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Attitudes of Men with Erectile Dysfunction: A Cross-National Survey


Michael A. Perelman, PhD, Psychiatry, Reproductive Medicine and Urology, The New York Presbyterian Hospital, Weill Medical College of Cornell University, 70 East 77th Street, Suite 1C, New York, NY 10021, USA. Tel: (212) 570-5000; Fax: (212) 570-2288; E-mail:


Introduction.  Erectile dysfunction (ED), the inability to achieve or maintain an erection sufficient for sexual performance, is a complex disorder involving multiple biopsychosocial factors.

Aim.  To better understand the psychological and behavioral aspects of ED and compare the attitudes of ED patients in different countries.

Methods.  The Cross-National Survey on Male Health Issues surveyed men aged 20–75 years in six countries. Participants completed questionnaires on attitudes, behavior, doctor-related issues, and comorbidities.

Main Outcome Measures.  Men rated their attitudes using a scale of 1 (strongly disagree) to 5 (strongly agree). Responses of “somewhat agree” and “strongly agree” were combined and the percentage calculated for each country and overall. A mean score for all responses (1–5) was calculated for each country.

Results.  Attitudes held by men with ED overlap significantly when compared between countries. Men in all countries agreed that ED was a source of great sadness for themselves and their partners, and nearly all disagreed with the idea that they were too old for sex. Men in all countries agreed that it was important to know they had the capacity to perform sexually, and half of all men reported they would do “nearly anything” to cure their ED. Men in all countries also agreed that their doctor was the best source of information on sexual issues. Men in the United States and the United Kingdom were less willing to accept ED, more motivated to find a cure, and less likely to consider ED a result of psychological problems.

Conclusions.  Attitudes of men with ED overlap significantly when compared between countries, but interesting differences were seen. Additional research is needed to understand how attitudes and behaviors reported reflect actual experiences. This study highlights some of the barriers that exist between physician–patient communication surrounding identification and treatment of ED.