Seasonal Variation in Erectile Dysfunction: A Case Series of Three Patients and Review of Clinical Implications

Erectile dysfunction (ED) is a prevalent condition affecting millions of men worldwide. Risk factors for ED are known to be more prevalent during some seasons, yet the potential seasonal variation in ED symptom severity remains underexplored. In this case series we present three men who reported marked seasonal fluctuation in erectile function. Each patient’s pattern, associated factors, evaluation and response to targeted interventions are described. The cases illustrate multiple plausible mechanisms linking seasonality to erectile dysfunction (ED) — mood and circadian changes (seasonal affective disorder), environmental temperature and vascular reactivity, and seasonally-varying comorbidities/medication exposure (e.g., allergy medications, cardiovascular stress). We discuss a pragmatic diagnostic workup and management approach, and highlight the need for clinicians to ask about seasonal patterns when assessing ED.