Prevalence of erectile dysfunction and associated factors among diabetic men attending the diabetic clinic at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia, 2020

On the other hand, it carries the risk of over- or under-estimating a medical condition that does not have objective medical parameters of definition. The subgroup and meta-regression analyses were conducted by country, sample size, and year of publication. For example, a study of frequency of sexual activity reported that 34. Algorithm for the diagnosis and management of erectile dysfunction. The crude and age and country-adjusted odds ratios (ORs) were calculated for each covariate. Among these individuals, 4146 (57%) agreed to participate.

This survey was planned to be maintained within one month period of time.

The average amount of sleep for those who reported ED is less than the average (p < 0. )Behavioral modification, including smoking cessation, nutritional counseling, and optimization of over the counter and prescription drugs that may be promoting erectile dysfunction should be the first line of treatment. Summary and conclusions, > Partner conflict. What are the location and severity of the curvature? Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C.

These analyses were initially completed where ED was defined as an EF score of 25 or less. Specific treatment for erectile dysfunction will be determined by your doctor based on: Erec-Tech vacuum therapy system. 4% in Korean [12], 86.

Lovibond SH, Lovibond PF. Some couples consider seeking treatment for ED together, while other men prefer to seek treatment without their partner's knowledge. At this time, the nature of an appropriate hormonal investigation, whether a complete hormone panel is required for every patient or whether a single testosterone determination constitute effective screening remains debated. However, African American (OR, 1. )

Results from the animal model.

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(0%) were diagnosed by a private health service and other medical providers. Chen J, Wollman Y, Chernichovsky T, Iaina A, Sofer M, Matzkin H. 7 حالة طفيفة و%2. 2 μU/ml ( p < 0. )

Sexuality is an essential part of life; however, erectile dysfunction (ED) has been one of the most common complaints among men with sexual health issues all over the world. Premature ejaculation is a male sexual dysfunction characterized by: Other data have emerged, and we now have a better understanding of the epidemiological profile of ED. In fact, we previously demonstrated that in the youngest quartile (17–42 years old), but not in the oldest one (62–88 years old), severity of reported ED and penile blood flow impairment (dynamic peak systolic velocity) were not associated to decreasing testosterone levels (50). None of these is currently recommended under the updated American Urological Association Guidelines for the Treatment of Erectile Dysfunction.

The study did not ask for difficulties maintaining an erection and thus may have underestimated the total prevalence. (5%) respondents were found to have severe ED. The rate found in our current study is considerably higher. In a study in Qatar the prevalence of erectile dysfunction among Qatari patients was 66. Corona G, Isidori AM, Buvat J, Aversa A, Rastrelli G, Hackett G, et al.

In contrast with the low prevalence of adrenal or thyroid disturbances in ED subjects, testosterone (T) deficiency is frequently found in subjects with ED (49,50) and, in turn, low T is frequently associated with the occurrence of sexual dysfunctions, including ED, even in general population (51).

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Apart from the factors already outlined (vascular risk factors, endocrinopthies and psychologic problems) that may lead to impotence the following conditions may induce erectile problems: Prevalence of ED in44 patients on chronic PD was assessed usingthe International Index of Erectile Function(IIEF-5) commonly called Sexual HealthInventory for Men (SHIM) score. In another study from Sweden, Malmsten et al22 included questions regarding impotence in a questionnaire mailed to over 10 000 randomly selected men aged 45 y or older. In the study reported here, age had a positive association with the rate of ED. The relationship between depressive symptoms and male erectile dysfunction: A population study of the association between sexual function, sexual satisfaction and depressive symptoms in men.

Multivariate logistic regression model. In a long-term follow-up investigation of this study,19 the crude incidence rate for ED was 26/1000 man years; increasing with age from 12/1000 to 30/1000 and 46/1000 for men aged 40–49, 50–59 and 60–69 y, respectively. Current treatment options for benign prostatic hyperplasia and their impact on sexual function. When the interactions of race were examined with the various other predictors, race did not modify the association of any of other variable with ED when age was included in the model.

