Erectile dysfunction in the community: a prevalence study

Objective: To investigate the prevalence of erectile dysfunction (ED) in th e South Australian community, and the influence of demographic and other ri sk factors. Design: Survey by mailed questionnaire (based on the University of Californ ia, Los Angeles prostate cancer index) of a subset (men who agreed to parti cipate) of a probability sample of the South Australian community who compl eted 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 wh en wanted, frequency of intercourse, nocturnal or morning erections, and hi story 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 affe cted 3% of 40-49-year-olds, increasing to 64% of 70-79-year-olds. The frequ ency of intercourse considered normal for age by men 50-69 years was 1-6 ti mes 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 trigly ceride levels, blood pressure medication and non-cancer surgery for prostat e 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 ove rseas studies. Disparity between potency and desire was greatest, and hence the age group in whom demand for treatment may be highest, in those 60 yea rs and older. Cardiovascular risk factors were predictors of ED in these ol der men, suggesting that prevention may benefit sexual function. Non-cancer prostate surgery may be a greater contributor to ED than previously realis ed.