Why Are Erection Issues Common among Servicemen?

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A couple of recent reports are shining the spotlight on the problem of impotence among active members of the U.S. armed forces.

Both studies indicate that erection problems are more common among active U.S. servicemen than among their civilian peers. While neither report goes into great detail about the causes of this phenomenon, they offer some signals that psychological factors are responsible for an inordinately large share of military impotence.

This is a significant departure from causes of impotence among men in the civilian sector where erection problems of psychological origin are estimated to account for only 10 to 20 percent of all impotence cases. For civilians, physiological factors are by far the biggest cause of erection problems, presenting almost a complete opposite of the situation among U.S. servicemen.

AFHSC 10-Year Report

Of the two reports, the most broad-based comes from the U.S. Armed Forces Health Surveillance Center, an agency responsible for monitoring health trends among men and women serving in the U.S. military.

The AFHSC report was published in the September 2014 issue of “Military Surveillance Monthly Report,” the agency’s monthly publication. The report tracked the number of impotence cases reported by U.S. servicemen between the beginning of 2004 and the end of 2013.

Rate More Than Doubled

Over that 10-year span, the number of ED cases reported annually by active military men doubled from a crude incident rate of 5.8 cases per 1,000 person-years in 2004 to an incident rate of 12.6 cases per 1,000 person-years.

Because the number of men and women serving in the military fluctuates significantly from month to month and year to year, AFHSC officials use these terms to measure health patterns. The term “person-years” represents “the product of the number of years times the number of members of a population who have been affected by a certain condition,” according to its definition in “Stedman’s Medical Dictionary, 28th Edition.”

Of the more than 100,000 cases of impotence reported during the 10 years from 2004 through 2013, roughly 40 percent were diagnosed as psychogenic in origin, which is two to four times the rate seen among civilians.

High Rate Among the Young

Perhaps even more startling were the results of a study about the incidence of impotence among younger men serving in the U.S. armed forces. Published in the October 2014 issue of “The Journal of Sexual Medicine” but previewed online a few months earlier, the study was based on a survey of 367 active duty male military service members between the ages of 21 and 40.

The Department of Veteran Affairs said its spending on impotence drugs has tripled as more veterans of fighting in Iraq and Afghanistan return to civilian life.
The Department of Veteran Affairs said its spending on impotence drugs has tripled as more veterans of fighting in Iraq and Afghanistan return to civilian life.

Conducted by members of the University of Southern California’s School of Social Work in the fall of 2013, the survey showed that 33 percent of the servicemen surveyed reported erection problems. This is more than three times the rate of impotence seen among young civilian men in the same age bracket.

While it would seem logical that men with symptoms of post-traumatic stress disorder might also suffer from erection problems, the USC study’s findings were truly eye-opening. Its survey showed that servicemen with PTSD were 30 times more likely to experience impotence. It also showed that active military men with PTSD were six times as likely to experience other forms of sexual dysfunction, such as low sex drive and an inability to achieve orgasm.

Survey Shows Few Seek Help

The USC study was conducted by the School of Social Work’s Center for Innovation & Research on Veterans & Military Families. Another disturbing finding from its survey was that only a small percentage of men surveyed actually sought help to treat their erection difficulties.

Only 12 percent of the U.S. servicemen reporting erection problems went on to seek treatment for their symptoms, according to the USC survey. Many of those who were suffering from impotence said they were concerned about what others might think, afraid of possible side effects from medication, or doubtful that the drugs would even work.

Sherrie Wilcox, lead investigator for the USC study, together with colleagues Anthony Hassan and Sarah Redmond, recognized a strong link between impotence and both mental and physical health issues. Specifically, they noted that survey respondents who suffered from anxiety and/or mild depression were nearly 10 times as likely to experience erection difficulties.

Which Is Causing Which?

Of this correlation, Wilcox said, “We know that sexual functioning problems are associated with so many mental and physical health problems, but we were surprised to find such high rates in some instances. What we don’t know is which is causing which. If they’re already having mental health problems, sexual functioning problems could be complicating things even more. All these factors are impacting each other.”

In the 10-year study of impotence cases reported among active U.S. servicemen, the highest incident rate among the branches of service was 10.9 cases per 1,000 person-years in the U.S. Army. Next came the U.S. Coast Guard with an incident rate of 8.3 cases per 1,000 person-years. The rates for other service branches were U.S. Air Force, 7.8; U.S. Navy, 7.3., and U.S. Marine Corps, 4.4.

Post-traumatic stress disorder, depression, and anxiety are common psychological causes of erection problems among active members of the U.S. military as well as veterans.
Post-traumatic stress disorder, depression, and anxiety are common psychological causes of erection problems among active members of the U.S. military as well as veterans.

More Study Needed

While the AFHSC study focuses primarily on raw data showing the number of cases of impotence reported over the 10-year span, the report concludes with an editorial comment section in which some avenues for further study are suggested. It reads:

“For example, examination of the co-morbid and co-occurring medical conditions in servicemen with ED might provide insight into the reasons that incidence rates of diagnoses of this condition are increasing. Several studies in veterans have examined the association between mental health diagnoses, especially PTSD, and the occurrence of ED.”

And the increased incidence of erection problems is not confined solely to active members of the U.S. armed forces, according to an early 2013 report from the Department of Veterans Affairs.

In that report, the cabinet department said that its spending on impotence drugs had nearly tripled over a six-year period. It blamed the sharp rise in spending on impotence drugs on a correspondingly steep increase in the incidence of psychological erection problems among veterans who served in Iraq and Afghanistan.

Iraq/Afghanistan Veterans

The department said more and more veterans were returning from battlefronts in the Middle East with mental health issues such as depression and post-traumatic stress disorder, both of which are recognized as causes of impotence.

In a study published in the February 2013 issue of “The Journal of Sexual Medicine,” researchers reported that a significant number of the veterans of fighting in Afghanistan and Iraq were experiencing some form of sexual dysfunction. They also observed that the risk factors for sexual problems differed somewhat between younger and older veterans.

For both younger and older veterans, high blood pressure and PTSD were important risk factors. However, among younger veterans income and marital status were seen as significant risk factors, while being African American was a more significant risk factor among older veterans.

Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.

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