Constance G. Bacon, ScD; Murray A. Mittleman, MD, ScD; Ichiro Kawachi, MD, PhD; Edward Giovannucci, MD, ScD; Dale B. Glasser, PhD; Eric B. Rimm, ScD
Grant Support: By the National Institutes of Health (grants CA55075 and HL35464) and Pfizer, Inc.
Potential Financial Conflicts of Interest:Employment: D.B. Glasser (Pfizer, Inc.); Consultancies: M.A. Mittleman (Pfizer, Inc., and Lily-ICOS); Honoraria: M.A. Mittleman (Pfizer, Inc., and Lily-ICOS); Stock ownership or options (other than mutual funds): D.B. Glasser (Pfizer, Inc.); Grants received: M.A. Mittleman (Pfizer, Inc.), E.B. Rimm (Pfizer, Inc.).
Requests for Single Reprints: Constance G. Bacon, ScD, c/o Eric B. Rimm, ScD, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.
Current Author Addresses: Drs. Bacon, Giovannucci, and Rimm: Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.
Dr. Mittleman: Beth Israel Deaconess Medical Center, 1 Autumn Street, Floor 5, Boston, MA 02115.
Dr. Kawachi: Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115.
Dr. Glasser: Pfizer, Inc., Sexual Health Team, 235 East 42nd Street, New York, NY 10017.
Author Contributions: Conception and design: C.G. Bacon, M.A. Mittleman, I. Kawachi, D.B. Glasser, E.B. Rimm.
Analysis and interpretation of the data: C.G. Bacon, I. Kawachi, E. Giovannucci, D.B. Glasser, E.B. Rimm.
Drafting of the article: C.G. Bacon, I. Kawachi, E. Giovannucci.
Critical revision of the article for important intellectual content: C.G. Bacon, M.A. Mittleman, I. Kawachi, E. Giovannucci, D.B. Glasser, E.B. Rimm.
Final approval of the article: C.G. Bacon, M.A. Mittleman, I. Kawachi, E. Giovannucci, E.B. Rimm.
Provision of study materials or patients: E.B. Rimm.
Statistical expertise: C.G. Bacon, M.A. Mittleman, E. Giovannucci.
Obtaining of funding: E. Giovannucci, D.B. Glasser, E.B. Rimm.
Collection and assembly of data: C.G. Bacon, E.B. Rimm.
Although many studies have provided data on erectile dysfunction in specific settings, few studies have been large enough to precisely examine age-specific prevalence and correlates.
To describe the association between age and several aspects of sexual functioning in men older than 50 years of age.
Cross-sectional analysis of data from a prospective cohort study.
U.S. health professionals.
31 742 men, age 53 to 90 years.
Questionnaires mailed in 2000 asked about sexual function, physical activity, body weight, smoking, marital status, medical conditions, and medications. Previous biennial questionnaires since 1986 asked about date of birth, alcohol intake, and other health information.
When men with prostate cancer were excluded, the age-standardized prevalence of erectile dysfunction in the previous 3 months was 33%. Many aspects of sexual function (including overall function, desire, orgasm, and overall ability) decreased sharply by decade after 50 years of age. Physical activity was associated with lower risk for erectile dysfunction (multivariable relative risk, 0.7 [95% CI, 0.6 to 0.7] for >32.6 metabolic equivalent hours of exercise per week vs. 0 to 2.7 metabolic equivalent hours of exercise per week), and obesity was associated with higher risk (relative risk, 1.3 [CI, 1.2 to 1.4] for body mass index >28.7 kg/m2 vs. <23.2 kg/m2). Smoking, alcohol consumption, and television viewing time were also associated with increased prevalence of erectile dysfunction. Men who had no chronic medical conditions and engaged in healthy behaviors had the lowest prevalence.
Several modifiable health behaviors were associated with maintenance of good erectile function, even after comorbid conditions were considered. Lifestyle factors most strongly associated with erectile dysfunction were physical activity and leanness.
We know little about age-specific prevalence and correlates of sexual function among U.S. men.
Among 31 742 male health care professionals, 74% younger than 59 years of age and 10% older than 80 years of age rated sexual function as good or very good. Moderate or big problems were identified by 12%, 22%, and 30% of those younger than 59 years of age, 60 to 69 years of age, and older than 69 years of age, respectively. Increasing age after age 50 years, inactive lifestyle, obesity, and multiple medical conditions and medications were associated with worse function.
These cross-sectional analyses show that sexual dysfunction is common, particularly among older men.
Table 1. Demographic Characteristics, Health Behaviors, and Comorbid Conditions for 31 742 Health Professionals without Prostate Cancer by Age Group
Table 2. Sexual Function in 31 742 Health Professionals without Prostate Cancer by Age Group
Reported prevalence of erectile dysfunction in the previous 3 months according to disease status and lifestyle risk factors.
Table 3. Relative Risk for Erectile Dysfunction in the Previous 3 Months by Age for Men without Prostate Cancer
Table 4. Cross-Sectional Relative Risks for Erectile Dysfunction in the Previous 3 Months according to Demographic Characteristics, Health Behaviors, and Comorbid Conditions among Men without Prostate Cancer (n= 29 228)
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Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study. Ann Intern Med. 2003;139:161–168. doi: 10.7326/0003-4819-139-3-200308050-00005
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Published: Ann Intern Med. 2003;139(3):161-168.
Cardiology, Coronary Risk Factors, Hematology/Oncology, Neurology, Prostate Cancer.
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