Erectile dysfunction affects the sexual health of many men around the world and can make having a good sex life difficult. Understanding what erectile dysfunction is can be a great first step toward seeking treatment for it. Let’s take a look at some erectile dysfunction statistics and some of the most frequently asked questions about the condition.
What is erectile dysfunction (ED)?
Erectile dysfunction (ED) is the inability to get and maintain an erection that’s firm enough for sexual intercourse. Men who experience ED have decreased blood flow to the penis, which could be caused by many things from drug side effects to stress or high blood pressure.
Here are the most common symptoms of ED:
- Difficulty getting an erection
- Difficulty maintaining an erection
- Reduced interest in sexual activity
- Low self-esteem
If these symptoms are present, a doctor may diagnose someone with ED. A doctor might also perform a physical exam and ask for a complete medical history. ED may be a warning sign of more serious underlying medical conditions like cardiovascular disease, so a doctor might order blood tests to check for other medical problems.
RELATED: Diagnosing erectile dysfunction
How common is ED?
- The worldwide prevalence of erectile dysfunction is expected to increase to 322 million men by 2025. (International Journal of Impotence Research, 2000)
- ED affects about 30 million men in the United States. (Current Opinion in Nephrology and Hypertension, 2012)
- 1 in 10 men is estimated to have ED at some point in his lifetime. (Cleveland Clinic, 2019)
- In one study of eight countries, the U.S. has the highest rate of self-reported ED (22%). (Current Medical Research and Opinion, 2004)
- Spain has the lowest rate of self-reported ED (10%). (Current Medical Research and Opinion, 2004)
Erectile dysfunction statistics by age
- ED affects about 10% of men per decade of life. For example, 50% of men in their 50s are affected by ED. (University of Wisconsin Health, 2019)
- Men older than 40 are three times as likely to experience complete ED than younger men. (The Journal of Urology, 1994)
- ED is less common but increasing in young men. It was previously believed that only 5% to 10% of men younger than 40 experienced ED. But a more recent study showed that ED was prevalent in 26% of men younger than 40. (Boston University School of Medicine, 2002) (The Journal of Sexual Medicine, 2013)
- Premature ejaculation is more common in younger men than older men. (The Journal of Sexual Medicine, 2013)
Erectile dysfunction statistics by severity
You can’t research ED statistics without reading about the Massachusetts Male Aging Study (MMAS) of 1987-1989. Including 1,290 people, MMAS was the most extensive study of ED since 1948. One measurement of ED in the study was the severity of impotence. Here are the results:
- Any degree of impotence: 52% of subjects
- Minimally impotent: 17% of subjects
- Moderately impotent: 25% of subjects
- Completely impotent: 10% of subjects
(The Journal of Urology, 1994)
Note: In a more recent study, severe ED was more common in younger men (49%) than in older men (40%). (The Journal of Sexual Medicine, 2013)
Erectile dysfunction statistics by cause
- ED is medication-related in 25% of patients in outpatient clinics. Blood pressure medications are the most common culprit in medication-induced ED. (Boston University School of Medicine, 2002)
- Vascular disease is the most common cause of natural ED, with 64% of erectile difficulties associated with heart attacks and 57% associated with bypass surgery. (Boston University School of Medicine, 2002)
- 35% to 75% of men who have diabetes will also experience ED. (Boston University School of Medicine, 2002)
- Up to 40% of men with renal failure have some degree of ED. (Boston University School of Medicine, 2002)
- 30% of men with COPD have impotence. (Boston University School of Medicine, 2002)
- Smoking cigarettes and using illicit drugs were more common in younger ED patients. (The Journal of Sexual Medicine, 2013)
- Obesity and diabetes are responsible for 8 million cases of ED. (Polski Merkuriusz Lekarski, 2014)
- The majority (79%) of men with ED are overweight (BMI of 25kg/m2 or higher). (Polski Merkuriusz Lekarski, 2014)
|Underweight||< 18.5 kg/m2|
|Normal weight||18.5-24.9 kg/m2|
|Obese||≥ 30 kg/m2|
You can calculate your BMI here.
Common erectile dysfunction complications
Sexual function can affect a person’s overall health and quality of life. Many men with ED may experience depression or low self-esteem at some point in time and ED can put stress on relationships. Many men with ED will complain that their sex lives are less than satisfactory, which is often the main reason they seek medical treatment.
- Men with ED experience twice as many heart attacks and strokes (6.3%) in comparison to men who don’t have ED (2.6%). (American Heart Association, 2018)
- People with depression have an increased risk of 39% to develop ED. (The Journal of Sexual Medicine, 2018)
- Having ED also increases the risk of depression by 192%. (The Journal of Sexual Medicine, 2018)
- People with ED are nearly three times more likely to experience depression than those without ED. (The Journal of Sexual Medicine, 2018)
- Sexual dysfunction is present for 20% to 25% of infertile couples. (Reproductive Partners Medical Group, 2020)
- 1 in 6 infertile men is affected by ED or premature ejaculation. (Nature Reviews Urology, 2018)
The cost of erectile dysfunction
Phosphodiesterase5-inhibitors (PDE5-Is) like Viagra are the recommended treatment for ED, but these medications won’t be effective in 40% of patients, according to The Journal of Urology. Alternative treatments include injections, vacuum devices, and penile implants.
