Sexual dysfunction among male veterans returning from Iraq and Afghanistan: prevalence and correlates

J Sex Med. 2013 Feb;10(2):516-23. doi: 10.1111/j.1743-6109.2012.02978.x. Epub 2012 Oct 22.


Introduction: Sexual dysfunction (SD) is not well described in the Iraq/Afghanistan veteran population despite high prevalence of multiple risk factors for this issue.

Aim: To estimate the prevalence and examine the association of various sociodemographic, mental health, comorbid conditions and life style factors with sexual dysfunction in Iraq/Afghanistan veterans.

Methods: This exploratory cross-sectional study was conducted using data from the VA administrative database. A total of 4,755 Iraq/Afghanistan veterans were identified who sought treatment from the Michael E. DeBakey Veterans Affairs Medical Center inpatient and outpatient clinic between September 2007 and August 2009.

Main outcome measures: Sexual dysfunction was determined by ICD9-CM codes related to sexual health issues and/or by specific medications, primarily phosphodiesterase-5 inhibitors (PDE5i), prescribed for erectile dysfunction.

Results: The overall prevalence of sexual dysfunction was 5.5% (N = 265). By age category, it was 3.6% (N = 145) for Iraq/Afghanistan veterans aged 18-40 years and 15.7% (N = 120) for Iraq/Afghanistan veterans aged > 40 years, respectively. A multivariate logistic-regression model revealed that annual income, marital status, post-traumatic stress disorder, and hypertension were significant risk factors of SD (all P < 0.05) among younger Iraq/Afghanistan veterans, whereas among the older Iraq/Afghanistan veterans, being African American and having PTSD and hypertension were significant risk factors of SD (all P < 0.05). There was marked discrepancy between documented erectile dysfunction and prescription of a PDE5i.

Conclusions: These data demonstrate that a significant proportion of Iraq/Afghanistan veterans have SD and that the risk factors differ between younger and older veterans. Our findings also suggest that SD is likely under-coded. To better identify the scope of the problem, systematic screening for sexual dysfunction may be appropriate perhaps as part of an initial post-deployment health evaluation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Afghan Campaign 2001-*
  • Age Factors
  • Comorbidity
  • Cross-Sectional Studies
  • Humans
  • Iraq War, 2003-2011*
  • Life Style
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Phosphodiesterase Inhibitors / therapeutic use
  • Risk Factors
  • Sexual Dysfunction, Physiological / drug therapy
  • Sexual Dysfunction, Physiological / epidemiology*
  • Sexual Dysfunction, Physiological / psychology
  • Sexual Dysfunctions, Psychological / drug therapy
  • Sexual Dysfunctions, Psychological / epidemiology*
  • Sexual Dysfunctions, Psychological / psychology
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology
  • United States
  • Veterans / psychology
  • Veterans / statistics & numerical data*
  • Young Adult


  • Phosphodiesterase Inhibitors