Plastic not so fantastic in the pants

Dear Dr G,

I read with horror a recent publication about microplastics and hope to put Dr. G on the spot for some clarification.

I am a young man in my early forties, you can describe me as an environmental activist, as I do care about what pollution is doing to our bodies.

Incidentally, my wife and I are also healthy individuals who are sexually active and have two healthy children.

As I would like to continue to maintain a healthy lifestyle and pay attention to what I eat, I am very cautious about pollutants that may have detrimental impact.

I recently read about microplastics detected in the penis of men having treatment for erectile dysfunction (ED), and therefore am very keen to put Dr. G on the spot for the matter.

Can you clarify what constitutes ED and what are the causes?

Can you also enlighten us what exactly are microplastics?

And how do they get into the environment?

Lastly, have you read the study on microplastics detected in men with ED. Can you tell me where this paper was published?

How exactly was the study done? And what is the impact of this study on men’s health?

Regards

Plastic Phil

Erectile Dysfunction, or ED, is defined as the inability to achieve or maintain erection for satisfactory sexual intercourse. ED is a common sexual dysfunction and is estimated to affect 18 million American men. In some studies, ED is reported to have a prevalence of up to 52%.

Although not surprising that more than 60% of men above the age of sixty reported the sexual dysfunction, the shocking finding is that ED also affected more than 36.9% of men aged 18 to 29 years old. ED affecting young men had generated much interest amongst scientists to unearth the true etiology. The causes of ED amongst youth may be associated with the rising non-communicable diseases that is also on the rise in younger men. These include hypertension, dyslipidemia, diabetes, obesity and depression.

Other causes of ED also include side effects of medicine, alcohol and smoking. In fact, ED is three times more likely to affect diabetic men, two times more likely in hypertensive men, twice more likely in men with high cholesterol, and twice more likely to affect men who smoke and drink.

All these non-communicable diseases are on the rise amongst youth, which may explain some of the causes of ED amongst the youth. Stress and anxiety were thought to be the main etiology of ED, however other causes are thought to be equally, or more important factors. The challenges faced by the youth these days cannot be undermined, especially in the era of the Covid-19 pandemic.

The scientific data revealed the stress and anxiety during the pandemic can cause ED in up to 10% of men who do not suffer from ED. The figure can be three times higher if an individual is infected with Covid-19, which is associated with inflammatory changes that can further affect the normal physiology of sexual functions.

Another area of contention are environmental pollutants that may be responsible for men suffering from ED. A recent publication from the International Journal of Impotence Research detected microplastics in penile tissue of men suffering from ED.

In this study published in 2024, tissue samples extracted from six individuals who underwent surgery for penile prosthesis were examined. Seven types of microplastics were detected in all tissues, with polyethylene terephthalate and polypropylene being the most prevalent. This research adds a key dimension to the discussion on man-made pollutants, and its impact on male sexual and reproductive health.

The term microplastics is used to differentiate from larger plastic wastes. Two classifications of microplastics are recognised, namely primary and secondary microplastics. Primary microplastics are plastic particles less than 5mm in size before entering the environment, which includes microfibers from clothing and microbeads from shampoos and skincare products. Secondary microplastics arises from degradation of larger plastic products through natural weathering before entering the environment.

Microplastics in the environment can be absorbed in the body through ingestion, touch and inhalation. The potential risks of microplastics to human health is poorly understood. The impact is also difficult to evaluate as the long durations between exposure of the contaminants making it impossible to study.

However, microplastics pollutants have been associated with various inflammatory conditions in the body. The pollutants also act as vector for antibiotic resistance. According to the scientific evidence published by European Union’s Science Advice Mechanism 2019: “Little is known with respect to human health risk of microplastics, and what is known is surrounded by uncertainty”. There is no question the challenges faced by the youth these days are mounting. Apart from more stress and anxiety in the modern digital world, the evidence of adversity of environmental pollutants is also mounting.

The emergence of microplastics in different parts of the human body has raised more questions than answers, and the recent publications of the detection of microplastics in the human penis in men with ED has put the limelight back on this potential long-term catastrophe.

Dr G is often put on the spot for his view on the causes of ED, including pollutants such as microplastics. In fact, he echoes the conclusions by the authors of the European Union’s Scientific Advice: “the poison is in the dose”, and there is a definitely urgent need to understand the potential modes of toxicity of microplastics to human body, highlighting that plastic may not be so fantastic in the pants.