Epidemiology of erectile dysfunction

Epidemiology of erectile dysfunction

Ever since the ground-breaking work of Kinsey, the prevalence of erectile
dysfunction has been a subject of debate. Althoughit is certain that many
millions of men are affected by the condition, there is a surprising dearth of
high-qualityepidemiological data with which to quantify accurately the
extent of the problem. A figure of one man in ten has often beenquoted as an
estimate of the prevalence of erectile dysfunction, but the frequency and
severity of the disorder vary markedlywith age. Erectile dysfunction is
uncommon in young men (with the exception of intermittent psychogenic
problems),becomes more common in middle age, and is highly prevalent in men
more than 60 years of age. Thus, to some extent,erectile dysfunction is a
natural expression of aging, but one that men are increasingly less willing to
accept without seekingtreatment. As the world's population ages over the
next few decades (Figure 35), the number of men who will suffer
erectiledysfunction seems certain to rise.

One problem for epidemiologists trying to quantify the extent and impact of
erectile dysfunction is the frequentunwillingness of men to discuss the
problem frankly. The accuracy of almost all data in this disease area is
therefore impairedby the reluctance of many, particularly older, men to
respond to what they regard as overly personal questions. However, withthe
development of simple questionnaires which can be self-administered, and the
gradual breakdown of social taboossurrounding the open discussion of sexual
issues, it is possible to anticipate higher-quality information in the
future.

At this time, however, the best data available concerning the prevalence of
erectile dysfunction are derived from theMassachusetts Male Aging Study
(Figure 36). The findings of this study may be summarized as follows. A total of
1290 menaged 40-70 years were included in the study; erectile dysfunction
was very common, with 52% of men reporting some degreeof erectile
dysfunction—mild in 17.1%, moderate in 25.2% and complete in 9.6%. Complete
erectile dysfunction wasreported by 5% of men at 40 years of age, rising to
15% at age 70 years. Loss of firm erections is often extremely bothersometo
men. Figure 37 demonstrates the degree of worry, the loss of confidence, the
negative feelings and the depression that canresult.