Erectile dysfunction in adult male tuberculosis patients: a comparative cross-sectional study

Tuberculosis remains a major global health challenge, with 10.7 million new cases and 1.23 million deaths in 2024. It can impair sexual function, frequently leading to erectile dysfunction. Despite its impact, erectile dysfunction is often overlooked in low-income countries like Ethiopia, where evidence among adult TB patients is limited. This study aims to determine the prevalence and associated factors of erectile dysfunction in adult tuberculosis patients and compare them to healthy tuberculosis-negative controls. A comparative cross-sectional study was conducted from June 15 to September 30, 2024 among 162 eligible adult tuberculosis patients and matched controls at the University of Gondar Referral Comprehensive Specialized Hospital. Participants were recruited using simple random sampling technique and data were collected via structured questionnaire. Five milliliters of venous blood were used to determine hormone levels using Beckman coulter DXI 800 chemistry hormonal analyzer. The one-way ANOVA, bivariable and multivariable statistical model was utilized for analysis and p value < 0.05 with a 95% CI was considered as statistically significant. New tuberculosis patients had significantly lower testosterone (p = 0.002 vs B cases on treatment, p < 0.0001 vs controls) and progesterone (p = 0.004 vs TB on treatment, p = 0.02 vs controls) however significantly higher estradiol levels (p < 0.0001) compared to both groups. Treatment duration significantly affected testosterone, estradiol and progesterone levels. The overall prevalence of erectile dysfunction was 77 (47.7%) (95% CI 39.6 to 55.5%). Age, alcohol consumption, and dietary diversity were significant determinants of erectile dysfunction in the study participants. In conclusion, newly diagnosed tuberculosis patients exhibited higher estradiol levels and lower testosterone and progesterone levels compared to patients on treatment and healthy controls. Erectile dysfunction affected nearly half of the study participants and was approximately twice as prevalent in tuberculosis patients. These findings highlight the importance of early detection and management of hormonal changes and erectile dysfunction in tuberculosis care, along with recommendations for a balanced diet and avoidance of alcohol.