Sexual Activity, Erectile Dysfunction and Their Correlates among 1,566 Older Chinese Men in Southern China


Samuel Yeung Shan Wong MD, MPH, CCFP, FRACGP, 4/F, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Tel: (852) 2252-8774; Fax: (852) 2606-3500; E-mail:


Introduction.  Few studies on sexuality and it correlates in adults have been conducted in Asia; most studies in Asia have focused instead on erectile dysfunction in men rather than sexuality or sexual activities.

Aim.  This study was conducted to evaluate the prevalence and factors associated with sexual activity and erectile dysfunction in elderly Chinese men aged 65 years and above.

Main Outcome Measures.  Sexual activity and sexual functions were assessed using the International Index of Erectile Function-5. Depressive symptoms were measured by the Chinese version of the Geriatric Depression Scale. Lower urinary tract symptoms (LUTS) were measured by the International Prostatic Symptom Score.

Methods.  Cross-sectional data from a large prospective cohort study of Chinese elderly men were used in this study. A questionnaire that included demographic, lifestyle, and medical risk factors and physical examination were administered to 1566 Chinese men aged between 65 to 92 years in Hong Kong.

Results.  Only 30.7% of men were sexually active in the previous 6 months in this sample and among those who were sexually active, 88% had some form of erectile dysfunction. Being sexually inactive in the previous 6 months was associated with being older (odds ratio [OR] = 1.80; confidence interval [CI]: 1.56–2.09), single (OR = 1.87; CI = 1.19–2.94) and the presence of peripheral arterial disease (OR = 2.43; CI: 1.25–4.71). In multiple multinomial logistic regression, having clinically relevant depressive symptoms (OR = 3.37; CI: 1.31–8.70) and having moderate to severe LUTS (OR = 1.63; CI: 1.01–2.64) were independently associated with increased risk of having erectile dysfunction.

Conclusion.  We showed that a large proportion of elderly men were not sexually active in Hong Kong. For those who were sexually active, most suffered from some degree of erectile dysfunction. Having clinically relevant depressive symptoms and LUTS were independently associated with increased risk of erectile dysfunction. Wong SYS, Leung JCS, and Woo J. Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in southern China. J Sex Med 2009;6:74–80.