Prevalence and Risk Factors of Erectile Dysfunction among Khat Consumers in Mogadishu, Somalia, and to Explore the Impact of Lifestyle Choices, Psychological Health, and Khat Use on Sexual Function and Overall Well-Being

Erectile dysfunction (ED) is increasingly acknowledged as a significant health concern that impacts men's quality of life across various demographics. While often associated with aging, recent evidence emphasizes the role of lifestyle choices, psychological factors, and substance abuse, especially in contexts like Somalia. In Mogadishu, the cultural practice of khat consumption and widespread drug abuse raise substantial issues regarding men's sexual health and overall well-being. This study aims to examine the distinctive patterns of ED among Somali men, delving into the interactions among these factors. The objective of this research is to investigate the prevalence and risk factors linked to ED among individuals using khat and abusing drugs in Mogadishu, Somalia, by evaluating demographic characteristics, psychological and physiological contributors to ED, as well as the impact of lifestyle choices. A cross-sectional survey was conducted involving male participants in Mogadishu, utilizing structured questionnaires that addressed demographics, khat and drug usage, physical activity levels, body mass index (BMI), sexual desire, psychological stress, and histories of chronic diseases (such as diabetes and heart disease). Descriptive statistics were used to analyze the data, focusing on establishing correlations between lifestyle factors and the prevalence of ED. The study yielded several notable findings: 63% of ED cases were found in men aged 50 and older, whereas only 8% were aged 20-30. A significant 79% of participants reported khat consumption, which was associated with a markedly higher prevalence of ED among users. Psychological issues were cited as the primary cause of ED in 42% of cases, with 33% attributing it to arterial disease and 17% to diabetes, while drug abuse was recognized by 8% as a contributing factor. Most participants indicated experiencing mild ED (46%), with 83% having heart disease and 92% facing complications related to diabetes. Lifestyle factors revealed a high prevalence of tobacco use (63%), and a substantial majority (79%) reported a lack of regular physical activity, with 75% classified as obese. Despite 63% using natural products purported to enhance sexual health, half indicated only a mild level of sexual desire, and emotional stress stemming from partner conflicts was reported by 71% of participants. These findings highlight that erectile dysfunction represents a significant public health issue in Mogadishu, with psychological factors being more prominent than physical ones. Younger men are particularly influenced by psychological aspects leading to ED, and lifestyle choices, notably khat consumption and sedentary behavior, play a significant role in the prevalence of ED in this demographic. To effectively address erectile dysfunction, public health initiatives should prioritize psychological counseling to tackle underlying issues, implement health education campaigns to raise awareness about the dangers associated with khat and drug use, and promote community interventions that encourage physical activity and healthy eating habits. Further research, especially longitudinal studies, is necessary to enhance the understanding of the intricate relationship between khat consumption and erectile dysfunction among Somali men. Integrating mental health resources into ED treatment protocols may lead to improved health outcomes and a better quality of life for affected individuals.