Medicated Sex in Britain: Evidence from the Third National Survey of Sexual Attitudes and Lifestyles

Key messages

• Ever use of medication to assist sexual performance is reasonably common in Britain, more so in men than women.
• It is associated with using other drugs, higher levels of sexual activity and unsafe sex in both women and men.
• In men, associations with high-risk behaviour persist after adjusting for same-sex behaviour, suggesting the association with high-risk is not restricted to those practicing same-sex sex.
• In men without erectile difficulties, medication use is associated with higher levels of sexual activity and also low interest in sex. This paradox is perhaps explained by low sexual confidence.
• Because medication is increasingly easy to access without prescription, there is a need for better professional and patient education on this phenomenon.

Objectives

To describe the prevalence of medication use to assist sexual performance in Britain and to identify associated factors.

Methods

Cross-sectional probability sample, undertaken in 2010–2012, of 15 162 people aged 16–74 years, resident in Britain, of whom, 5617 men and 8095 women reported sexual experience (ever) and 4817 men were sexually-active (reported sex in the last year).

Results

Ever use of medication to assist sexual performance (medicated sex) was more commonly reported by men than women (12.9% (95% CI 11.9% to 13.9%) vs 1.9% (95% CI 1.7% to 2.3%)) and associated with older age in men and younger age in women. It was associated with reporting smoking, and use of alcohol and recreational drugs, as well as unsafe sex (≥2 partners and no condom use in the last year) in both men and women. Among men, the proportion reporting medicated sex in the last year was higher among those reporting erectile difficulties (ED) than those not doing so (28.4% (95% CI 24.4% to 32.8%) vs 4.1% (95% CI 3.4% to 4.9%)). In all men, medicated sex was associated with more frequent sexual activity, meeting a partner on the internet, unsafe sex and recent sexually transmitted infections diagnosis; associations that persisted after adjusting for same-sex behaviour and ED. However, there were significant interactions with reporting ED, indicating that among men with ED, medicated sex is not associated with same-sex behaviour and ever use of recreational drugs.

Conclusions

A substantial minority of people in Britain report medicated sex, and the association between medicated sex and risky sexual behaviour is not confined to high-risk groups.

Full article at:  http://goo.gl/XZYd9Y

By:  Kirstin R Mitchell,1 Philip Prah,2 Catherine H Mercer,2 Jessica Datta,1 Clare Tanton,2 Wendy Macdowall,1 Andrew J Copas,2 Soazig Clifton,2 Pam Sonnenberg,2 Nigel Field,2 Anne M Johnson,2 and Kaye Wellings1

¹Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK

²Research Department of Infection and Population Health, University College London, London, UK

Correspondence to Dr Kirstin Mitchell, Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK; Email: ku.ca.mthsl@llehctim.nitsrik

AMJ and KW are joint senior authors.

Sex Transm Infect. 2016 Feb; 92(1): 32–38., Published online 2015 Jun 19. doi:  10.1136/sextrans-2015-052094

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Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries

INTRODUCTION:

Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature.

AIM:

The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men.

METHODS:

An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality.

RESULTS:

Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function.

CONCLUSIONS:

In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously. Klein V, Jurin T, Briken P, and Štulhofer A. Erectile dysfunction, boredom, and hypersexuality among goupled men from two European countries.

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By:  Klein V1, Jurin T2,3, Briken P1, Štulhofer A2.

• 1Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
• 2Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
• 3Unit for Health and Clinical Psychology, Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia. 

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Topical Anaesthetics for Premature Ejaculation: A Systematic Review & Meta-Analysis

Eutectic Mixture of Local Anaesthetics (EMLA) is recommended for use off-label as a treatment for premature ejaculation (PE). Other topical anaesthetics are available, some of which have been evaluated against oral treatments. 

The purpose of this systematic review was to evaluate the evidence from randomised controlled trials (RCTs) for topical anaesthetics in the management of PE. Bibliographic databases including MEDLINE were searched to August 2014. The primary outcome was intra-vaginal ejaculatory latency time (IELT). Methodological quality of RCTs was assessed. IELT and other outcomes were pooled across RCTs in a meta-analysis. Between-trial heterogeneity was assessed. Nine RCTs were included. Seven were of unclear methodological quality. 

Pooled evidence (two RCTs, 43 participants) suggests that EMLA is significantly more effective than placebo at increasing IELT (P < 0.00001). Individual RCT evidence also suggests that Topical Eutectic-like Mixture for Premature Ejaculation (TEMPE) spray and lidocaine gel are both significantly more effective than placebo (P = 0.003; P < 0.00001); and lidocaine gel is significantly more effective than sildenafil or paroxetine (P = 0.01; P = 0.0001). 

