The epidemiology of erectile dysfunction and its risk factors

Abstract

Erectile dysfunction (ED) affects millions of men throughout the world. The literature is ample, but an accurate estimate of its prevalence is still difficult since figures mainly refer to the USA, and are based mostly on small selected samples of people. Caution must anyway be used in comparing data from studies conducted in the past because of possible differences in the definition and classification of ED. Many factors are believed to contribute to the development and maintenance of ED. The influence of age and of several medical conditions (diabetes, vascular disease, and chronic diseases such as hepatic failure, renal failure and dialysis) is well defined. Also well documented is the role of some drug groups, whereas the role of other pharmacological agents is still controversial because of the frequent coexistence of other pathological conditions or concomitant exposure to other drugs. Less well defined and sometimes controversial is the role of risk factors mainly related to life-style such as cigarette smoking, alcoholism, total cholesterol levels and certain types of trauma. This paper reviews the main data on the epidemiology of ED and some related risk factors.

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

“…The present study was conducted among patient with vascular disorders, which predispose patients to development of ED (4, 20). The study results showed significant increase in HRR in patients subjected to cardiac rehabilitation.…”

“…Cardiac rehabilitation improved the IIEF-5 score; however, the change in EQ due to training was negatively related to age and initial EQ. In the literature, the risk of sexual disorders among men with IHD is 39%–65% (7, 20). Furthermore, autonomic dysfunction is among the known etiologic factors of ED (7).…”

“…For patients suffering from IHD, both vascular disorders and autonomic dysfunction occur simultaneously. In clinical practice, assessment of the functioning of the autonomic nervous system is performed indirectly using heart rate variability analysis (20, 21). However, a review of published research shows that heart rate variability analysis alone does not allow practitioners to observe the dynamic response of the autonomic system to exercise stress (7).…”

Surveillance of cardiovascular risk factors for outpatients in different erectile dysfunction severity

“…Further, the degree of ED is related to the number and severity of the risk factors themselves. 1,19,20 Recent studies have shown that the similar pathogenic involvement of the nitric oxide (NO) pathway leading to the early impairment of endothelium-dependent vasodilatation and late obstructive vascular changes is common to both ED and other vascular diseases. 21,22 In 2003, a pathophysiological mechanism, the 'artery-size hypothesis,' was proposed by Montorsi et al to explain the link among ED, CAD, and stroke.…”

“…17 Questions 1-5 and 15 of the IIEF constitute the erectile function domain, which is used to assess global erectile function. Scoring the IIEF domain of erectile function allowed the classification of each patient as follows: absent of ED (26)(27)(28)(29)(30), mild ED (17)(18)(19)(20)(21)(22)(23)(24)(25), moderate ED (11)(12)(13)(14)(15)(16) and severe ED (0-10).…”