Fortnightly review: Update on male erectile dysfunction
BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7132.678 (Published 28 February 1998) Cite this as: BMJ 1998;316:678
- G Wagner (gorm@mfi.ku.dk), associate professora,
- I Saenz de Tejada, directorb
- a Panum Institute, University of Copenhagen, 2200 Copenhagen N, Denmark
- b Andrology Unit, Urology Service, Hospital Ruber Internacional, Madrid, Spain
- Correspondence to: Professor Wagner
- Accepted 10 September 1997
Male erectile dysfunction—defined as “the inability to achieve or maintain an erection sufficient for sexual intercourse”—is one of the most common sexual dysfunctions in men.1 Although erectile dysfunction can be primarily psychogenic in origin, most patients have an organic disorder, commonly with some psychogenic overlay.1 Some men assume that erectile failure is a natural part of the aging process and tolerate it; for others it is devastating. Withdrawal from sexual intimacy because of fear of failure can damage relationships and have a profound effect on overall wellbeing for the couple.2 Since erectile dysfunction often accompanies chronic illnesses, such as diabetes mellitus, heart disease, hypertension, and a variety of neurological diseases, physicians from many medical disciplines will see patients with this disorder.3
Summary points
Although around 10% of men aged 40 to 70 years have complete erectile dysfunction, only a few seek medical help
As erectile dysfunction is frequently associated with a number of systemic illnesses and surgical treatments, a wide range of doctors must be aware of the condition in their patients
Current effective treatments include psychosexual counselling, vacuum erection devices, intracavernosal and transurethral drug delivery, and penile prostheses
Promising oral treatments are currently being investigated
Both doctors and the public need to be better informed about erectile dysfunction and its treatment
Methods
The publications comprising this review were selected from a formal search of the full Medline database (using the terms erectile dysfunction, impotence, and penile erection). Articles from the authors' personal collections are also included.
Prevalence
The Massachusetts male aging study measured several health related variables in 1290 men aged 40 to 70 years.3 Erectile dysfunction was very common. Fifty two per cent of the men reported some degree of impotence—mild in 17.1%, moderate in 25.2%, and complete in 9.6%.3 Complete impotence was reported by 5% …
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