An investigation of erectile dysfunction in Gwent, Wales

Abstract

Objective To quantify incidence of erectile dysfunction (ED) and the associated 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 clinics, primarily to check for prostate disease, 2025 (aged 55±70 years) attended. 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-speci®c antigen (PSA) analysed and those referred for investigation of prostatic disease underwent serum testosterone analysis. Results Complete ED was reported by 265 men (13.2%), and was closely related 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±65and 22.2% of those aged 66±70. 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 smoking 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 serum PSA levels did not in¯uence 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.

Relationship between smoking and erectile dysfunction

“…11,13,19,26 Higher prevalence of ED has been reported both among current and exsmokers. [20][21][22]25,[27][28][29][30][31] In some studies only heavy smoking (30 cigarettes or more/day) was significantly associated with ED, 18,23 while another study found that smoking was related to the prevalence of complete ED only in current smokers with treated heart disease, hypertension and arthritis. 13 Some studies suggest that the prevalence of ED increases with the number of years of smoking, 18,20,25,31 while others have failed to detect a relationship between years smoked or cigarettes smoked daily and ED.…”

“…Association between smoking and ED has been assessed mainly in prevalence studies, which have considerable weaknesses for elucidating the etiology of ED. [12][13][14][15][16][17][18][19][20][21][22][23] Only two longitudinal studies have evaluated the effect of smoking on erectile function. One has clearly shown that smoking does not have an effect on the incidence of ED, 12 and the other has also found no effect in whole sample, 11 while doubling of risk in a subgroup of men free from vascular diseases.…”

Prevalence of erectile dysfunction among middle-aged men in a metropolitan area in Germany

“…However, the prevalence rates found in these studies have varied widely. [3][4][5][6][7][8][9][10] The first epidemiological study of male sexual behavior was published in 1948 by Kinsey et al 11 They recruited a total of 15 781 men up to 80 years of age and found a prevalence of erectile dysfunction ranging from o1% for young men to 80% in the uppermost age group. The Massachusetts Male Aging Study, a community-based observational study of a random sample of men between 40 and 70 years of age, showed a 52% overall prevalence rate for impotence.…”

Effect of life-style factors on incidence of erectile dysfunction

“…1 There are substantial gaps in our knowledge of the occurrence and etiology of ED. [2][3] The use of tobacco and consumption of alcohol are major public health problems worldwide, and the available evidence on the role of smoking [2][3][4][5][6][7] and alcohol consumption [4][5][8][9][10][11][12] on erectile function is controversial. Few population-based follow-up studies have been published on the effect of smoking and alcohol consumption on erectile function.…”