- Only a quarter of men with ED actually receive treatment. (The Journal of Sexual Medicine, 2014)
- 1 in 4 men who seek ED treatment is younger than 40. (The Journal of Sexual Medicine, 2013)
- Spending for the three most popular ED drugs (Viagra, Levitra, and Cialis) is over $1 billion worldwide every year. (Clinical Pharmacology and Therapeutics, 2011)
- While PDE5-Is only make up 37% of the total annual costs of all ED related services. Additional costs include doctor’s appointments, diagnostic procedures, hormone therapy, etc. (Journal of Urology, 2005)
- ED pills like Viagra (PDE-5 inhibitors) had the lowest annual cost per patient. Each patient with ED spent about $120 per year in 2001 on treatment. (Journal of Urology, 2005)
- If ED medications fail, penile prosthesis surgery is the most cost-effective treatment for ED in the long-term. Although they can cost upward of $20,000, insurance and Medicare generally cover penile implants. (Coloplast) (The Journal of Urology, 2018)
RELATED: Does insurance cover viagra?
Treating erectile dysfunction
Prescription medication is usually the first type of treatment option for ED. Here are some of the most common drugs that can increase erectile function:
However, the efficacy of these medications depends on the root cause of ED. “Sildenafil and tadalafil work, in the same way, to dilate blood vessels and increase blood flow to the penis,” says Leann Poston, MD, a contributor for Ikon Health. “If the cause of ED is not due to a lack of blood flow to the penis, neither drug will be helpful.”
Additionally, a physical cause of ED (i.e., hypertension) can damage blood vessels enough to the point that ED medications won’t work. “If small blood vessels are damaged due to high blood pressure, elevated LDL cholesterol, or diabetes, the vessels will not respond well to these medications and men will report no benefit,” Dr. Poston says.
Dr. Poston adds that “over time, these medications may lose their effectiveness due to progressive damage to small blood vessels.” She pointed to two studies to support this:
In a four-year study of sildenafil versus a placebo:
- Nearly 4% of men discontinued treatment due to an adverse event (side effect).
- Approximately 6% discontinued treatment over the four-year study because the medication was ineffective.
(Therapeutics and Clinical Risk Management, 2007)
In another study:
- About three-quarters (74%) of men reported Viagra worked for them.
- Three years later, more than half of the men who were reinterviewed were still taking the drug.
- Almost 40% of the men still taking the drug had to increase their dose by 50 mg to achieve an erection.
- It took between one and 18 months for treatments to lose their effects.
Doctors and researchers are always looking for new ways to treat ED. Here are some of the latest treatments options for ED that may work for some men:
- Shockwave therapy may help treat ED caused by vascular disease. Low-intensity shock waves pass through erectile tissue to help encourage blood flow and blood vessel growth.
- Stem cell therapy is the injection of stem cells into the penis. Some minor studies have been done on this, but more research is needed before the treatment becomes mainstream.
- Platelet-rich plasma can help grow new blood vessels and heal wounds, and platelet-rich plasma treatment may help treat ED because of the healing ability of platelets.
Erectile dysfunction questions and answers
At what age do men have trouble getting an erection?
Men can have trouble getting an erection at younger and older ages, but older men have an increased risk of erectile dysfunction. About 45% of men aged 65 to 74 develop ED.
How common is erectile dysfunction in your 20s?
Erectile dysfunction is not as common for younger men to experience; it affects about a quarter (26%) of men under the age of 40. Some studies have shown the prevalence of ED to be only 8% for men aged 20 to 29.
What is the main cause of erectile dysfunction?
While ED itself is primarily a result of a lack of blood flow to the penis, there are multiple causes of the condition. Heart disease, high cholesterol, obesity, coronary artery disease, diabetes mellitus, high blood pressure, metabolic syndrome, low testosterone levels, kidney disease, and prostate cancer are the most common risk factors of ED.
How does a man with erectile dysfunction feel?
A man with erectile dysfunction may feel many different things. The condition often leads to low self-esteem, feelings of undesirableness, unattractiveness, embarrassment, or unworthiness. Speaking with a mental health professional, health care professional, or being honest with your sexual partner can sometimes help these feelings go away.
Does erectile dysfunction last forever?
ED is treatable and even reversible. A 2014 study in The Journal of Sexual Medicine found a 29% remission rate in men with ED. Ask a men’s health specialist or urologist about medications and lifestyle changes that can improve sexual function.
Erectile dysfunction research
- The worldwide prevalence and epidemiology of erectile dysfunction, International Journal of Impotence Research
- Erectile dysfunction, Cleveland Clinic
- New insights into hypertension-associated ED, Current Opinion in Nephrology and Hypertension
- Obesity and erectile dysfunction, Polski Merkuriusz Lekarski
- Erectile dysfunction and depression, The Journal of Sexual Medicine
- 1 patient out of 4 with newly diagnosed erectile dysfunction is a young man, The Journal of Sexual Medicine
- Undertreatment of erectile dysfunction: claims analysis of 6.2 million patients, The Journal of Sexual Medicine
- Erectile dysfunction treatment and causes, University of Wisconsin Health
- Epidemiology of ED, Boston University School of Medicine
- Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study, The Journal of Urology
- Management of erectile dysfunction: A cost-effectiveness analysis, The Journal of Urology
- Penile implants, Coloplast
- Prevalence of ED in the general population, Current Medical Research and Opinion
- Erectile dysfunction may be a warning sign for more serious health problems, American Heart Association
- Erectile dysfunction and infertility, Reproductive Partners Medical Group, Inc.
- Sexual dysfunction and male infertility, Nature Reviews Urology
- Economic cost of male erectile dysfunction, PharmacoEconomics
- The costs of caring for erectile dysfunction in a managed care setting, The Journal of Urology
- Should U.S. government insurance programs pay for erectile dysfunction drugs?, Clinical Pharmacology and Therapeutics
- A study of sexuality and health among older adults in the United States, The New England Journal of Medicine
- Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction, Therapeutics and Clinical Risk Management
- Viagra wears off after two years, BMJ