  • Medications for diabetes, hypertension, cardiovascular disease and depression may also cause erectile difficulties.
  • (9%) of participated completed their college education.

International Journal of Endocrinology

These included age, religion, disease history, BMI, alcohol/beer consumption, anxiety, quality of life, and consensual sex with their wives/partners during sexual activity. Complications from the use of a vacuum constriction device are relatively minor. In this analysis, the use of antidepressants, current cigarette smoking, the use of antihypertensive medication, not being married or cohabiting, and no education past high school were all independently associated with an increased probability of ED. Marceau L, Kleinman K, Goldstein I, McKinlay J. Which medical conditions, risk factors, or treatments increase the prevalence of ED?

14 Parazzini F. Those with thyroid disease, liver disease, renal disease, bronchial asthma, psychiatric disease and cerebrovascular disease also had higher rates of erectile dysfunction although the results were not statistically significant (Table 3). 5 hours NA ($525) 2. However, even in younger subjects, overlooking the contribution of cardio-metabolic factors to pathogenesis of ED is a mistake that can lead to the loss of the opportunity of early recognition of patients who deserve a change in life-style or a pharmacological correction of risk factors. Richters J, Grulich AE, de Visser RO, et al. Besides the overall quality assessment, several remarks can be made on separate validity criteria, such as the representativeness of the study population (item d in the quality assessment). HH and NN were responsible for doing basic steps in data collection and analysis. In a population of subjects attending the Sexual Medicine and Andrology Unit of the University of Florence for sexual dysfunction, more than 2,500 men reported autoeroticism in the previous 3 months.

This may be explained, in part, by the use of medication to lower lipid levels, which increased with age. In this article, we’ll look at the prevalence of ED. The low and middle quality of life group was 2. 5%), whereas mild dysfunction was found in the remaining patients (22/63, 26. However, there is a significant amount of variation in the primary studies on DM regarding the prevalence of erectile dysfunction (ED) in Africa. Similar results have been reported in other community studies.


Regarding the sampling technique employed, 7 of the studies [17, 21, 41, 42, 46–48] used the consecutive sampling technique to select study participants. The association between psychiatric conditions and sexual dysfunctions, including ED, is well known. As in every epidemiologic study—particularly those dealing with sensitive questions—the results are subject to a certain degree of inaccuracy, but, rather than a random variation in reporting ED prevalence, it could be expected that the prevalence would be underreported.

19 Infection rates in the era of coated devices and improved techniques are reported to be less than 1%. Testosterone and erectile physiology. Thirty-two patients werehypertensive, 19 of them had coronary arterydisease and 13 patients were diabetics. The first six of these had five response options ("nil", "poor", "fair", "good", "very good" for domains i-iii; "never had an erection when I wanted one", "less than half the time when I wanted one", "about half the time I wanted one", "whenever I wanted one" for domain iv; "once or more daily", "1-6 times weekly", "1-3 times monthly", "less than once a month", "not at all" for domain v; "never", "seldom [less than a quarter of the time]", "not often [less than half the time]", "often [more than half the time]", "very often [more than 75% of the time]" for domain vi), while the seventh had four ("no erections at all", "not firm enough for any sexual activity", "firm enough for masturbation and foreplay only", "firm enough for intercourse"). As can be seen in Figure 4, the probability of ED independently increased with 10-year coronary risk or blood glucose levels. However, the proportion is lower than a study conducted in Pakistan 88% [14]. Pulmonary diseases:

9% for ED among men aged 30-80 years. The prevalence of ED in this study is comparably smaller to the cross-sectional study conducted by Oyelade et al. Materials and Methods: This recent NHANES (2020-2020) was the first to collect information on erectile dysfunction.

