Association of Areca Nut Chewing With Risk of Erectile Dysfunction

INTRODUCTION: Areca nut chewing has been shown to increase the risk of cardiovascular disease, but its association with erectile dysfunction (ED) has not been investigated. AIM: To investigate the association between areca nut chewing and risk of ED. METHODS: Consecutive men at public health centers for oral malignancy screening or health checkup were invited to complete a questionnaire. MAIN OUTCOME MEASURE: The Sexual Health Inventory for Men (SHIM). RESULTS: Of the 2,652 respondents, 1,038 (mean age = 43.8 ± 11.1 years) were eligible for the areca nut chewing group and 1,090 non-areca nut chewers were selected as the age-matched control group. In the areca nut group, the mean duration of chewing was 13.2 ± 9.6 years, 61.7% consumed more than 10 portions per day, and 76.2% used it with betel leaf, 16.7% used it with betel inflorescence, and 7.1% used it with betel leaf and inflorescence. Smoking, alcohol drinking, obesity, hypertension, and diabetes were more predominant in areca nut chewers compared with controls. ED defined by self-report and by SHIM score was more prevalent in areca nut chewers than in controls (13.7% vs 9.8% and 48.7% vs 43.3%, respectively; P < .05 for the two comparisons). Areca nut use with betel inflorescence was associated with a higher risk of ED (odds ratio = 2.25, 95% confidence interval = 1.55–3.28) with a dose-dependent effect, whereas using it with betel leaf was not (odds ratio = 1.00, 95% confidence interval = 0.79–1.26) after adjustment of possible confounders. CONCLUSION: Areca nut chewing with betel inflorescence was associated with an increased risk of ED. These findings warrant further studies. Huang Y-J, Jiann B-P. Association of Areca Nut Chewing With Risk of Erectile Dysfunction. Sex Med 2017;5:e163–e168.