• Epidemiology;
  • Erectile Dysfunction;
  • Aging


Introduction.  Using the Massachusetts Male Aging Study (MMAS) data from the years 1987–1995, we previously demonstrated high rates of both progression (33%) and regression (35%) of self-reported severity of erectile dysfunction (ED). These results have not been replicated using more recent data—relevant in light of the introduction of phosphodiesterase type 5 inhibitors (PDE5i) to treat ED—nor compared with those from other populations.

Aim.  To estimate age-specific progression and regression of ED severity among subjects with at least mild self-reported ED.

Methods.  We used the two most recent data collection waves from the MMAS (baseline in 1995–1997 and follow-up in 2002–2004, approximately 7 years of follow-up) and data from the Men's Attitudes to Life Events and Sexuality (MALES) study (baseline in 2001 and follow-up in 2004, approximately 3 years of follow-up); 367 MMAS and 617 MALES subjects contributed data. MMAS participants were a population-based sample of men living in Boston, Massachusetts, United States. MALES subjects were obtained from a multinational convenience sample.

Main Outcome Measures.  ED was measured using the validated single-question self-report of ED severity (“none,”“minimal,”“moderate,” or “complete”). ED progression was defined as worsening of ED over time, whereas regression was defined as a lessening of ED severity. Logistic regression analyses were adjusted for age, body mass index (MMAS only), and use of PDE5i.

Results.  In MMAS and MALES, 21% (confidence interval [CI]: 17%, 25%) and 25% (22%, 29%) of subjects, respectively, exhibited regression; 51% (45%, 57%) in MMAS and 28% (23%, 33%) in MALES exhibited ED progression. A minority of subjects (14% in MMAS and 28% in MALES) reported use of PDE5i. The proportion of subjects reporting progression increased with age. The higher rate of progression in MMAS may be due in part to the shorter follow-up time (∼3 years) in MALES.

Conclusions.  Among subjects with some level of self-reported ED, progression and regression are common over a several-year period. Strategies for therapy and intervention for ED should acknowledge this basic evolution with time. Travison TG, Sand MS, Rosen RC, Shabsigh R, Eardley I, and McKinlay JB. The natural progression and regression of erectile dysfunction: Follow-up results from the MMAS and MALES studies. J Sex Med 2011;8:1917–1924.