Erectile dysfunction in the community: a prevalence study

Abstract

Objective To investigate the prevalence of erectile dysfunction (ED) in the South Australian community, and the influence of demographic and other risk factors. Design Survey by mailed questionnaire (based on the University of California, Los Angeles prostate cancer index) of a subset (men who agreed to participate) of a probability sample of the South Australian community who completed a multiuser interview survey. Participants and setting Men over the age of 40 in South Australia. Main outcome measures Sexual desire, orgasm, ability to have an erection, adequacy (firmness) of erections for intercourse, frequency of erections when wanted, frequency of intercourse, nocturnal or morning erections, and history of prostate surgery; total sexual function score based on these. Results 612 men (86.7%) agreed to answer the sexual function survey; 427 (69.8%) returned questionnaires. ED was strongly correlated with age in all seven domains of sexual function. Erections inadequate for intercourse affected 3% of 40–49‐year‐olds, increasing to 64% of 70–79‐year‐olds. The frequency of intercourse considered normal for age by men 50–69 years was 1–6 times weekly; the disparity between this and reported frequency increased in men over 60 years, as did the difference between sexual desire and potency. A history of vigorous exercise was protective across all ages. High triglyceride levels, blood pressure medication and non‐cancer surgery for prostate disease were independent predictors of poor sexual function at older ages. High cholesterol level was an independent predictor of impotence. Conclusions We found similar or higher levels of ED than in comparable overseas studies. Disparity between potency and desire was greatest, and hence the age group in whom demand for treatment may be highest, in those 60 years and older. Cardiovascular risk factors were predictors of ED in these older men, suggesting that prevention may benefit sexual function. Non‐cancer prostate surgery may be a greater contributor to ED than previously realised.

Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS)

“…Whether this is related to a genuine underlying biological mechanism such as that mediated by alteration in sex hormone metabolism in smokers [28], although others have found no association [29], or whether it reflects indirectly the operation of other unrecognised health factors influencing both smoking status and PD, remains to be clarified. In contrast, evidence to suggest that smoking [20,30] and alcohol consumption [8] increase the risk of ED were not confirmed in this study. Alcohol consumption appears to have no independent effect on the range of reproductive health disorders examined in this study.…”

“…Associations with cerebrovascular disease and hypertensive disease identified in age-adjusted analyses have been shown in other studies [3,20], although in our study these associations were reduced in multivariate analysis. Similarly, strong associations between LUTS and cardiovascular disease and treatment of hypertension have been demonstrated [34].…”

“…The relationship between physical inactivity and lower risk of PD was not explained by adjustment for other lifestyle factors and co-morbid conditions, such as via a relationship between obesity and lowered blood testosterone concentrations, and remains enigmatic [19]. In contrast to previous studies [7,20,21], the effects of obesity on reproductive health were diminished when adjusted for other lifestyle and co-morbid conditions, suggesting that other factors are confounding this effect. Sedentary lifestyle may be the predetermining factor, irrespective of obesity whereas previous studies have suggested that increased physical activity is associated with less adverse male reproductive health, including erectile dysfunction [22], prostate disease and lower urinary tract symptoms [19].…”

Management of erectile dysfunction: perceptions and practices of Nigerian primary care clinicians

“…11,12,13 A cross-sectional study found that 22% of men visiting GPs in London had sexual difficulties. 15 Fatusi et al reported an overall prevalence rate of 43.8% among men living in some communities in Ile-Ife, Nigeria.…”

“…8,9 Though many prevalence studies have reported that ED is common in most communities, there is evidence that it is often under-diagnosed in primary care settings. 10,11,12,13,14 Clinicians at the primary care level certainly have an important role to play in the management of ED, since this setting allows early identification of affected individuals and prompt treatment or referral to specialist care. Since the majority of the Nigerian populace receive their health services at the primary care level, it is imperative to explore the role of the clinicians in this setting in the diagnosis and management of the disorder.…”