Erectile Dysfunction

Symptoms

The main symptom is the inability to attain or maintain adequate erection to complete sexual activity.

As a result of this symptom, affected men may also experience depression and distress, and this symptom can cause interpersonal (including marital) issues.

Demographics

Studies indicate that in the United States at least 30 million American men suffer from some degree of erectile dysfunction (ED). Of these, 10 to 20 million have a severe degree of ED resulting in the complete inability to attain or maintain a penile erection. The number of ED victims in the U.S. is projected to increase by nearly 10 million by the year 2025. With the advancement of men's median age in western industrial countries and the general population growth in developing nations, the worldwide incidence is projected to increase to greater than 320 million by 2025. ED accounts for more than 500,000 annual visits to health care professionals.

As with other chronic disorders and the conditions that are commonly associated with ED (diabetes, hypertension, cardiovascular disease), the prevalence of ED increases with advancing age, with an estimated prevalence of 39% in men aged 40 and 67% in those aged 70. These figures may actually underestimate the true dimensions of the problem since ED is notoriously under-reported, undiagnosed and under-treated because of the perceived stigma associated with the diagnosisof ED. It is reported that 70% of ED remains undiagnosed and in a survey of general medical practice less than 12% of men with ED reported having received treatment for it.

Interview

An essential first step in the diagnosis of ED is the taking of a thorough sexual, medical, and psychosocial (both psychological and social) history. The sexual history should include information such as the frequency of sexual intercourse, its duration, the quality and degree of penile erection, the presence or absence of nocturnal erections, and the success or failure of penetration. Any sexual dysfunction on the part of the partner, such as painful intercourse (dyspareunia) or vaginal dryness, should be ascertained. The use of one of several available self-directed patient questionnaires may be a useful adjunct to the sexual history. The sexual history helps in distinguishing ED from other abnormalities in sexual function such as ejaculatory and orgasmic disturbances and loss of sexual desire.

The general medical history may disclose one or more distinct causes of ED including the presence of associated conditions, the use of medications that can cause the disorder, and/or a history of substance abuse.

A psychosocial history, preferably with the participation of the patient's sexual partner, should include current sexual practices, the presence or absence of stress and performance anxiety, and any special circumstances under which ED occurs.

Content licensed from:

Author Info: Ralph Myerson M.D., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Mental Disorders, 2003

This feature is for informational purposes only and should not be used to replace the care and information received from your healthcare provider. Please consult a healthcare professional with any health concerns you may have.