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Allpatients with diabetes had ED. Indeed, alterations in the vascular hemodynamics (whether, arterial insufficiency or corporovenocclusive dysfunction) is believed to be the most common cause of organic erectile dysfunction. Sexual dysfunction in renal failure: Among a number of different possible predictors, including life-style, drug abuse, perceived physical fitness and BMI, only perceived impairment in mental health and depression, either newly occurred or continuously present, were associated with both persistence and development of ED (75). Risk factors, including age, hypertension, stroke, history of heart disease, diabetes, kidney disease, history of prostate operation and interpersonal stress, and their association with ED in this study will be evaluated using chi-square test statistics. For instance, the Cologne Male Survey have found that the prevalence of erectile dysfunction could be as high as 19. We decided not to contact authors of the selected studies as this could introduce a bias; authors of recent studies may be easier to contact, and information may be more easily available than from older studies.

The prevalence of DM in Africa also continues to rise, thus imposing an extraburden on Africa’s healthcare systems [3]. 3% mild–moderate ED; 5. A score 9 or greater (corresponding to the upper quintile) was used as indicative of the presence of depressive symptoms. Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects.


These differences between our result and other studies could be explained on the basis of difference in culture and methodologies used including difference in the sample sizes and sample techniques. The men were classified as having a specific disease if they reported having received a physician’s diagnosis or if they were taking medications for the disease in question. Heruti R, Shochat T, Tekes-Manova D, Ashkenazi I, Justo D. (002)], [OR = 5.

The relationship between the PE and ED is bidirectional and successful treatment of one often requires treatment of the other.

As a result, Hue city was chosen as the most representative setting in Vietnam for this study to measure ED prevalence and associated factors as well as to identify the need among married men for treatment of ED. Several studies accessed the prevalence of ED. The psychological correlates of erectile dysfunction include anxiety, depression and anger. Men who are physically inactive, have metabolic syndrome, smoke, have high blood pressure, cardiovascular disease, high cholesterol, or low testosterone are also at an increased risk of developing ED. The studies from Leicestershire (UK) and Krimpen aan den IJssel (The Netherlands) used the same definition and questionnaire (International Continence Society male sex questionnaire). Moreover, chronic illness and the other health problems among the respondents were self-reported. They were classified as follows: Assessing risk of myocardial infarction and stroke:


24–26 Adipocytes also generate inflammatory cytokines associated with impaired endothelial function, cardiovascular events, and ED. The effects of demographic risk factors such as income and education were more apparent in older age groups and were consistent with lower sexual function in lower socioeconomic groups. The entire process of study screening, selection, and inclusion were described with the aid of a flow diagram. Fujioi J, Iwamoto K, Banno M, Kikuchi T, Aleksic B, Ozaki N. The journal of sexual medicine, if you are trying to access this site from the United States and believe you have received this message in error, please reach out to [email protected] Sexual dysfunction in schizophrenia: 1% sharing the problem with their friends for help.

Cosgrove DJ, Gordon Z, Bernie JE, Hami S, Montoya D, Stein MB, et al.

However, when hypogonadism is clinically suspected but the morning total testosterone level is repeatedly normal, bioavailable testosterone or free testosterone may account for the effects of sex hormone–binding globulin levels on testosterone activity. Management of sexual dysfunction due to antipsychotic drug therapy. Sixty-seven (47. )

However, the different response rates cannot influence the study of the association between ED and possible risk factors because the survey was presented to potential subjects as a survey of the general health of adult men.
9% reported having consensual sex with their wives/partners.


We also explored whether the diagnosis of ED might be useful in identifying previously undiagnosed and untreated medical conditions. Moreover, as mentioned previously, we did not identify all of the potential predictors of ED among patients with DM. 19,20 Although most studies have been able to adjust for increasing age, only a few have had sufficiently robust data to adjust simultaneously for age, diabetes, and cardiovascular disease and confirm that each is independently associated with ED. However, when considering separately younger and older men, this association was confirmed only in younger ones, and it was still significant after excluding men reporting severe ED during masturbation (35).

The lowest average score was 56. 1 Our study was based on a representative sample of the South Australian community, and employed rigorous methods which have been previously used in other prevalence studies. Sample members were selected according to a random starting point and a fixed periodic interval. Diabetes is associated with a number of complications that may result in ED, including macrovascular disease, microvascular disease, renal failure, and neuropathy. Current cigarette smoking declined with increasing age from 27% for those aged 40 to 49 years to 11% for those 70 years and older. Mannino DM, Klevens RM, Flanders WD.

