Erectile Dysfunction in Australia

Erectile dysfunction (ED) is the persistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. Worldwide, 100 million men are estimated to have some degree of ED, with around 30 million men in the United States and around one million men in Australia affected. With our ageing, but relatively fit, population the incidence of ED is certain to escalate.

The first major community-based study on ED was the Massachusetts Male Aging Study (MMAS), an observational study (conducted from 1987 to 1989) of a random sample of men aged between 40-70 years living in and around Boston, Massachusetts. This study yielded, for the first time, an understandable concept of ED; comparable studies in Australia have been singularly lacking.

The first report on the prevalence of erectile dysfunction in Australia was a study by Chew et al from the Keogh Institute for Medical Research in Perth. The generalisability of this 1996 study was limited as it only included men who presented to general practices in Perth.

The South Australian study confirms that age is the strongest contributing demographic factor to erectile dysfunction, with 60 years of age being the turning point where desire exceeds potency and sexual frequency diminishes. The MMAS found that 52% of men aged between 40 and 70 years had some form of erectile dysfunction, with almost 60% of 60-year-old men having this complaint. Both studies found that sexual function was also affected by risk factors such as smoking, hypertension, obesity and a high total cholesterol level with a low concentration of high density lipoprotein. Vigorous exercise was found to be protective. The Perth study also found diabetes mellitus (types 1 and 2) to be significant contributors to erectile dysfunction.

Erectile dysfunction is clearly an established and recognised male health problem -- one that is decreasingly being regarded as an inevitable consequence of ageing. The estimated 10% of men currently seeking help will increase, as more men will seek help in the future. Doctors will need to improve their skills in obtaining patients' sexual histories as more men request help. A full assessment of men, with emphasis on cardiovascular risk factors, will help direct the consultation to discussion of sexual matters -- it makes good sense to combine cardiac and sexual issues.

Erectile dysfunction is a common problem for Australian men. Seeking medical advice should not be seen as an embarrassing process, you are not alone.

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