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Worry, Desire, and Sexual Satisfaction and Their Association with Severity of ED and Age


Oliver Gralla, MD, Department of Urology, University of Cologne, Joseph-Stelzmann-Strasse 9, Cologne, Germany 50931. Tel: +49 221 4786297; Fax: +49 221 4783495; E-mail:


Introduction.  This study evaluates worry about sexual and relationship functioning, sexual desire, and sexual satisfaction as indicators of sexual quality of life in men of different age groups suffering from mild to severe erectile dysfunction (ED).

Aim.  To increase insight in the mechanisms of some key indicators of sexual quality of life in different age groups.

Methods.  The study sample consisted of 904 men with mild to severe ED. Mean age was 60.7 years (standard deviation [SD] = 12.4) and mean erectile function (EF) (International Index of Erectile Function [IIEF]) score was 14.5 (SD = 8.9). Multivariate analyses of variance were conducted to test the differences in outcomes among two age groups (65 ≤ age > 65) and two levels of ED (16 ≤ EF > 16).

Main Outcome Measures.  We analyzed age, severity of ED, and interrelated indicators of sexual quality of life as worry about sexual or relationship functioning, sexual desire, and overall sexual satisfaction. Beyond, we aimed to see on which of these measures their interaction had specific independent effects.

Results.  Younger men at a higher level of ED reported higher levels of worry about sexual and relationship functioning than older men with high ED. Older men reported slightly less sexual desire than younger men; also, more ED was associated with lower sexual desire. Finally, men with less severe ED reported higher sexual satisfaction than men with more severe ED, whereas at all levels of ED severity, older men reported more sexual satisfaction than younger men.

Conclusions.  Indicators of sexual quality of life among men with ED are poorer in those with more severe ED. However, younger men with severe ED worries concerning sexual functioning were more pronounced than among their older counterparts. Independent of the degree of severity of ED, older men indicated lower sexual desire but higher overall sexual satisfaction. Observed age-group differences were very small, however. Gralla O, Knoll N, Fenske S, Spivak I, Hoffmann M, Rönnebeck C, Lenk S, Hoschke B, and May M. Worry, desire, and sexual satisfaction and their association with severity of ED and age. J Sex Med 2008;5:2646–2655.