Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study

Abstract

We provide current, normative data on the prevalence of impotence, and its physiological and psychosocial correlates in a general population using results from the Massachusetts Male Aging Study. The Massachusetts Male Aging Study was a community based, random sample observational survey of noninstitutionalized men 40 to 70 years old conducted from 1987 to 1989 in cities and towns near Boston, Massachusetts. Blood samples, physiological measures, socio-demographic variables, psychological indexes, and information on health status, medications, smoking and lifestyle were collected by trained interviewers in the subject's home. A self-administered sexual activity questionnaire was used to characterize erectile potency. The combined prevalence of minimal, moderate and complete impotence was 52%. The prevalence of complete impotence tripled from 5 to 15% between subject ages 40 and 70 years. Subject age was the variable most strongly associated with impotence. After adjustment for age, a higher probability of impotence was directly correlated with heart disease, hypertension, diabetes, associated medications, and indexes of anger and depression, and inversely correlated with serum dehydroepiandrosterone, high density lipoprotein cholesterol and an index of dominant personality. Cigarette smoking was associated with a greater probability of complete impotence in men with heart disease and hypertension. We conclude that impotence is a major health concern in light of the high prevalence, is strongly associated with age, has multiple determinants, including some risk factors for vascular disease, and may be due partly to modifiable para-aging phenomena.

Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease

“…In the analysed group of patients in that study, the erection process, which is dependent on cooperation between the nervous system and the vascular system, was significantly negatively related to the age of the men in the study group. The relationship between the autonomic nervous system, age and EQ is probably the result of the age-related progression of risk factors and their long-term detrimental effect on the blood vessels responsible for erection, as previously observed by both Blanc et al (30) in a rehabilitated population of men and by Feldman et al (31) in the Massachusetts Male Aging Study. Another significant factor with a proven effect on ED prevalence as well as on EQ of the analysed group of patients is diabetes, due to its multi-directional negative effect on the human body and consequently the erection process.…”

The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction

“…Because hypertension is the most prevalent medical risk factor for ED, 34 it is of interest to determine whether ED in hypertensive patients can be identified and classified via the IIEF. Burchard et al 35 evaluated this hypothesis by administering IIEF and medical history questionnaires to a representative sample of 104 hypertensive patients at an outpatient hypertension center.…”

Body mass index, physical activity and erectile dysfunction: An U-shaped relationship from population-based study

“…The responses ranged from 'extremely difficulty' to 'not difficult at all' and 'not difficult at all' was used to indicate absence of ED while the other responses were combined to collectively indicate the presence of ED. The rationale was because both IIEF-15 17 and IIEF-5 12 as well as the Massachusetts Male Aging Study 18 defined ED as having 'some degree of ED'.…”