National Institutes of Health Consensus Development Impotence Conference Statement - Prevalence of Male Erectile Dysfunction

Written by Krista

• Epidemiological studies directed at the prevalence of male erectile dysfunction and its medical and psychological correlates, particularly in the context of possible racial, ethnic, socioeconomic, and cultural variability.
• Additional studies of the mechanisms by which risk factors may produce erectile dysfunction.
• Studies of strategies to prevent male erectile dysfunction.
• Randomized clinical trials assessing the effectiveness of specific behavioral, mechanical, pharmacologic, and surgical treatments, either alone or in combination.
• Studies on the specific effects of hormones (especially androgens) on male sexual function; determination of the frequency of endocrine causes of erectile dysfunction (e.g., hypogonadism and hyperprolactinemia) and the rates of success of appropriate hormonal therapy.
• Longitudinal studies in well-specified populations; evaluation of alternative approaches for the systematic assessment of men with erectile dysfunction; cost-effectiveness studies of diagnostic and therapeutic approaches; formal outcomes research of the various approaches to the assessment and treatment of this condition.

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• Social/psychological studies of the impact of erectile dysfunction on subjects, their partners, and their interactions, and factors associated with seeking care.
• Development of new therapies, including pharmacologic agents, and with emphasis on oral agents, that may address the cause of male erectile dysfunction with greater specificity.
• Long-term followup studies to assess treatment effects, patient compliance, and late adverse effects.
• Studies to characterize the significance of erectile function and dysfunction in women.

CONCLUSIONS

• The term "erectile dysfunction" should replace the term "impotence" to characterize the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance.

• The likelihood of erectile dysfunction increases progressively with age but is not an inevitable consequence of aging. Other age-related conditions increase the likelihood of its occurrence.
• Erectile dysfunction may be a consequence of medications taken for other problems or a result of drug abuse.
• Embarrassment of patients and the reluctance of both patients and health care providers to discuss sexual matters candidly contribute to underdiagnosis of erectile dysfunction.
• Contrary to present public and professional opinion, many cases of erectile dysfunction can be successfully managed with appropriately selected therapy.
• Men with erectile dysfunction require diagnostic evaluations and treatments specific to their circumstances. Patient compliance as well as patient and partner desires and expectations are important considerations in the choice of a particular treatment approach. A multidisciplinary approach may be of great benefit in defining the problem and arriving at a solution.
• The development of methods to quantify the degree of erectile dysfunction objectively would be extremely useful in the assessment both of the problem and of treatment outcomes.
• Education of physicians and other health professionals in aspects of human sexuality is currently inadequate, and curriculum development is urgently needed.
• Education of the public on aspects of sexual dysfunction and the availability of successful treatments is essential; media involvement in this effort is an important component. This should be combined with information designed to expose "quack remedies" and protect men and their partners from economic and emotional losses.
• Important information on many aspects of erectile dysfunction is lacking; major research efforts are essential to the improvement of our understanding of the appropriate diagnostic assessments and treatments of this condition.
• Erectile dysfunction is an important public health problem deserving of increased support for basic science investigation and applied research.