Reproductive behavior and erectile dysfunction in the undergraduate university students: cross-sectional study; Comportamiento reproductivo y disfunción eréctil en estudiantes universitarios de pregrado: estudio transversal

Background: Very little is known about erectile function (EF) and its associated predictors in the university students. The aim was to quantify the prevalence and some associated predictors of EF in a large sample of the university students from the largest National University in Kazakhstan. Methods: At Kazakh National University, 1556 male students aged 16 to 23 years filled in anonymous self-administered web-based questionnaire on their sexual and reproductive behavior, including the International Index of Erectile Function (IIEF-5) in 2023. We report age-specific prevalence of erectile dysfunction (ED), defined as IIEF-5 below 22 and the association of IIEF-5 score with selected predictors in adjusted regression models. Results: At least one sexual intercourse was reported by 1306 (84%) students with the first coitus at the median age 17 (interquartile range (IQR) 17; 19) years; and 10% students reported only one ever intercourse. The median number of partners in the preceding 12 months was 1 (IQR 1; 2), but 27% reported they planned to have a child in the next 2 years (100% of 16–17- year-old and 0% of 19–20-year-old students). IIEF-5 score ranged from 21 to 25 (median 25, IQR 21; 25), and was negatively associated with age, independent of ethnicity, place of residence, number of partners and other predictors. No ED was reported by 63% (N = 827), whereas mild ED prevalence was 37% (N = 479) among students who had at least one intercourse. Conclusions: The overall prevalence of ED was very low and associated with age. Preventive interventions in place are likely efficient, but future research should focus on previously unmeasured sexual behavior attributes. © 2025 Elsevier B.V., All rights reserved.