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Erectile Dysfunction

Prevalence and Risk Factors in the U.S.

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Updated February 09, 2011

Erectile dysfunction (ED) affects approximately one in five American men, appears to be associated with cardiovascular and other chronic diseases and may predict severity and a poor prognosis among those with heart disease.

In large part the result of new medications to treat erectile dysfunction, there has been a 50 percent increase in doctor visits related to erectile dysfunction from 1996 to 2000. Despite this, previous estimates of erectile dysfunction (ED), have not included a diverse population.

In response to this situation, researchers at The David Geffen School of Medicine at UCLA, and the Urologic Diseases in America Project analyzed data from over 3500 male participants of the 2001-2002 National Health and Nutrition Examinational Survey (NHANES). The goal was to arrive at a better understanding of U.S. national estimates of prevalence and risk factors for ED.

Recent Study on the Prevalence and Risk Factors Association with Erectile Dysfunction

Following recommendations from the National Institutes of Health Consensus Development Panel on Impotence, erectile dysfunction was self-defined by subjects based on their answer to the question:

How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?

Responses included "always or almost always able," "usually able," "sometimes able," "never able," and "don't know."

Men who responded that they were “always, almost always able” or “usually able” to maintain an erection sufficient for sexual intercourse were considered to not have ED. Men who responded that they were “sometimes able” or “never able” to have an erection sufficient for sexual intercourse were considered to have ED. Those who refused to answer the question or responded “don’t know” were excluded from the study.

While the press release for the study begins by pointing out that the study found almost 1 in 5 men had ED, the facts, particularly in regards to aging, show a more predictable, and possibly less dire, picture of things. Here are some of the statistics from the study (figures may not add to 100% because of rounding):

  • Men 20-29: 93.5% did not have ED, 6.5% had ED
  • Men 30-39: 96.2% did not have ED, 3.8% had ED
  • Men 40-49: 91.7% did not have ED, 8.2% had ED

The figures continue to increase until the age of 75. 77% of men 75 and older were living with ED.

In terms of other factors that might contribute to ED, including age and other medical conditions, findings included:

  • Hispanic men had almost twice the risk of ED as white men.
  • Obesity, hypertension, smoking and diabetes also were associated with risk of ED.

There are many interesting things to consider about these numbers. Let’s start with the 77% figure for men over 75.

What does it mean to say that 77% of a population lives with something that is not life threatening? If that many people have an experience at a particular age, does it make sense to think of this experience as a medical condition? Is it just a predictable reality of aging?

Given this number one would hope researchers are asking themselves whether it makes sense to define norms of sexual functioning without taking age into account. In other words, should a 20-year-old erection be like an 80-year-old erection? Who is served by defining something as a dysfunction as opposed to defining it as a "normal" part of aging? How do these labels impact both our experience of something and the ways we think about changing it?

Another interesting data point is that fact that ED seems to be more prevalent in men in their 20’s than it is for men in their 30’s. This may be in part a function of younger men needing to learn ejaculatory control, and getting the hang of it in their 30’s. It might be something else. Either way, it points to the fact that erectile functioning actually fluctuates across the lifespan, and again raises the issue of how we are defining erectile dysfunction versus how we are describing erectile functioning.

Source:

Saigal, C.S., Wessells, H., Pace, J., et. al. "Predictors and Prevalence of Erectile Dysfunction in a Racially Diverse Population" Archives of Internal Medicine Vol. 166 (2006): 207-212.

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