Help seeking behaviour among men with erectile dysfunction in primary care setting (original) (raw)
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Scientific Reports, 2023
Erectile dysfunction (ED) is a pervasive problem among men, often shrouded in silence and stigma. This manuscript analysed the National Health and Morbidity Survey 2019 data to identify the prevalence of moderate to severe ED among men aged 18 and above in Malaysia and describe its associated factors. Self-administered questionnaire on ED utilised a locally validated International Index of Erectile Function. Variables on sociodemographics, risky lifestyles and comorbidities were obtained via an interviewer-administered questionnaire. The prevalence was determined using complex sampling analysis, and logistic regression was used to determine the associated factors of ED. A sample of 2403 men aged ≥ 18 participated, with a moderate to severe ED prevalence was 31.6% (95% CI 28.8, 34.6). The mean (± SD) of the total score of IIEF-5 for overall respondents was 18.16 (± 4.13). Multiple logistic regression analysis revealed a significant association between moderate to severe ED among men aged 60 years and above, single or divorcee, men without formal, primary, and secondary education, non-government employees, unemployed, and retiree, as well as physically inactive men. Focused public health interventions are necessary to improve education in sexual health, increase health promotion programs, and promote healthy ageing across the population. The World Health Organization defines sexual health as "fundamental to the physical or emotional health and well-being of individuals, couples, and families and their social or economic development 1. " Erectile dysfunction (ED) is a common problem among men worldwide and is one of the burdens of sexual health-related issues. ED is defined as "the consistent or recurrent inability to attain and maintain a penile erection sufficient for sexual intercourse 2. " The prevalence of ED is expected to increase globally, with estimated range of 3-76.5% 3. By 2025, 322 million men are expected to be affected by ED worldwide, up from 152 million men in 1995 4. Penile erection is a physiological response of neurovascular events integrated with an endocrine and psychological process. It involves smooth muscle relaxation, sinusoidal engorgement with arterial blood, and venous outflow occlusion. Disruption of any of these processes leads to erectile problems. Psychogenic, organic (i.e., neurogenic, hormonal, arterial, cavernosal, or drug-induced), or mixed psychogenic and organic are the three types of ED 5. The latter was the common type observed in a patient with ED. The importance of ED as a public health issue has grown exponentially. The prevalence of ED was high among men with underlying medical problems and risky lifestyles, including cardiovascular disease (CVD), hypertension, dyslipidemia, obesity, and smoking 6. ED itself costs a financial burden to the healthcare system, let alone its complication 7. A prescribing pattern and cost analysis study in England reported that the rate of primary care prescriptions increased twofold between 2009 and 2019, owing primarily to more men being screened or seeking ED help 8. ED shares similar underlying pathophysiology with CVD and mounting evidence that ED
The prevalence of erectile dysfunction in men visiting outpatient clinics
International Journal of Impotence Research, 2006
The prevalence of erectile dysfunction (ED) in men visiting outpatient clinics was analyzed using data reported by 1352 randomly chosen physicians who were requested to interview five to 20 consecutive patients aged X40 years about the presence of ED. A total of 25.12% of the physicians returned the questionnaires, containing data on 3552 patients, of whom 42.7% had ED, 44.9% had no ED and 12.4% declined to answer the questions. The duration of ED was o1 year in 8.1% of patients, 1-2 years in 32.2% and 42 years in 59.7% of patients. 86.4% of men with ED had X1 chronic disease. ED was present in 70.3% of men with coronary heart disease, 67.8% of those with hypertension, 78% of those with diabetes and 70.5% of patients with psychiatric diseases. 93.2% of patients with ED used one or more drugs chronically. In conclusions, 42.7% of men visiting outpatient clinics had ED. Patients with ED often had one or more chronic diseases and used at least one drug chronically. Older patients are less inclined to talk to their physicians about sexual problems.
International Journal of Impotence Research, 2002
We present data collected among men attending a free call service on information on erectile dysfunction (ED) activated in Italy during the period 1997 -1999. Their attitudes towards discussion with their partner and physician about the condition are considered. Each subject, was asked if he was affected by ED (defined as inability to achieve and maintain an erection sufficient for satisfactory sexual performance). In the case of a positive answer, the subject was asked if he had ever discussed his condition with partner or a physician. A total of 12 761 subjects with ED called the service: 7265 (56.9%) reported to have discussed their condition with their partner. The proportion tended to increase with duration of ED, being 47.9% in subjects reporting ED lasting < 6 months and 59.9% in those reporting ED lasting > 3 y (w 2 1 trend < 0.05). Likewise, the proportion of subjects reporting to have discussed ED with a physician was 50.3% (6416 subjects), being 33.6% in subjects with ED lasting < 6 months and 57.9% of those with ED lasting > 3 y (w 2 1 trend, P < 0.01).