TEMPE spray is associated with significantly more adverse events than placebo (P = 0.003). More systemic adverse events are reported with tramadol, sildenafil and paroxetine than with lidocaine gel. 

Diverse methods of assessing sexual satisfaction and ejaculatory control with topical anaesthetics are reported and evidence is conflicting. Topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain.

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By:   Marrissa Martyn-St James A E, Katy Cooper A, Kate Ren A, Eva Kaltenthaler A, Kath Dickinson A, Anna Cantrell A, Kevan Wylie B, Leila Frodsham C and Catherine Hood D 

A School for Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. B Porterbrook Clinic, Sexual Medicine, 9 Sunderland Street, Sheffield, S11 8HN, UK. C Institute of Psychosexual Medicine, Building 3 Chiswick Park, 566 Chiswick High Road, London, W4 5YA, UK. D St George’s Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK. E Corresponding author. Email: m.martyn-stjames@sheffield.ac.uk 

 

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Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction During a 6-month Observational Study (EDATE): Impact of Patient Characteristics and Comorbidities

To explore the impact of patient-characteristics and relevant comorbidities on treatment continuation rates, effectiveness, and satisfaction in patients with erectile dysfunction (ED) who started or switched to tadalafil 5 mg once daily (TAD-OaD) at baseline.

In the EDATE observational study, phosphodiesterase-type-5 (PDE5)-inhibitor pretreated or naïve ED patients who started or switched to TAD-OaD were prospectively followed for 6 months. Time to discontinuation of TAD-OaD was estimated using the Kaplan-Meier product-limit method at Months 2, 4, and 6 in subgroups stratified by age (18 − 65 years and >65 years), PDE5-inhibitor pretreatment, ED-severity (mild, moderate, severe), and presence or absence of relevant comorbidities (BPH, diabetes, CVD, hypertension, dyslipidemia). LSmean change from baseline in International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) scores and associated 95 % CIs were assessed using a mixed-model for repeated measures. Visit, ED etiology, and subgroups were included as fixed-effects.

Overall, 778 patients received prescriptions for initiating or switching to TAD-OaD at baseline. At Month 2, >90 % of patients remained on TAD-OaD, except those aged >65 years (86.7 %) and patients with severe ED (89.0 %). More than 80 % of patients in all subgroups, except those aged >65 years (75.0 %), continued TAD-OaD at Month 6. There was a significant LSmean negative effect on IIEF- EF domain-score improvement for BPH, previous PDE5-inhibitor treatment, and mild vs moderate ED; the latter possibly linked with a bigger treatment-effect in those with more severe ED at baseline. The LSmean effect on change in IIEF-EF was significantly positive for diabetes, most likely because those with diabetes had more severe ED at baseline. For all other parameters, no statistically significant LSmean effects in IIEF-EF changes were observed. No comorbidity or baseline-characteristic except age affected changes in EDITS.

Under routine clinical conditions, treatment continuation rate or satisfaction does not seem to be significantly affected by the presence of comorbidities in men who choose ED-treatment with TAD-OaD. The magnitude of treatment effectiveness was affected by certain baseline characteristics and comorbid conditions.

Full article at:  http://goo.gl/eMo8Fx

By: Dimitrios Hatzichristou¹, Gianluca d’Anzeo^2*, Hartmut Porst³, Jacques Buvat⁴, Carsten Henneges⁵, Andrea Rossi², Karim Hamidi⁶ and Hartwig Büttner⁵

¹Centre for Sexual and Reproductive Health and 1st Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece

²Medical Advisor Urology, Eli Lilly Italy S.p.A., Via A. Gramsci 731/733, Sesto Fiorentino, 50019, FI, Italy

³Private Practice of Urology and Andrology, Hamburg, Germany

⁴Centre d’Etude et de Traitement de la Pathologie de l’Appa reil Reproducteur et de la Psychosomatique (CETPARP), Lille, France

⁵Lilly Deutschland GmbH, Bad Homburg, Germany

⁶Eli Lilly and Company, Neuilly sur Seine, France

 

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Anxiety & Depression among Greek Men with Primary Erectile Dysfunction & Premature Ejaculation

Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent sexual disorders among males associated with significant distress and impairment in quality of life. The aim of this study was to investigate the prevalence of anxiety and depression symptoms among patients with primary ED and PE.

A sample of 57 men (ED = 31; PE = 26) were compared to 25 male outpatients with anxiety disorder (AD) and 25 healthy controls. Principal assessment measures included the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory (BDI).

