated that the association between migraine and ED was much stronger in the migraine patients with age < 40 years (RR = 32.29) than in those with age > 40 years (RR = 1.75).
Sensitivity analysis indicated that no single study had dominated the combined RR and the heterogeneity.
To conclude, ED is a common disease among men with migraine, especially those patients whose age is below 40 years old. Compared to the healthy controls, migraine patients were at a 32-fold increased risk of ED.
"Migraine-induced ED may correspond with multiple factors including chronic illnesses, chronic pain, and psychosocial causes (like anxiety and depression)," wrote the authors. "Since phosphodiesterase-5 inhibitors (ie, sildenafil) might induce or exacerbate migraine, thus it is not recommended to prescribe these drugs for patients with migraine-mediated ED."
Reference:
The study titled, "Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis," was published in The Journal of Sexual Medicine.
DOI: https://doi.org/10.1016/j.jsxm.2021.12.014
KEYWORDS: Journal of Sexual Medicine, migraine, erectile dysfunction, ED, phosphodiesterase-5 inhibitors, sildenafil, Weicheng He, sexual disorder, men, sexual function, headache