Erectile dysfunction, discrepancy between high prevalence and low utilization of treatment options: results from the ‘Cottbus Survey’ with 10 000 men


  • M.M. and O.G. contributed equally to this work.

Matthias May, MD, Department of Urology, Carl-Thiem-Klinikum Cottbus, University Teaching Hospital Charité zu Berlin, Thiemstrasse 111, D-03048 Cottbus, Germany.



To investigate the age-stratified prevalence of erectile dysfunction (ED) and its comorbidities, and to assess the population’s knowledge, utilization, and general attitude towards the treatment for ED.


In all, 10 000 men received a 35-item questionnaire including the International Index of Erectile Function (IIEF) and sociodemographic questions regarding life style, comorbidities, quality of sexual life and knowledge or experience of ED therapy. In all, 3124 responses were included (31.2%), 2499 men lived in well established partnerships and were assessed as the basic study group.


In the entire population the prevalence rate of ED was 40.1%. However, although known, medical treatment for ED is used only by a minority of affected men. The prevalence of ED was independently associated with age, peripheral arterial occlusive disease, hypertension, ischaemic heart disease, diabetes mellitus, and liver diseases. Correlations between sexual quality of life (QoL) and ED were statistically significant (P < 0.01) and moderate to strong (absolute values: Spearman’s ρ 0.35–0.76). Although 96% of the study population knew at least one phosphodiesterase type 5 (PDE5) inhibitor by name, only 53% considered taking the medication and only 9% of the men with ED had had experience with available PDE5 inhibitors.


The sexual QoL was significantly reduced by ED. Despite high levels of awareness and general acceptance of oral medication for ED, experience with PDE5 inhibitors was low. Further investigation is required to evaluate the general impact of ED on sexual QoL and the need or wish for treatment.