Epidemiology of Erectile Dysfunction and Key Risk Factors

Erectile dysfunction (ED) is a common, age-related disorder in men, which has been associated with multiple medical and psychosocial risk factors. In addition to the well-known association with age, cardiovascular risk factors have been associated with ED in multiple studies. Based upon these findings, ED has been proposed as a sentinel event or harbinger of future cardiovascular risk for younger or older men with ED. Other studies have shown an association between ED and depressed mood or loss of well-being in many men with the disorder. Based on recent analyses of the Massachusetts Male Aging Study, we have shown that approximately 1/3 of men with ED show improvement in their symptoms over time (remission), whereas 2/3 show progression or no change over time. Progression was most evident in older men with other health risks. Recent findings from the Boston Area Community Health (BACH) study have shown that apparent associations between ED and race/ethnicity are due primarily to differences in socioeconomic status between the groups. The role of medical comorbidities, concomitant medications, and lifestyle factors has also been highlighted in these studies. Future studies will investigate mechanisms associated with these effects and the broader psychosocial impact of ED.