Erectile Dysfunction in the Community: Trends over Time in Incidence, Prevalence, GP Consultation and Medication Use—the Krimpen Study: Trends in ED

Abstract

Introduction In the general population, erectile dysfunction (ED) is surrounded by a “taboo.” Epidemiologists studying this problem have to be aware of the phenomenon of the “tip-of-the-iceberg.” Aims Our aim is to describe the iceberg phenomenon for ED and their help-seeking behavior in the general population during a period when public interest in ED heightened and waned after the introduction of the drug sildenafil. Methods The data were obtained as part of a large longitudinal community-based study, i.e., the Krimpen study. With four rounds of data collection with an approximate 2.1 years interval, the local pharmacists provided data on medication use, whereas abstracts from the medical record and history were provided by the local general practitioners (GPs). The data from the questionnaires were entered into the Krimpen study database but were not communicated to the GPs. Main Outcome Measures ED: according to the ICS-questionnaire, GP consultation: search of electronic medical dossier for ED or reports from any specialist, use of ED medication as delivered by the pharmacy. Results The age-standardized prevalence of ED is stable, i.e., around 40%. During the period 1995 to 2000, the incidence increased from 5% to 6.5%, then it stabilizes around 5% per year. The first-time use of ED medication increases exponentially between 1995 and 2000, then it stabilizes at about 3.5% per year. The number of GP consultations by men with ED increases up to 1999, after which it stabilizes at about 1.8% per year. Conclusion We suggest that the availability and awareness of a new pharmacological option induced a change of behavior among GPs and their patients.

Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study

“…One study found that smoking was significantly negatively associated with help seeking [13]. Another study found that men who contacted the GP regarding ED were slightly but significantly more overweight compared to the men who did not contact a GP [31]. We found no significant associations between smoking status, alcohol consumption, BMI and contact with a GP.…”

The global prevalence of erectile dysfunction: a review

“…The global prevalence of ED, as measured by all other questionnaires, was 3-76.5% (Table 3 [5,19,[37][38][39][40][41][42][43][44][45][46][47][48][49][50]). The prevalence by continent was: 22-46.3% [5,42,46], 14% [5], 10-76.5% [5,37,38,40,45,48,50], 49.4% [47], 8-65% [19,[39][40][41]43,44], 53.6% [49] for North America, South America, Europe, Oceania, Asia and Africa, respectively. The prevalence of ED increased with increasing age [5,19,38,[40][41][42][43][44]50].…”

An open-label, long-term evaluation of the safety, efficacy and tolerability of avanafil in male patients with mild to severe erectile dysfunction

“…ing and procurement (6). For the achievement of successful intercourse, PDE5is that have been prescribed for more than a decade have demonstrated favourable efficacy (7), ranging from 52% to 66% at their highest doses (8)(9)(10).…”

“…Several factors, including clinical presentation, patient demographic and personal situation, may influence the choice of a PDE5i (5), and data from a large longitudinal community‐based study from the Netherlands (the Krimpen study) suggested that the availability and awareness of new treatment options (i.e. PDE5is) for ED induced a change of behaviour in general practitioners and their patients, regarding treatment‐seeking and procurement (6). For the achievement of successful intercourse, PDE5is that have been prescribed for more than a decade have demonstrated favourable efficacy (7), ranging from 52% to 66% at their highest doses (8–10).…”