The Journal of Men's Health & Gender, 2005
Background: Erectile dysfunction (ED) is a common, consequential, and clinically neglected sexual problem. The current research is designed to study the experience of communication about ED among men with ED, partners of men with ED, and physicians who treat ED. Methods: Qualitative research with 10 men with ED, 10 female partners of men with ED, and 15 physicians who treat men with ED, was used to formulate questions pursued in quantitative research with larger samples of men with ED (N = 449), partners of men with ED (N = 429), and physicians who treat men with ED (N = 389), concerning communication about ED among these parties. Results: Men with ED and partners of men with ED reported strikingly similar perceptions of ED, positive responses to communicating about ED, and negative responses to failing to communicate about ED. Results concerning communication about ED with physicians, preferred attributes of oral therapy for ED, and correlates of PDE5 inhibitor therapy use are reported in Part II of this publication. Conclusions: These findings can be used to guide clinical counselling and patient education to facilitate communication about ED and treatment seeking for this condition where appropriate. ß 2005 WPMH GmbH. Published by Elsevier Ireland Ltd.
Erectile Dysfunction: Causes and Diagnosis, Clinical Case Reports Journal
Erectyle Dysfunction: Causes and Treatment, 2018
In a survey published in 2003, the results of a standardized questionnaire survey of about 600 men aged 40 to 70 years in four countries of the world were cited, according to which the ED rate in Brazil was 15%, in Italy 17%, in Malaysia -22% and in Japan -34% [1].
Please cite this article in press as: Irekpita E, et al. Clinical, cultural and psychosocial impediments to self reporting of erectile dysfunction (ED) by men in Edo state, Nigeria. Afr J Urol (2017), http://dx. Abstract Introduction: Organic ED is presently considered as vasculogenic in the majority of affected middle age and elderly men and a sentinel event for cardiovascular disease. When men present with ED, it is advised that the opportunity should be used to assess their cardiovascular health. Objective: To determine the impediments to self reporting of ED and to assess the help seeking habits of men in Edo state with regards to ED. The secondary objective is to evaluate how acceptable sexual assessment is to these men when they present. Subjects and methods: This is a cross sectional study using a multi-facet, questionnaire with a section consisting of the international index of erectile function (IIEF). All men above 30 years who consented were included. Results: The response rate was 71.1%. The mean IIEF score was 20.33 with standard deviation of 4.656. The overall prevalence of ED was 51.2. Three hundred and eight of the respondents (33.3%) did not know where ED is treated, 273 (29.5%) thought that it is treated by complementary and alternative medicine practitioners while 237 (25.6) opted for the hospital as a point of care. This had a statistically significant correlation with location of the respondent (P = 0.000), level of education (P = 0.000) and senatorial zone (P = 0.000). Sexual evaluation was acceptable to 384 (41.5%) respondents when men present without ED and 757 (81.8%) when ED has occurred. This had a statistically significant correlation with level of education (P = 0.000), alcohol consumption (P = 0.000) and senatorial zone (P = 0.000).
Characteristics and expectations of patients with erectile dysfunction: results of the SCORED study
International Journal of Impotence Research, 2008
In an observational study in men with erectile dysfunction (ED) consulting a general practitioner (GP) or urologist in Belgium, demographics, ED characteristics (including erection hardness score), co-morbidities and treatment expectations were evaluated using a structured questionnaire. In total, 341 GPs and 41 urologists recruited 1492 patients. Most (74%) were untreated and 25% had ED for 43 years. Considering PDE5 inhibitors, erection hardness (89%) and maintenance (92%) were considered 'very important' by most patients. Only 18% of physicians initiated discussion about ED, despite 41% of patients having X3 known risk factors. The questionnaire was considered helpful by 81% of GPs and 83% of their patients. Overall, patients are under-diagnosed, and physicians are reluctant to ask about ED. A questionnaire including erection hardness score is useful to facilitate discussion about ED in general practice. Erection hardness and maintenance are more important to patients as compared to fast onset or long duration of action.
2013
Introduction. Data suggest that ED is still an underdiagnosed and undertreated condition. In addition, it seems that men with ED are unsatisfied about their relationship with their physician and with the available drugs. Aim. The study aims to identify health-related characteristics and unmet needs of patients suffering from erectile dysfunction (ED) in big 5 European Union (EU) nations (France, Germany, Italy, Spain, and UK). Methods. Data were collected from the 2011 5EU National Health and Wellness-Survey on a population of 28,511 adult men (mean age: 47.18; SD 16.07) and was focused on men (5,184) who self-reported ED in the past 6 months. In addition, the quality of life (QoL) and work productivity/activity were explored. Main Outcome Measures. Health-related QoL (HRQoL) and work productivity were measured with SF-12v2 and WPAI validated psychometric tools. Results. One in every 20 young men (age 18-39) across 5EU experienced ED in the past 6 months. About half of men (2,702/5,184; [52%]) with ED across all ages did not discuss their condition with their physician. Interestingly, among those men who did discuss their condition with their physician, 68% (1,668/2,465) do not currently use medication. These findings were more evident in the age group of 18-39 years. Only 48% (2,465/5,184) had a closer relationship with their physician, suggesting that this quality of relationship may be unsatisfactory. Compared with controls, ED patients have a significantly higher intrapsychic and relational psychopathological comorbid burden and relevant decreasing in HRQoL, with a significantly higher impairment on work productivity/activity. Conclusion. Data suggest that there is a need for a new therapeutic paradigm in ED treatment which images the achievement of a new alliance between physician and patient. Hence, alternative drug delivery strategies may reduce the psychological and social impact of this disease. Jannini EA,