Greater levels of STAI state anxiety were reported among the ED, PE, and AD groups as compared to healthy controls. In contrast ED and AD groups scored higher than controls on the STAI trait anxiety and BDI, but PE scores were not different from healthy controls in both measures.

The study findings suggest that both primary ED and PE are conditions associated with significant state anxiety; however, PE appears to be less associated with trait anxiety and depression compared to ED, a finding that corroborates the recent acknowledgement of PE as a more biologically based condition. Limitations and potential clinical implications are also discussed.

Full article at: http://goo.gl/rDZq8I

By: Iraklis Mourikis, Marianthi Antoniou, Efi Matsouka, Eleni Vousoura, Chara Tzavara, Chrysa Ekizoglou, George N. Papadimitriou, Nikos Vaidakis, and Iannis M. Zervas

Department of Psychiatry, Eginition Hospital, Athens University Medical School, 72-74 Vas. Sophias Ave., 11528 Athens, Greece

Sexual Disorders Clinic, First Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Ave, 11528 Athens, Greece

Department of Psychiatry, Eginition Hospital, Athens University Medical School, 72-74 Vas. Sophias Ave., 11528 Athens, Greece

Sexual Disorders Clinic, First Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Ave, 11528 Athens, Greece

Iraklis Mourikis, Email: moc.liamg@ruomri.

  

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Increased Risk of Dementia in Patients with Erectile Dysfunction: A Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study

Erectile dysfunction (ED) is a well-known predictor for future cardiovascular and cerebrovascular disease. However, the relationship between ED and dementia has rarely been examined. This study investigates the longitudinal risk for Alzheimer's disease and non-Alzheimer dementia in patients with ED.

We collected a random sample of 1,000,000 individuals from Taiwan's National Health Insurance database. From this sample, we identified 4153 patients with newly diagnosed ED between 2000 and 2009 and compared them with a matched cohort of 20,765 patients without ED. All patients were tracked for 7 years from the index date to identify which of them subsequently developed dementia.

During the 7-year follow-up period, the incidence rate of dementia in the ED cohort was 35.33 per 10,000 person-years. In the comparison groups, it was 21.67 per 10,000 person-years. After adjustment for patients characteristics and comorbidities, patients with ED were 1.68-times more likely to develop dementia than patients without ED (95% CI = 1.34–2.10, P < 0.0001). In addition, older patients and those with diabetes, hypertension, chronic kidney disease, stroke, depression, and anxiety were found to be at increased risk for dementia. Analyzing the data by dementia type, we found the hazard risk for Alzheimer's disease and non-Alzheimer dementia to be greater in patients with ED (adjusted HR 1.68, 95% CI = 1.31–2.16, P < 0.0001 and 1.63, 95% CI = 1.02–2.62, P = 0.0429, respectively). Log-rank test revealed that patients with ED had significantly higher cumulative incidence rates of dementia than those without (P < 0.0001).

Patients with ED are at an increased risk for dementia later in life.

Below:  The cumulative incidence rate for dementia for patients with erectile dysfunction (ED) and without ED (log-rank P value < 0.0001)

Below:  The cumulative incidence rate for Alzheimer's disease for patients with erectile dysfunction (ED) and without ED (log-rank P value = 0.0001)

Below:  The cumulative incidence rate for non-Alzheimer dementia for patients with erectile dysfunction (ED) and without ED (log-rank P value = 0.0533)

Full article at: http://goo.gl/ioj6Bs

By: Chun-Ming Yang, MD, Yuan-Chi Shen, MD, Shih-Feng Weng, PhD, Jhi-Joung Wang, PhD, and Kai-Jen Tien, MD

From the Department of Neurology, Chi Mei Medical Center, Tainan (C-MY); Department of Urology, Kaohsiung Chang Gung Memorial Hospital (Y-CS); Cheng Shiu University, Kaohsiung (Y-CS); Department of Medical Research, Chi Mei Medical Center (S-FW, J-JW); Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science (S-FW); Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center (K-JT); and Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan (K-JT).

Correspondence: Kai-Jen Tien, Department of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, No. 901, Zhonghua Rd., Yongkang Dist., Tainan City 710, Taiwan, R.O.C. (e-mail: moc.liamg@jktcmmc).

   

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Predictors of Emergency Department Visits and Inpatient Admissions among Homeless & Unstably Housed Adolescents & Young Adults

Individuals under age 25 years are estimated to comprise one third of the homeless population nationally. Understanding the reasons for utilization of hospitals by homeless youth is important for optimizing disposition planning.

