The hidden level of erectile dysfunction in young men

Both the frequency and the severity of erection problems increase with age. And since the older age groups were under-represented in the study, the true frequency of erection problems and of severe erection problems in men may have been higher than the recorded levels of 25.1 and 8.5%. [In the current editor's opinion these figures are so high that they are hard to believe....but this is what the study found. The study was conducted in Western Australia, and if truly representative of the men's sexual health in that state, then Australian men are in crisis.]

Australian demography is changing rapidly, and the proportion of men aged 65 years and older will increase dramatically in the years to come - which means erection problems will pose huge clinical and socioeconomic burdens on healthcare providers and social support services in the years ahead - if men choose to seek help, which currently they are not doing. The majority of the participants in the Western Australia Men's Health Study, from where these results are taken, were married or had partners, even though an astonishing 25% or more of these men were not enjoying an active sex life. Of the men aged 70 years and older, a fair proportion remained sexually active.

All these findings matched the results from the Global Study of Sexual Attitudes and Behaviors, a large scale project in which over thirteen thousand men from 30 countries were asked about their sexual behavior. Over 84% of men in this study aged between forty and eighty said they'd had sexual intercourse within the 12 months preceding the study. Among the men who were sexually active, about half said they had sexual intercourse regularly.

When the authors compared men who had never been married with those who were married or had partners, they found, perhaps unsurprisingly, that having never been married was significantly associated with an increased chance of having erection problems; in short, fewer married men have erection problems than non-married men, though which is cause and which effect remains unclear. Analysis of the results of the study also showed that being separated or divorced may be one of the predisposing factors for erection problems. (Though once again, of course, whether the erection problems were a cause of, or simply unrelated to, separation and divorce, is unclear. In other studies, it has been shown that men with severe erection problems are much more likely to be single, without regular sexual partners.

Erection problems have previously been associated with lower socioeconomic status. The current study demonstrated that erection problems occurred in a smaller proportion of men who were in full- or part-time employment compared to the unemployed. Clerical, sales and service workers had the highest frequency of erection problems, although there were few other correlations of note between erection problems and occupational group. There was no difference between "blue collar" and "white collar" workers in this respect.

Of the 468 men in the study who reported on the length of time for which they had endured erection problems, 47.9% had had the problem for between one and five years. This matches other studies in the general population, where 55% of men with the problem were found to have had erectile dysfunction of one sort or another for this period. The current authors' observation that men who had had it for longer also had more severe problems is neither surprising nor novel. In spite of erection problems being a common and often long-standing condition, only 14.1% of the men with erection problems had ever received any treatment. This suggests that there is an urgent need for sexual education and awareness information at every level. And certainly, if it's true that the longer the erection problems continue, the worse they get, then men with any erection problem should get professional assistance as soon as possible so that therapeutic intervention can be started in the milder stages of erectile dysfunction.

It's also important to remember that erection problems may indicate cardiovascular and endothelial disease - so once again, there is a clear incentive for erection problems to be comprehensively investigated. In this study in WA, erectile dysfunction was found to be apparently under-diagnosed and grossly undertreated. Whether or not this is true - and if it is, whether or not it applies to the rest of the world - remains to be seen.
 

The Journal of Sexual Medicine

Volume 5 Issue 1 Page 60-69, January 2008

To cite this article: Kew-Kim Chew MBBS, FRCPEdin, FRCPGlasg, Bronwyn Stuckey MBBS, FRACP, Alexandra Bremner BSc(Hons), GradDipAppStats, PhD, Carolyn Earle BSc, PGradDipHithSci, Konrad Jamrozik MBBS, D Phil (2008) Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic Factors
The Journal of Sexual Medicine 5 (1) , 60–69 doi:10.1111/j.1743-6109.2007.00548.x

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