Epidemiology of erectile dysfunction: results of the 'Cologne Male Survey'

The last few decades have seen a marked increase in mean life expectancy in Central Europe. This has made elderly people and their quality of life a m atter of ever-increasing medical concern. Available data from the United St ates and Scandinavia relating to erectile dysfunction (ED) do not enable us to draw valid conclusions about the current situation in Germany. The aim of the present study was to evaluate the epidemiology of male sexuality in Germany, and the proportion of men who need medical treatment because of in creased suffering from this. A newly developed and validated questionnaire on male erectile dysfunction was mailed to a representative population sample of 8000 men, 30-80 y of ag e in the Cologne urban district. The response included 4489 evaluable replies (56.1%). The response rates in different age groups ranged from 49.2% to 68.4%. Regular sexual activity w as reported by 96.0% (youngest age group) to 71.3% (oldest group). There we re 31.5%-44% of responders who were dissatisfied with their current sex lif e. The prevalence of ED was 19.2%, with a steep age-related increase (2.3-5 3.4%) and a high co-morbidity of ED with hypertension, diabetes, pelvic sur gery and 'lower urinary tract symptoms'. When treatment need was defined by co-occurence of ED and dissatisfaction with sex life, 6.9% men required tr eatment for ED. Oral treatment of ED was preferred by 73.8% of respondents. There were 46.2% respondents who were willing to contribute more than DM 5 0 (25 Euro) per month for ED treatment. We conclude that regular sexual activity is a normal finding in advanced ag e. ED is a frequent disorder, contributing to dissatisfaction with sex life in a considerable proportion of men. The high burden of ED is reflected in willingness to pay for treatment. ED is frequently associated with chronic diseases. Therefore adequate diagnostic workup is essential, to offer pati ents individually adapted treatment. General non-reimbursability of treatme nt for ED appears to be unacceptable.