Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: From the male attitudes regarding sexual health survey

Introduction. Most U.S. population-based estimates of erectile dysfunction (ED) prevalence restricted upper age, were not nationally representative, or underrepresented minority groups. Aim. To estimate, by race/ethnicity in the United States, the prevalence of ED and the impact of sociodemographic, health, relationship, psychological, and lifestyle variables. Methods. This cross-sectional, population-based, nationally representative probability survey conducted between May 2001 and January 2002 in the general community setting facilitated equivalent representation among U.S. non-Hispanic white (N=901), non-Hispanic black (N=596), and Hispanic (N=676) men aged 40 and older by using targeted phone lists to oversample the minority populations. Main Outcome Measure. Estimated prevalence of moderate or severe ED, defined as a response of sometimes or never to the question How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?. Results. The estimated prevalence was 22.0% (95% confidence interval [CI], 19.4-24.6) overall, 21.9% (95% CI, 18.8-24.9) in whites, 24.4% (95% CI, 18.4-30.5) in blacks, and 19.9% (95% CI, 13.9-25.9) in Hispanics, and increased with increasing age. The odds ratio increased with increasing age. Probability also increased with diabetes, hypertension, and moderate or severe lower urinary tract symptoms (LUTS) overall; age ≥70 years and diabetes in whites; severe LUTS in blacks; and age ≥60 years, moderate LUTS, hypertension, and depression in Hispanics. It decreased with exercise and college vs. less than high school education overall; with exercise, good relationship quality, and according to alcohol intake in blacks; and with high school or college education in Hispanics. Conclusions. The odds of ED increased with increasing age across race/ethnicity when controlling for sociodemographic, health, relationship, psychological, and lifestyle variables. These initial analyses suggest further study of the interrelationships among risk factors for ED.