Erectile dysfunction (ED) is a sexual health issue characterized by the consistent struggle to get or keep an erection. It can affect individuals with penises around the world, and it is often assessed using the International Index of Erectile Function (IIEF-5).

The prevalence of ED increases with age and is linked to conditions like diabetes and depression. However, defining and measuring ED varies widely, making it hard to gauge its true extent. Therefore, there is debate over whether ED is rising in younger men, possibly due to factors like pornography and medication side effects.

Research on recent ED rates and access to treatment is lacking. Some studies use prescriptions or insurance records to estimate prevalence, but this misses those individuals without access to care. Understanding ED prevalence and barriers to treatment is crucial since ED is linked to other health issues like heart disease. As such, nationally representative studies using better diagnostic tools are needed to address this gap.

In this vein, a new study aimed to determine the current prevalence of ED, access to care, comorbidities, medications, and barriers to care among men in the United States. Data from the 2021 National Survey of Sexual Wellbeing (NSSW), a nationally representative survey, were used.

The study focused on 1,822 cisgender men aged 18 and over. Sociodemographic characteristics, ED prevalence (based on IIEF-5 scores), severity, diagnosis, perceived erectile confidence, health conditions, medications, and barriers to seeking care were assessed. Descriptive statistics were used to analyze the data, excluding the people who did not respond.

The results of this study provide valuable insights into the prevalence and management of ED in the U.S., shedding light on the experiences of men and the challenges they face in accessing care. In the study, 24.2% of men were diagnosed with ED, with varying levels of severity: 1.3% severe, 2.5% moderate, 5.1% mild-moderate, and 15.3% mild.

More individuals in the 18-24 age bracket (17.9%) met the diagnostic criteria compared to those in the 25-34 (13.3%) or 35-44 (12.7%) age brackets, yet fewer than those in the 45-54 (25.3%) or 55-64 (33.9%) age brackets. Only 16.7% of participants discussed their erectile difficulties with a healthcare provider, and 7.7% had been diagnosed with ED.

Nevertheless, concerns about ED were prevalent, with 16.5% lacking confidence in their ability to get and maintain an erection over the past 6 months, and 13.6% experiencing insufficient hardness for penetration at least half the time over the past 6 months. Viagra was the most common prescription medication for ED.

Many participants did not seek care due to not feeling the need, while others cited concerns about COVID-19 exposure, embarrassment, lack of time, or lack of knowledge of where to seek help. Despite these barriers, the majority reported not needing to see a doctor in the past year.

Ultimately, this study provides information on the prevalence, severity, and management of ED, highlighting the need for increased awareness and access to care. Interestingly, there was a large disparity between the high prevalence of self-reported ED and the low rate of diagnosis by healthcare providers. This underscores the importance of integrating discussions about sexual health into routine medical visits. Identifying and addressing ED early not only improves quality of life but can also provide a sign of underlying health issues.

References:

• Mark, K. P., Arenella, K., Girard, A., Herbenick, D., Fu, J., & Coleman, E. (2024). Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing. The Journal of Sexual Medicine, 21(4), 296–303. https://doi.org/10.1093/jsxmed/qdae008