Introduction

We analyzed erectile dysfunction (ED) in a representative sample of 45-year-old German men and assessed the association with lifestyle risk factors and ED-related comorbidities.

Methods

Data was collected within the German Male Sex-Study (part of the PROBASE prostate cancer screening trial) between April 2014 and April 2016. _x000D_ 45-year old men living in four German regions (Dusseldorf, Hannover, Heidelberg, Munich) were invited within a screening trial. 10.135 Caucasian, heterosexual and sexually active men were included in this analysis. An anamnesis interview was obtained for all men including information on comorbidities and medication. Weight and waist circumference were measured on site._x000D_ Erectile function was evaluated using the International Index of Erectile Function (IIEF-EF(6)). The presence of ED was defined as IIEF-EF-Score <=25._x000D_ Association of ED and comorbidities/risk factors were analyzed by logistic regression._x000D_

Results

The prevalence of ED was 25.2% (IIEF-EF: 6-10: 3.1%, 11-16: 9.2%, 17-21: 4.2%, 22-25: 8.7%). We ascertained a baseline risk of 14.4% for men without ED-related comorbidities and with healthy lifestyle factors: no smoking, waist circumference <94cm, physical activity >=4 days a week, IPSS=0._x000D_ In multiple logistic regression with backward elimination the following factors associated with ED were identified: _x000D_ Comorbidities: Depression [OR 1.87], lower urinary tract symptoms (defined as International Prostate Symptom Score >7) [OR 1.68], diabetes mellitus [OR 1.38], hypertension [OR 1.22]._x000D_ Risk factors: Poor general health status (first question of SF12) [OR 1.72], waist circumference (>=102cm) [OR 1.31], physical activity (<2 days a week minimum 30 minutes per day mild exercise) [OR 1.27], smoking regularly [OR 1.15]._x000D_ The only factor eliminated during variable selection was BMI even though this factor showed a crude OR of 1.42._x000D_ ED-prevalence increased with the number of risk factors (0 factors: 21.9%; 3 factors: 33.4%) and number of comorbidities (0 comorbidities: 22.4%; 3-4 comorbidities: 64.3%)._x000D_

Conclusions

ED was found in every fourth 45-year-old German man. Prevalence increased significantly with the number of risk factors and comorbidities.

Funding

none