Epidemiology Update of Erectile Dysfunction in Eight Countries with High Burden

Introduction: Prior epidemiology studies on erectile dysfunction (ED) have varied in geography/place, time period, and methodology. Due to this variability, comparisons of data across studies are greatly limited. Additionally, little is known about the rates of comorbid ED and benign prostatic hyperplasia (BPH). Aim: To update the prevalence of ED and patient characteristics using a single methodology in 8 countries: Brazil, China, France, Germany, Italy, Spain, the United Kingdom, and the United States. Methods: This retrospective cross-sectional study included men (>= 18 years) who self-reported experiencing difficulty in achieving or maintaing an erection in the past 6 months in the 2015 and 2016 National Health and Wellness Surveys (N = 97,159). Pairwise comparisons between the United States and each of the other countries were performed among respondents with ED and no BPH, aged >= 18 years, and within the subset of men aged 40-70 years. Main Outcome Measures: ED prevalence (with BPH, with no BPH, and overall), health characteristics, and ED risk factors were assessed. Results: ED with BPH was found to be < 6.0% in all countries. ED prevalence overall varied from 37.2% (Brazil) to 48.6% (Italy). Similar patterns were observed for the subset of men aged 40-70 years. Patients in Brazil were younger (aged >= 18: 43.85 vs. 52.35; aged 40-70: 52.94 vs. 56.76 years; for both, P<.05) than those in the United States. ED-related comorbidities were more common in European countries, comparatively. Conclusion: This study provides an important update and outlook to ED epidemiology in Brazil, China, France, Germany, Italy, Spain, the United Kingdom, and the United States. Overall, ED prevalence is high, relative to some previous estimates. Findings from this study highlight the continued burden ED plays in the lives of men in these countries. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.