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Psychogenic and Organic Causes of Erectile Dysfunction: Part I

Joyce So, BSc
Co-author:
Dr. Sidney Radomski,
Urology, Toronto Western Hospital

In 1992, the National Institutes of Health Consensus Development Conference1 suggested the use of the term "erectile dysfunction" instead of "impotence" to describe one of the most common chronic medical problems affecting men over the age of 40. Erectile dysfunction is defined as the persistent inability to attain or maintain a sufficient penile erection for sexual intercourse in at least 50% of attempts. The prevalence and degree of erectile dysfunction increases with age, with men in their fifties being three times more likely to have this condition compared to men in their twenties.2 By the age of 65, 25% of men are afflicted with erectile dysfunction, a number which increases to 55% among 75-year-olds and 65% among 80-year-olds.2 However, erectile dysfunction should not be considered part of the normal aging process.

The multi-disciplinary, community-based Massachusetts Male Aging Study (MMAS)3 of men aged 40 to 70, conducted between 1987 and 1989, showed that 35% of the men reported moderate to complete erectile dysfunction, with 52% reporting at least some degree of dysfunction. They also reported a decrease in libido and the number of sexual thoughts, fewer nocturnal or morning erections, and less frequent intercourse with age.