National Trends in Medication Prescriptions for Male Lower Urinary Tract Symptoms and Erectile Dysfunction: Findings from the Norwegian Prescription Database

Abstract

Background and objective

Trends for the medical management of male lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) remain-under reported at a national level. Our aim was to analyse national trends in prescribing patterns for ED and LUTS medications among men in Norway.

Methods

Data were extracted from the Norwegian Prescription Database (Norwegian Institute of Public Health) for the period 2004–2020. Medications were identified according to the Anatomical Therapeutic Chemical classification system.

Key findings and limitations

For BPH medications collectively, the total annual number of prescriptions increased from 23 711 in 2014 to 102 531 in 2020. α-Adrenoceptor antagonists were prescribed five times more often than 5α-reductase inhibitors. Ten in 100 men aged ≥75 yr now receive a prescription for a BPH medication. By 2020, 19 per 1000 men received a prescription for ED medication. Sildenafil was the most popular choice (47%), followed by tadalafil (43%) and vardenafil (4.8%); the number of users per 1000 men increased from 4.4 to 9.3. Among medications used for urinary incontinence/urgency, mirabegron was the most popular choice (62%) in 2020, followed by oxybutynin (17%).

Conclusions and clinical implications

Prescriptions for medications for BPH, ED, and urinary incontinence/frequency have increased at a national level. Further studies are needed to link this with individual data to ascertain discontinuation rates and conversion from pharmacotherapy to surgical intervention.

Patient summary

In Norway, there were increasing trends in the use of medications to treat benign prostate enlargement (BPE), erectile dysfunction, and urinary incontinence between 2004 and 2020. The biggest rise was for medications for BPE, which are now prescribed more often than for medications for erectile dysfunction. In recent years, the number of surgeries performed for BPE has fallen.