Aug. 4, 2003 --- A new study shows that as men age they eventually will come face to face with erectile dysfunction (ED), commonly known as impotence.

The research, published in the August 2003 issue of Annals of Internal Medicine, shows that ED is common among older men and sexual function sharply decreases after age 50.

Erectile dysfunction is the inability to attain or maintain an erection adequate for the sexual satisfaction of both partners. At one time, doctors tended to blame ED on psychological problems or, with older men, on the normal aging process. Today, urologists say physical factors underlie perhaps 90% of cases of persistent erectile dysfunction in men older than 50.

Researchers surveyed more than 31,000 health professionals, aged 53-90, about their sexual function. They asked volunteers to rate their ability in the previous three months -- without treatment -- to have and maintain an erection adequate for intercourse. Men with "poor" or "very poor" ability were considered to have erectile dysfunction.

Researchers assessed other factors such as age, physical activity, alcohol intake, and smoking -- which can affect erectile function.

The Younger the Man, the Better the Function

Results showed that age played a primary role in men who said they had ED. The older the men, the higher the reports of ED. The reports ranged from "good" function among younger men to a steady decline to "poor" among the older group.

The majority of younger men (74%) rated sexual function as good or very good; only 10% of men older than 80 rated sexual function the same. Only 12% of younger men reported big or moderate problems. But nearly a quarter to a third of men older than 50 reported this degree of severity in sexual function.

• 2% reported first experiencing ED before age 40
• 4% reported first experiencing ED between ages 40 to 49
• 26% reported first experiencing ED between ages 50 to 59
• 40% reported first experiencing ED between ages 60 to 69

Men with a healthy lifestyle and no chronic disease had the lowest risk for erectile dysfunction; the greatest difference was seen for men aged 65-79. For instance, men who exercised at least three hours per week had a 30% lower risk for ED than those who exercised little. Obesity, smoking, and excessive TV watching were also associated with having a greater risk of erectile dysfunction.

Erectile dysfunction affects as many as 20 million American men. It can be devastating to self-esteem and have far reaching effects on relationships. Researchers say they hope their study will shed new light on the condition and help fight its social stigma.

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