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Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study

Constance G. Bacon, ScD; Murray A. Mittleman, MD, ScD; Ichiro Kawachi, MD, PhD; Edward Giovannucci, MD, ScD; Dale B. Glasser, PhD; and Eric B. Rimm, ScD
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From Harvard School of Public Health, Brigham and Woman's Hospital, Harvard Medical School, and Beth Israel Deaconess Medical Center, Boston, Massachusetts; and Pfizer, Inc., New York, New York.

Ann Intern Med. 2003;139(3):161-168. doi:10.7326/0003-4819-139-3-200308050-00005
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This group of 31 742 health professionals with no known history of prostate cancer ranged in age from 53 to 90 years at the time of the 2000 questionnaire. As shown in Table 1, men in the oldest age group were less likely to be married, smoke, or engage in physical activity and were more likely than younger men to have comorbid conditions. Table 2 provides unadjusted frequencies and mean ratings for many aspects of sexual function. There is a clear, linear, age-related decline for nearly all of the variables assessed. For instance, mean overall sexual function was equivalent to “good” (mean overall score, 4.1) in the youngest men and declined steadily to “poor” (mean overall score, 1.8) in the oldest group. When men with prostate cancer were excluded, the age-standardized prevalence of erectile dysfunction in the previous 3 months was 33%.


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Reported prevalence of erectile dysfunction in the previous 3 months according to disease status and lifestyle risk factors.2

*Chronic disease includes other cancer, heart disease, hypertension, diabetes, or stroke. †Risk factors include antidepressant use, consumption of more than two alcoholic drinks per day, smoking, body mass index ≥ 25 kg/m , exercise <21.5 metabolic equivalents per week, or television viewing >8.5 h/wk.

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Summary for Patients

Sexual Function in Men Older Than 50 Years of Age

Impotence, or erectile dysfunction, is an inability to get or keep an erection firm enough for sexual intercourse. Causes can be psychological or physical. Physical causes include heavy drinking, chronic diseases such as diabetes, and some drugs that are used to treat hypertension and depression. Older men more frequently have erectile dysfunction or risk factors for erectile dysfunction than do younger men. Despite this, we don't have precise estimates of how common erectile dysfunction is among men older than 50 years of age.


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