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While research indicates that roughly 18 percent of American men over the age of 20 regularly experience erection difficulties, a recent study shows that barely one-quarter of these men go on to seek treatment for their impotence.
The study, published in the July 2014 issue of ¨The Journal of Sexual Medicine,¨ found that only 25.4 percent of 6.2 million patients diagnosed with erectile dysfunction went on to seek treatment within 12 months of their diagnosis.
Making these findings all the more amazing is the ready availability of a wide array of treatments for impotence, among which the family of PDE5-inhibiting drugs leads the list. However, in defining treatment, researchers considered not only these impotence drugs but also other treatments, including androgen replacement therapy and the use of injection or urethral prostaglandins.
Large-Scale Survey
A team of five urology researchers undertook the study to fill in a gap in the body of research covering the treatment of erection difficulties among American men. In the introduction to their study, the authors wrote: ¨Until now, research conducted on the treatment of erectile dysfunction has been derived from surveys involving small populations.¨
From a pool of more than 85 million men diagnosed with ED, researchers selected just over 6.2 million to be tracked for a period of 12 months.
For the purposes of their study, researchers determined that men who were diagnosed with erection difficulties were considered to be treated if they filled a prescription for a PDE5 inhibitor, injection or urethral prostaglandins, or androgen replacement therapy.
74.6 Percent Untreated
Of the 6.2 million ED patients that researchers tracked, 74.6 percent went untreated. Of those who did seek treatment, three-quarters filled prescriptions for one of the popular PDE5 inhibitors, which include Viagra (sildenafil citrate), Cialis (tadalafil), Levitra and Staxyn (vardenafil), and Stendra (avanafil).
The study also found that men who were 60 or over were much less likely to seek treatment for their erection difficulties than men between the ages of 40 and 59.
More than a year before the study’s publication in ¨The Journal of Sexual Medicine,” its authors presented their findings at the 28th annual congress of the European Association of Urology in Milan, Italy.
Study Led by Cakir
Leading the study was Omer Cakir, M.D., a member of the faculty at Northwestern University’s Feinberg School of Medicine in Chicago.
Although it has been widely assumed that many cases of erection difficulties go unreported because of patient embarrassment and reticence to broach the topic with their doctors, researchers found that “once the topic is initiated, patients become willing to discuss their potency issues.”
While the study on undertreatment of ED relied upon data from men who were diagnosed as impotent, it is widely believed that many cases of ED go undiagnosed because men hesitate to bring up the subject with medical professionals.
Underreporting of ED
In a separate study, urology researchers at Albert Einstein Medical Center in Philadelphia surveyed 500 men age 50 or over who had visited a urologist’s office for reasons other than ED. These men were asked whether they had any erection difficulties and, if so, whether they had ever consulted their primary physician or urologist about such problems.
Of the 500 men surveyed, 218 reported that they had experienced at least some degree of ED. When asked why they had failed to consult a medical professional about their symptoms of impotence, 161 — 74 percent — said they were embarrassed to discuss the matter. Another 12 percent said they believed that impotence was a natural part of the aging process, and 5 percent said they didn’t consider the problem worthy of attention.
Want Doctor to Broach Topic
More than 80 percent of the 170 men who said they had not discussed their erection difficulties told researchers they would have welcomed a discussion of the matter if their doctors had initiated the dialogue.
Findings on the prevalence of erection difficulties among American men come from a study conducted by epidemiologists at the Johns Hopkins Bloomberg School of Public Health in Baltimore. That study, published in the February 2007 issue of “The American Journal of Medicine,” was based on the analysis of data collected from 2,126 adult male participants in the 2001-2002 National Health and Nutrition Examination Survey, or NHANES.
Data from the NHANES survey are considered “nationally representative of the noninstitutionalized adult male population” in the United States. Erection difficulties were assessed by a single question on the NHANES survey, which was conducted as a computer-assisted, self-paced interview.
High Incidence Among Diabetics
Although diabetes was already recognized as a primary risk factor for impotence, the survey indicated that the prevalence of ED among men with diabetes was 51.3 percent. The survey also showed that the risk of ED increased with advancing age and was significantly higher in men with a history of cardiovascular disease and hypertension.
While in the past the vast majority of erection difficulties were widely believed to stem from psychological causes, today medical professionals acknowledge that 80 to 90 percent of all ED case are physiological in origin. And ED that is physiological in nature is more readily treatable with the medications currently available.
Strong Blood Flow Is Key
To get and keep an erection, a man needs strong blood flow to the penis, which has caused a number of medical professionals to observe that, generally speaking, what’s good for the heart is also good for the penis. Both, of course, depend on strong blood flow to ensure optimal function.
The most popular ED drugs are those known collectively as PDE5 inhibitors, so-called because they temporarily block the effects of an enzyme known as phosphodiesterase-5. The PDE5 enzyme interferes with normal erectile function by breaking down cyclic guanosine monophosphate, or cGMP, a chemical messenger that helps to facilitate the erection process.
Feelings of sexual desire in the brain trigger a release of nitric oxide, which floods into the male genitalia and increases local levels of cGMP, which dilates blood vessels and allows strong blood flow to the penis. As blood fills erectile tissue in the penis, an erection occurs.
How PDE5 Inhibitors Work
PDE5 inhibitors work by temporarily disabling the effects of the PDE5 enzyme, thus allowing cGMP to play its important role in getting and keeping an erection.
If you are having erection difficulties and looking for a reliable online source for one of the PDE5 inhibitors, eDrugstore.com offers a full line of these drugs, all of which are FDA-approved and supplied by licensed U.S. pharmacies.
If your doctor has written a prescription for one of these drugs, you can fax or scan and email it along with your order to eDrugstore. If you don’t have a prescription, eDrugstore can set up an online consultation with one of its contract physicians. You’ll be asked to supply details about your medical history and current symptoms. If eDrugstore’s physician determines that the use of one of the PDE5 inhibitors is appropriate for you, he or she will authorize a prescription.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.
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