Objectives of the present study were to: (1) report prevalence of emergency department (ED) and inpatient admissions among homeless and unstably housed youth; (2) describe demographic characteristics of those youth who seek hospital care; (3) describe their patterns of injury, illness, psychiatric, and substance use conditions; and (4) identify demographic and diagnostic predictors of ED visit or hospital readmission.

Retrospective cohort study of 15-25-year-olds (N=402) who were admitted to the ED or inpatient floors of 2 urban teaching hospitals in King County, WA between July 1, 2009 and June 30, 2012 and whose address was "homeless" or "none" or a homeless shelter or service agency (ie, homeless or unstably housed), during any recorded encounter between July 1, 2009 and June 30, 2012.

A total of 1151 ED visits and 227 inpatient admissions were documented. Fifty percent of patients had an ED visit or hospital readmission within 1 year, with 43.1% receiving care within 30 days of discharge. Cox regression showed that female individuals with an injury diagnosis and male individuals with an acute medical condition at index visit were more likely to have an ED visit or hospital readmission during the following year, as were patients who provided a private address at their index visit.

Homeless young people who seek hospital care demonstrate a high rate of ED visits and hospital readmissions, with unique predictors of utilization associated with sex and housing status. Additional research is necessary to determine how best to transition these young people from hospital-based to community-based care.

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By: Mackelprang JL1, Qiu Q, Rivara FP.

• 1*Department of Psychology, Seattle University †Harborview Injury Prevention & Research Center ‡Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.  

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Antihypertensive Drugs and Male Sexual Dysfunction: A Review of Adult Hypertension Guideline Recommendations

Published clinical practice guidelines have addressed antihypertensive therapy and sexual dysfunction (SD) in many different ways.

In this systematic review, we evaluated guidelines that address antihypertensive drug-associated SD, guideline recommendations, and recent guideline trends.

Thirty sets of guidelines for hypertension management in adults that had been published in the English language since 2000 were reviewed. The primary outcome measure was antihypertensive-associated SD potential, which was independently evaluated using specific questions by 2 authors in a nonblinded standardized manner.

Sexual dysfunctions associated with thiazide-class diuretics, β-blockers, and centrally acting sympathoplegics were addressed by half of the guidelines reviewed. There is no clarity on β-blockers and thiazide-class diuretics because one-third of the guidelines are vague about individual β-blockers and diuretics, and there is no statement on third-generation β-blockers and thiazide-like diuretics that can improve erectile function. The revised guidelines never use terms such as loss of libido, ejaculatory dysfunction, lack of orgasm, and priapism. Summary versions of guidelines are inadequate to reflect the key interpretation of the primary guidelines on SD associated with antihypertensives, even in the major guidelines that were updated recently. Therapeutic issues such as exploring SD in clinical history, assessing SD prior to and during treatment with antihypertensives, substituting the offending agents with alternatives that possess a better safety profile, intervening with phosphodiesterase-5 inhibitors, and avoiding the concomitant use of nitrovasodilators are superficially addressed by most guidelines, with the exception of 2013 European Society of Hypertension/European Society of Cardiology and Seventh Joint National Committee recommendations.

Future guideline revisions, including both full and summary reports, should provide a balanced perspective on antihypertensive-related SD issues to improve the impact of hypertension treatment guidelines on patient care and quality of life.

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By: Al Khaja KA1, Sequeira RP2, Alkhaja AK3, Damanhori AH4.

• 1Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain khlidj@agu.edu.bh.
• 2Department of Pharmacology & Therapeutics, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
• 3Qatar Foundation, Doha, Qatar.
• 4Primary Care, Ministry of Health, Manama, Kingdom of Bahrain. 

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A Swiss Longitudinal Study of the Prevalence of, and Overlap Between, Sexual Problems in Men and Women Aged 20 to 50 Years Old

The aim of this study was to obtain data on the development and course of sexual problems and their interrelationships by investigating a representative sample of men and women over a period of 30 years.

A representative sample of 299 women selected from the complete electoral register and 292 men selected from screening lists for military service in Zurich, Switzerland, answered questions about their sexuality as part of a series of seven interviews between ages 20 (1979) and 50 (2008). Of the initial sample of 591 participants, 43% (57% of them male) were lost to follow-up. Interviews were conducted using the Structured Psychopathological Interview and Rating of the Social Consequences of Psychological Disturbances for Epidemiology (SPIKE), a semistructured interview. Sexual problems were identified on the basis of the study participants' self-appraisal. One-year prevalence rates, lifetime risks, and overlap of functional, emotional, and sexual desire problems in men and women were evaluated.