These data suggest physical activity and other measures for the prevention of cardiovascular disease and diabetes may prevent decline in erectile function. Supplementary file 1: Romeo JH, Seftel AD, Madhun ZT, Aron DC. The overall age-specific prevalence of moderate or complete ED was 9% for men aged 40 to 44 years, 12% for 45 to 49 years, 18% for 50 to 54 years, 29% for 55 to 59 years, 38% for 60 to 64 years, and 54% for those 65 to 70 years. Accordingly, the mean age of the participants was 45. 7% of married 60-65-year-old people did not have sexual intercourse within the preceding month, 14 while we found that 34.

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Good manual dexterity is also needed to use the device; if manual dexterity is impaired, a willing sexual partner can learn to apply the device. Crossref | PubMed | Scopus (1024) | Google ScholarSee all References clinicians should consider discussion of this common quality of life issue with their diabetic patients. The presence of either condition is independently associated with a 3- to 4-fold increase in coronary events. However, the association of ED with certain risk factors was greatly amplified in current smokers in the MMAS. Data can provide guidance for effective education, prevention, and treatment programs to address the challenges of ED in Vietnam and worldwide. Men who reported being “sometimes able” or “never able” to get and keep an erection were categorized as having erectile dysfunction, while men who reported being “always or almost always able” or “usually able” were not. All authors have read and agreed to the final version of this manuscript and have equally contributed to its content.

Thus, it was necessary to ensure compliance with three principles of research ethics: 6%) vs those without (4. The association of demographic and cardiovascular risk factors with total sexual function (expressed as a continuous variable) and with impotence (a dichotomous variable) was examined after allowing for the effects of age by means of analysis of variance and logistic regression.

A cohort of 28,691 men completed the screening questionnaire and provided their age. (5) had higher odds in ED. Therefore, evaluating the importance of comorbidities or risk factors for ED should include an adjustment for age. The benefits to the respondents were explained as the research results would be used as the basis for planning interventions for prevention and treatment of erectile dysfunction, as well as development of local programs for sexual health care with the objective of enhancing the quality of life for men in Hue City in particular and in Vietnam in general.

Erectile Dysfunction And Cardiovascular Disease

Panser LA, Rhodes T, Girman CJ, et al. It is now known that, for most men, erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. Prostate conditions included benign prostatic hyperplasia, a history of prostatitis, prostate surgery, and prostate cancer.

Since males, especially older males, are particularly sensitive to the social support of intimate relationships, withdrawal from these relationships because of such fears may have a negative effect on their overall health [1].


Conditions commonly associated with ED include diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment (Table 2). Alcohol consumption was not found to be significantly associated with ED, consistent with Oyelade et al. Where factors or their first-order interactions were significant, a combined model was examined. In subjects over 80 years of age this figure rose to 60%. The participants with increased age had reportedly higher prevalence of ED. A number of factors were significantly (P < 0. )In addition, an Egger regression test was conducted, and was considered statistically significant for the presence of publication bias [36]. Rationale for combination therapy of intraurethral prostaglandin E(1) and sildenafil in the salvage of erectile dysfunction patients desiring noninvasive therapy.

How to calculate vascular age with the SCORE project scales:

(1%) agreed to complete a further, mailed questionnaire on urological issues. Vascular age carries the advantage of easily and directly communicating the concept of high relative risk to patients, in particular to younger ones, who are by definition at low absolute risk (“Your CV risk is the same of a man that is 15 years older than you”). The prevalence of erectile dysfunction varies widely in studies from different countries. We administered the IIEF (International Index of Erectile Function), SAS (self-rating anxiety scale) and SDS (self-rating depression scale) questionnaires. A total of 15% of men had had erectile difficulties for an extended period during their life.

