Erectile dysfunction (ED) is a common problem in general medical practice affecting especially the elderly and those with cardiovascular disease and diabetes mellitus. A study was undertaken by questionnaire distributed to consecutive adult male attendees at 62 general medical practices. 1240 completed questionnaires were available for analysis. The mean age of participants was 56.4 y (range 18 ± 91 y). 488 men (39.4%) reported ED: 119 (9.6%)`occasionally', 110 (8.9%)`often', and 231 (18.6%)`all the time' (complete ED). Among 707 men aged 40±69 y 240 (33.9%) reported ED and 84 (11.9%) had complete ED. The prevalence of complete ED increased with age, rising from 2.0% in the 40 ± 49 y age group to 44.9% in the 70±79 y age group. Only 11.6% of men with ED had received treatment. Hypertension, ischaemic heart disease, peripheral vascular disease and diabetes mellitus were frequently associated with ED. 40% of diabetic men aged 60 y or older had ED all the time.

Introduction This is a report of a population-based cross-sectional observational study in Western Australia (WA) on male erectile dysfunction (ED). Aim To assess the prevalence of ED in WA and to examine its associated sociodemographic factors. Method Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the WA Electoral Roll. Main Outcome Measures In addition to items covering sociodemographic and clinical information, the Australian Standard Classification of Occupations (ASCO), the Socioeconomic Index for Area (SEIFA), and the 5-item International Index of Erectile Function (IIEF-5) were used. Results One thousand seven hundred seventy (41.9%) of 4,228 questionnaires were returned. One thousand five hundred eighty (89.3%) were completed questionnaires from men aged 20.1 to 99.6 years (mean 57.9, median 59.1, standard deviation 18.5). The prevalences of any ED and of severe ED among adult males in WA, adjusted for age distribution, were 25.1 and 8.5%, respectively. Standardized to World Health Organization (WHO) World Standard Population, the corresponding prevalences were 23.4 and 7.4%. Prevalence, as well as severity, of ED increased with age. Thirty-eight percent of the participants who were married or had partners experienced ED (severe ED 19.1%). The prevalence of ED was not significantly different between “white-collar” and “blue-collar” workers. Despite the great majority of the affected participants having experienced ED for >1 year, only 14.1% reported having ever received any treatment for ED. Conclusions The study has provided population-based epidemiological data on ED in Western Australian men covering a wide range of ages. The finding that ED is age related, highly prevalent, and grossly underdiagnosed and undertreated is pertinent to global population aging and a rapidly aging Australian population. To facilitate comparisons across populations with different age distributions, all future population-based studies on ED should be standardized to WHO World Standard Population.

Introduction Various studies report increased risk of erectile dysfunction (ED) in men with cardiovascular (CV) disease and postulate an intimate nexus between the two conditions. Aim To examine the association of ED with CV risk factors and disease in a population-based cross-sectional observational study conducted in Western Australia (WA). Method Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the WA Electoral Roll. Main Outcome Measures In addition to items covering sociodemographic and self-reported clinical information, the 5-item International Index of Erectile Function (IIEF-5) was used. Results Of the 1,580 participants, the ages of 1,514 were known and ranged from 20 to 99 years (mean 57.9, median 59.1, standard deviation 18.5). CV risk factors and disease were more prevalent with increasing age and among participants with ED and severe ED. The age-adjusted odds of ED were significantly higher among participants with hypertension (odds ratio [OR] 1.47; 95% confidence intervals [CI] 1.05, 2.07), ischemic heart disease (OR 1.80; 95% CI 1.10, 2.94), and stroke (OR 3.30; 95% CI 1.22, 8.88), and with these conditions and peripheral arterial disease grouped together as CV disease (OR 1.85; 95% CI 1.34, 2.56). Many participants with hyperlipidemia were receiving treatment, and the age-adjusted odds for ED were not significantly higher. The age-adjusted odds of ED among participants with diabetes mellitus were 2.76 (95% CI 1.52, 5.00), and were 3.21 (95% CI 1.03, 10.05) when hypertension and hyperlipidemia were also present. Conclusions The findings support the postulated intimate nexus between ED and CV disease. The adverse effects of age and CV risk factors and disease on erectile function compound each other. The socioeconomic, epidemiologic, and clinical implications are immense.