Risk factors for erectile dysfunction in a cohort of 108 477 Australian men

Marianne F Weber, David P Smith, Dianne L O'Connell, Manish I Patel, Paul L de Souza, Freddy Sitas and Emily Banks
Med J Aust 2013; 199 (2): 107-111. || doi: 10.5694/mja12.11548


Objectives: To quantify relationships between erectile dysfunction (ED), ageing and health and lifestyle factors for men aged 45 years and older.

Design: Cross-sectional, population-based study seeking data on health, sociodemographic and lifestyle factors by questionnaire (the 45 and Up Study).

Participants and setting: 108 477 men aged 45 years or older, living in New South Wales, and recruited into the 45 and Up Study between 10 January 2006 and 17 February 2010.

Main outcome measures: Self-reported ED.

Results: In the 101 674 men reporting no prior diagnosis of prostate cancer, 39.31% (95% CI, 39.01%–39.61%) had no ED, 25.14% (95% CI, 24.87%–25.40%) had mild ED (ie, experienced ED sometimes), 18.79% (95% CI, 18.55%–19.03%) had moderate (ie, usually experienced) ED and 16.77% (95% CI, 16.55%–17.00%) had complete ED. After adjusting for sociodemographic characteristics, the odds of moderate/complete ED increased by 11.30% (OR, 1.11; 95% CI, 1.11–1.12) each year from the age of 45 years. Overall, the risk of moderate/complete ED was higher among men with low socioeconomic status, high body mass index, those who were sedentary, current smokers and those with diseases including diabetes, heart disease, and depression/anxiety, compared with men without these risk factors. Moderate alcohol consumption was associated with a significantly reduced risk of ED in men aged 45–54 years, but not in older men. Almost all men aged 75 or older reported moderate/severe ED; however, increased physical activity was associated with a lower odds of ED in this group.

Conclusions: In a large population-based cross-sectional study, ED increased considerably with age. There are a range of potentially modifiable risk factors for ED, including smoking, low physical activity, and high body mass index.

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  • Marianne F Weber1
  • David P Smith1
  • Dianne L O'Connell1
  • Manish I Patel2
  • Paul L de Souza3
  • Freddy Sitas1
  • Emily Banks4

  • 1 Cancer Research Division, Cancer Council NSW, Sydney, NSW.
  • 2 Discipline of Surgery, University of Sydney, Westmead, NSW.
  • 3 University of Western Sydney, Sydney, NSW.
  • 4 National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.



We thank the men participating in the 45 and Up Study, which is managed by The Sax Institute in collaboration with major partner Cancer Council New South Wales; and partners the National Heart Foundation of Australia (NSW Division); NSW Ministry of Health; beyondblue: the national depression initiative; Ageing, Disability and Home Care, Department of Family and Community Services NSW; UnitingCare Ageing; and the Australian Red Cross Blood Service.

Competing interests:

Manish Patel has served on advisory boards for Astra Zeneca, Ipsen, Abbott, GSK, Pfizer, Ferring, and Janssen. He has also received royalties from Health Press for fast facts on prostate cancer. Dianne O'Connell has received consultancy fees from the Evaluation Subcommittee of the Medical Services Advisory Committee (Australian Department of Health and Ageing) to provide expert advice on the strength and quality of evidence for medical services, procedures and tests being considered for government subsidisation.

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