title: Attitudes of men with erectile dysfunction: a cross-national survey.
abstract: BACKGROUND
  Erectile dysfunction (ED), the inability to achieve or maintain an erection sufficient for sexual performance, is a complex disorder involving multiple biopsychosocial factors.
  
  
  OBJECTIVE
  To better understand the psychological and behavioral aspects of ED and compare the attitudes of ED patients in different countries.
  
  
  METHODS
  The Cross-National Survey on Male Health Issues surveyed men aged 20-75 years in six countries. Participants completed questionnaires on attitudes, behavior, doctor-related issues, and comorbidities.
  
  
  METHODS
  Men rated their attitudes using a scale of 1 (strongly disagree) to 5 (strongly agree). Responses of "somewhat agree" and "strongly agree" were combined and the percentage calculated for each country and overall. A mean score for all responses (1-5) was calculated for each country.
  
  
  RESULTS
  Attitudes held by men with ED overlap significantly when compared between countries. Men in all countries agreed that ED was a source of great sadness for themselves and their partners, and nearly all disagreed with the idea that they were too old for sex. Men in all countries agreed that it was important to know they had the capacity to perform sexually, and half of all men reported they would do "nearly anything" to cure their ED. Men in all countries also agreed that their doctor was the best source of information on sexual issues. Men in the United States and the United Kingdom were less willing to accept ED, more motivated to find a cure, and less likely to consider ED a result of psychological problems.
  
  
  CONCLUSIONS
  Attitudes of men with ED overlap significantly when compared between countries, but interesting differences were seen. Additional research is needed to understand how attitudes and behaviors reported reflect actual experiences. This study highlights some of the barriers that exist between physician-patient communication surrounding identification and treatment of ED.
authors.affiliation: Weill Medical College of Cornell University-Psychiatry, Reproductive Medicine, & Urology, New York, NY 10021, USA. perelman@earthlink.net
authors.forename: Michael
authors.initials: M
authors.lastname: Perelman
authors.forename: Ridwan
authors.initials: R
authors.lastname: Shabsigh
authors.forename: Allen
authors.initials: A
authors.lastname: Seftel
authors.forename: Stanley
authors.initials: S
authors.lastname: Althof
authors.forename: Dan
authors.initials: D
authors.lastname: Lockhart
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D003469:Culture; D007172:Erectile Dysfunction / Q000208:ethnology* / Q000523:psychology*; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology