ERECTILE dysfunction may affect up to one in five men and can be a strong indicator of future heart disease, according to three new studies of the condition.

Research published yesterday in the Archives of Internal Medicine shows that as many as one fifth of men of all ages may suffer from erectile problems.

A study of more than 2,000 American men, led by scientists at the University of California, Los Angeles, found that 6.5 per cent of men in their twenties suffered from the problem, increasing to more than three quarters of those aged 75 and over.

Erectile dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse. However, because of the sensitive nature of the condition, it has been difficult to estimate how many men it affects.

The limited research carried out in Britain has suggested that about 2.3 million British men suffer from the condition, with about 5 per cent of 40-year-old men and up to

25 per cent of 65-year-olds thought to be affected.

However, research carried out in the US indicates a significantly higher prevalence, at 18.4 per cent in adult men.

Obesity, hypertension, smoking and diabetes were all shown to be associated with the risk of ED, while Hispanic men were found to be at nearly twice the risk than that of white men. The American rate, calculated from a pool of patients in California, may therefore be higher than could be expected in Britain, where the Hispanic population is much lower.

Two other studies lent further support to the links between the sexual condition and other chronic diseases, and suggested how it may give warning of other approaching health problems.

Work by scientists at the University of Chicago Hospitals showed that men with ED may contract more severe cases of coronary heart disease than those without.

Researchers evaluated 221 men with an average age of just under 60, who had been referred for diagnostic tests for the evolution of heart disease. More than half the participants reported ED. Sufferers tended to be older and were more likely to have heart disease, diabetes and hypertension.

The authors said that in patients receiving stress testing for cardiovascular problems, “the presence of ED (was) common and a strong predictor of clinically significant coronary heart disease and established markers of an adverse cardiovascular prognosis”. They said that an analysis and monitoring of sexual function may be useful when identifying risk in patients suspected of having coronary heart disease.

A third study, of Canadian men visiting primary care physicians, found that about half reported having ED, which was linked with cardiovascular disease, diabetes, future risk of heart disease and increased fasting blood sugar levels.

The scientists, from Montreal General Hospital and McGill University, said the research showed that general practitioners were in a unique position to inquire about a patient’s sexual behaviour and track down related problems.

“Primary care physicians are uniquely positioned to inquire about a patient’s sexual function during a routine office visit,” the authors said. “However, there is little information available regarding the prevalence of ED among patients seen in this clinical setting.

“(Doctors) may find that taking a sexual history provides important clinical information beyond the detection of erectile dysfunction.”

New medications for erectile dysfunction, which were introduced in the late 1990s, prompted a 50 per cent increase in visits to doctors in the US about the condition.

MALFUNCTIONING

Research suggests that 75 per cent of sexual dysfunction cases in men under 35 are psychologically based (compared with 10 per cent for men over 50)

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