The MMAS instrument contained 23 questions, 9 of which related to erectile capability. Most of the men complaining of ED did not seek medical attention. J Sex Marital Ther 2020;38: The prevalence of ED in DM patients in Africa remains high. The prevalence of ED varied across countries, but the age distribution was similar ( Fig. )

  • 9% in Ghana [17].
  • Conversely, low T levels in young men, although less frequent, are of particular importance.
  • Drug associated erectile dysfunction is common and the list of medications that can induce erectile dysfunction is significant.
  • In total, they identified 41 relevant studies that examined the prevalence of erectile dysfunction or its role in other conditions.


The increased risk of ED was associated with diabetes, heart disease, lower urinary tract symptoms, heavy smoking, and depression and increased by 10% per year of age. Abstract | Full Text PDF | PubMed | Scopus (3723) | Google ScholarSee all References The HPFS assessed sexual function via mailed questionnaire in 2020 (response rate for original survey=32% with 79% of these participants completing the 2020 questionnaire) among over 30,000 men aged 53 to 90 years. Studies reported in books were not included in the current review. (4%) in the 30–39 years old age group. 80 times higher risk for ED than those who did report consensual sex (CI: )JAMA 2020;286:

Erectile dysfunction IDF: 21x21Bacon, C. Kouidrat Y, Pizzol D, Cosco T, Thompson T, Carnaghi M, Bertoldo A, et al. The associations between erectile dysfunction and diabetes, and other known cardiovascular risk factors should serve as powerful motivators for male patients for whom diet and lifestyle changes are needed to improve their cardiovascular risk profile. 36 In one study, the incidence of CAD in men younger than 40 years who had ED was seven times that in the control population. The resulting score out of a possible 34 was expressed as a percentage; a score of 0 indicated worst possible function and 100% indicated best possible function in all domains.

F1/ETIK/2020 before enrolling any participant for the study. This result was similar to Moreira et al. Diabetes, hypertension, hyperlipidemia, and previous prostate surgery also increased with advancing age, whereas past or present depression did not appear to be age related. The findings also indicate that lifestyle changes, such as increased physical activity and measures to prevent cardiovascular disease and diabetes, may also prevent decreased erectile function. Cognitive distraction could be also provided by excessive worry for physical, and in particular genital, self-image. KEY RECOMMENDATIONS FOR PRACTICE Clinical recommendation Evidence rating References Current smoking is significantly associated with ED, and smoking cessation has a beneficial effect on the restoration of erectile function. In a reasonably nationally representative US study focussing on a relatively younger population (18–59 y of age), one dichotomous question on trouble maintaining or achieving an erection was asked in a face-to-face interview. They also found that men who were physically active and stayed lean had a lower prevalence for ED.

Materials And Methods

Respondents were asked about smoking, alcohol consumption, and exercise. Total score range from 1 to 25. This study sought to document the prevalence of ED among married men in Vietnam and to explore care options.

The association of ED with various potential risk factors including hypertension, stroke, history of heart disease, diabetes, kidney disease, history of prostate operation and interpersonal stress were evaluated using Chi-square analysis.

40 to 49, 50 to 59, 60 to 69, and 70 years or older in an effort to provide approximately 1000 patients for analysis in each age group. Frequency and determinants of erectile dysfunction in Italy. Also, due to the associated stigma, men with the problem rarely seek help [2]. ED has been for long time considered a problem mainly related to psychological conditions and distress. 6%) and one in three (29.


Sexual function and hormonal abnormalities in uremic men on chronic dialysis and after renal transplantation. (0%) of them did so on a regular basis. Community prevalence has been examined in international, but not Australian, studies. Increased incidence of depressive symptoms in men with erectile dysfunction. The study was conducted between 1987-1989, in and around Boston. 2% in Italy, and 15.

Sexual function and depressive symptoms among male North American medical students. The researchers assessed the sexual function of 31,742 men between the ages of 53 and 90, who were enrolled in the Health Professionals Follow-up Study (www. )These data demonstrate that primary care physicians may find that taking a sexual history provides important clinical information beyond the detection of ED. Minimally impotent: The prevalence of ED was assessed in two ways, with a single question on whether the respondent had any erectile disability, and with the International Index of Erectile Function (IIEF). Among those individuals without cardiovascular disease or diabetes, the calculated 10-year Framingham coronary risk (OR, 1. )