Erectile dysfunction constitutes a great burden for society due to its high prevalence and impact on the quality of life, and is also a risk factor for CVD, dementia and mortality from all causes
Erectile dysfunction (ED) represents a growing health problem that causes a significant impact on the quality of life (CV) of men worldwide. It is estimated that 322 million men worldwide will be affected by erectile dysfunction in 2025, an increase of 152 million men compared to 1995.

This is also reflected in a growing economic burden. Annual spending in the US UU.

The expenditure in treatments for ED it was $ 330 million in 2000, as compared with $ 185 million in 1994 (excluding pharmaceutical costs.)

Couples of men with ED experience less sexual satisfaction, correlated with the degree of DE in their partner.

The physiology to achieve and maintain an erection involves the integration of psychological, hormonal, neurological and vascular pathways. ED is, therefore, a symptom of a wide range of pathologies.
It is often classified into organic etiologies (endocrine, neurological, vascular and structural) and psychogenic ; however, both are often very interconnected and difficult to discern.

The main risk factor associated with erectile dysfunction is age , and the increasing prevalence of erectile dysfunction is related to the global aging of the population. Other risk factors independently associated with erectile dysfunction are diabetes, cardiovascular disease (CVD), depression and benign prostatic hypertrophy (BPH).

The prevalence of erectile dysfunction is difficult to estimate due to the range of definitions used. The consensus development conference of the National Institutes of Health (NIH), held in 1993, defined ED as “the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.” However, the challenge remains to measure ED accurately in population-based studies, particularly given the subjective nature of this definition.

It consists of 15 items categorized by five domains of sexual functioning and, therefore, represents a significant burden for respondents.

Therefore, a shortened version of the IIEF was subsequently developed , the five-item version of the IIEF (IIEF-5) or Sexual Health Inventory for Men (SHIM), with high sensitivity and specificity in the detection of ED in subjects of clinical trials for sildenafil citrate.

A single item questionnaire was created and evaluated against the IIEF in the Massachusetts Male Aging Study (MMAS), a prospective cohort study from Boston, USA. UU.

A high agreement was found between the MMAS questionnaire and the IIEF. The IIEF and MMAS derived questionnaires are the most common tools used to identify ED in population-based studies; however, other tools still exist and are used frequently. This remains an important limitation for the translatability of the study results.

Conclusion

ED detection tools in population-based studies are an important source of discrepancy. Non-validated questionnaires may be less sensitive than the International Index of Erectile Function (IIEF) and the questionnaire derived from the Massachusetts Male Aging Study (MMAS).

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