The findings confirmed higher lifetime risks in women than in men for any sexual problem (females 67.0%; males 46.0%) and for functional (39.3%; 22.1%), emotional (35.7%; 15.9%), and sexual desire problems (51.6%; 33.3%). While in general men's sexual problems increased with age, no such association was observed in women. The overlap of all three problems (functional, emotional, and sexual desire) was reported by 16.9% of women but only 5.0% of men. Although there are commonalities, the type but also the development and, in particular, the overlap of sexual problems in women and men are markedly different.

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By: Angst J1, Hengartner MP1,2, Rössler W1,3, Ajdacic-Gross V1, Leeners B4.

• 1a Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital , University of Zurich.
• 2b Department of Applied Psychology , Zurich University of Applied Sciences.
• 3c Institute of Psychiatry, Laboratory of Neuroscience (LIM 27) , University of Sao Paulo.
• 4d Division of Reproductive Endocrinology , University Hospital Zurich.

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Current Status and Clinical Studies of Oriental Herbs in Sexual Medicine in Korea

Below:  The raw materials of various herbal medicines and mixtures of multiple plants. (A) Korean red ginseng, (B) Korean mountain ginseng, (C) Gingko biloba, (D) Rubus coreanus, (E)Cornus officinalis, (F) Schisandra chinensis, (G) Lepidium meyenii, (H) male silkworm extract.

Below: Commercial products of various herbal medicines and mixtures of multiple plants. (A) Korean red ginseng, (B) Korean mountain ginseng, (C) Gingko biloba, (D) Rubus coreanus, (E)Cornus officinalis, (F) Lepidium meyenii, (G) male silkworm extract, (H) SS cream.

Erectile dysfunction (ED) is one of the most common diseases among aging men. Although previous studies have shown that type 5 phosphodiesterase inhibitors (PDE5-Is) are very effective for the treatment of ED, many researchers are currently attempting to identify therapeutic agents from natural sources with comparable or better effects than PDE5-Is. Herbal medicine is thought to be advantageous because it is natural; moreover, it not only treats isolated symptoms, but also maintains general well-being. Furthermore, since newly created chemical compound libraries have limited structural diversity with regard to pharmaceutical agents, more attention has recently been paid to the ability of oriental herbs to enhance physical health, including sexual function. Herein, we review the current status of Korean preclinical or clinical studies of the application of oriental herbs to sexual medicine.

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Asexuality Development among Middle Aged & Older Men

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The specific reasons for asexuality in the population without sexual intercourse

The distribution of chronic disease and sexual status among age groups

Abstract

Objectives

To assess erectile function in middle-aged and older men with asexuality status and further analyze their specific reasons for this condition.

Subjects and Methods

Men who had regular sexual intercourse attempts (sex frequency≥1 time per month) were classified into mild erectile dysfunction (ED), moderate to severe ED and non-ED according to International Index of Erectile Function-5, and men having no sexual intercourse attempts for at least 6 months were defined as having an asexuality status. The risk factors associated with ED were collected in a sample of 1,531 Chinese men aged 40 to 80 years, and the self-report reasons for asexuality were recorded in asexual cohort individually. Comparative analyses and multivariate regression models were conducted among these groups.

Results

The prevalence rates of ED and asexuality status were 49.9% and 37.2%. The asexuality status group had higher risk factors than the moderate to severe ED group in terms of old age (age≥65, adjusted odds ratio (OR) 17.69 versus (Vs.) 7.19), diabetes (crude OR: 2.40 Vs. 2.36) and hypertension (crude OR: 1.78 Vs. 1.72). The specific reasons for the asexuality status were “erectile difficulty” (52.9%), “do not care about sexuality” (53.5%)”, “no longer necessary to have sexuality at this age” (47.7%), “severe stress” (44.4%), “severe fatigue” (26.3%) and “masturbation” (26.9%).

Conclusions

Men with an asexual status suffer from higher risk factors for ED than men with moderate to severe ED. The majority of this asexual status could be attributed to a full ED, although the reasons for this transient asexuality also involved sexual attitudes and interests, sexual partners and masturbation.

Prevalence of Erectile Dysfunction & Associated Factors among Diabetic Men, Tanzania

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Below:  Prevalence and Severity of erectile dysfunction among male patients attending Diabetic Clinic at MNH (N=312)

Abstract

Introduction: There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital.

Methods: A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011.

Results: More than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (p<0.001). No lifestyle factor was associated with ED.

Conclusion: The prevalence of ED is high among DM patients. Interventions aimed at prevention, early diagnosis and detection of DM and its complications, and adherence to treatment to prevent complications should be implemented. Further studies should emphasize on temporal variation to show true causality of DM on erectile dysfunction.