An investigation of erectile dysfunction in Gwent, Wales

Objective To quantify incidence of erectile dysfunction (ED) and the associ ated risk factors in men attending community clinics in a large population in Wales, UK. Subjects and methods Of 4060 men who were invited to attend 11 community cl inics, primarily to check for prostate disease, 2025 (aged 55-70 years) att ended, Of these, 2002 men answered a questionnaire about personal details, medical, family and sexual history, and detailed alcohol and smoking habits . All had their serum prostate-specific antigen (PSA) analysed and those re ferred for investigation of prostatic disease underwent serum testosterone analysis. Results Complete ED was reported by 265 men (13.2%), and was closely relate d to age (r=0.19, P<0.001) and medication (r=0.2, P<0.001). ED occurred in 6.9% of men aged 55-60 years, 12.5% aged 61-65 and 22.2% of those aged 66-7 0. Patients taking diabetic medication had the highest relative risk for ED and 11.3% of men with ED were taking nitrates. The numbers of years of smo king had the third closest correlation with impotence (r=0.16, P<0.001). A low serum testosterone level was a poor predictor of ED and increasing seru m PSA levels did not influence the distribution of ED. Conclusion About 13% of these men aged 55-70 years had complete ED; if this value is extrapolated to the whole of the UK, this equates to almost half a million men being unable to achieve any erections. The estimate would be much greater if those with milder forms of ED are included.