Disordered Eating Behaviors During Childhood and Adolescence and Erectile Function: A Prospective Cohort Study

Disordered eating behaviors may impact male reproductive health through several mechanisms, such as disrupting hormone production or harming psycho-sexual health. Despite this, few studies have evaluated these associations.

To prospectively investigate the associations between disordered eating behaviors during childhood and adolescence with erectile function in adulthood.

We included 2428 male participants (9-15 years at enrollment) from the Growing Up Today Study (1996-2021). Multivariable linear regression with generalized estimating equations were used to calculate the adjusted mean difference (aMD) in erectile function score and 95% confidence intervals (CI). Past year frequency of binge eating, laxative use, and self-induced vomiting were self-reported on repeated questionnaires during follow-up. Erectile function was self-reported using the 5-item International Index of Erectile Function (IIEF-5) Questionnaire (range: 5- 25) in 2013 and 2021.

In 2013 (mean age: 28 years) and 2021 (mean age: 36 years), we identified 44 and 308 cases of mild-to-moderate erectile dysfunction (IIEF-5 score ≤ 16). During follow-up, ever report of binge eating, self-induced vomiting, and laxative use was 17.8%, 3.9%, and 2.3%, respectively. Compared to participants who never binge ate, participants who binge ate had lower erectile function scores (aMD: -0.58, 95% CI: -1.05, -0.11). This harmful association was stronger among men who had a cumulative exposure of more than monthly binge eating compared to never binge eating (aMD: -2.15, 95% CI -5.00, 0.71). Self-induced vomiting and laxative use were not associated with erectile function.

Men who engage in binge eating during adolescence may have worse erectile function in adulthood. Laxative use and self-induced vomiting, while rare, were not appreciably associated with erectile function. These associations were consistent after adjustment for adult body size, comorbid mental health diagnosis, and sexual orientation. Our findings contribute to a growing literature indicating that exposures during childhood and adolescence may be important for adult reproductive health outcomes.