Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

Abstract

Background: Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate.

Methods: Men ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches), and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF) were administered.

Results: Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053), of whom 54% (399/744) had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range) number of risk factors was 2.9 ± 1.7 (3-8) in the "yes" group, 3.2 ± 1.7 (3-9) in the "unsure" group, and 2.6 ± 1.5 (2-8) in the "no" group.

Conclusion: Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction.

Trial registration: ClinicalTrials.gov Identifier NCT00343200.

Figure 1

Erectile dysfunction severity by screening question response. IIEF-EF = Erectile Function domain of the International Index of Erectile Function. Using the IIEF-EF, erectile dysfunction severity categories are no ED (score ≥26 out of 30) mild (score 22-25), mild-to-moderate (score 17-21), moderate (score 11-16), and severe (score ≤10)[13,14].

Figure 2

Erectile dysfunction severity at screening. Erectile dysfunction severity at screening was based on Erectile Function Domain of the International Index of Erectile Function score in men who responded "yes," "no," or "unsure" to the question, "Do you have erectile dysfunction?" Percentages with each erectile dysfunction severity category were calculated within the individual response groups ("yes," "no," or "unsure"). Erectile Function domain of the International Index of Erectile Function severity categories are no ED (score ≥26 out of 30), mild (score 22-25), mild-to-moderate (score 17-21), moderate (score 11-16), and severe (score ≤10)[13,14].

Figure 3

Comparison of erectile dysfunction severity in comorbidity subgroups by screening question response. LUTS = lower urinary tract symptoms. Erectile Function domain of the International Index of Erectile Function severity categories are no ED (score ≥26 out of 30), mild (score 22-25), mild-to-moderate (score 17-21), moderate (score 11-16), and severe (score ≤10)[13,14].