title: The multinational Men's Attitudes to Life Events and Sexuality study: the influence of diabetes on self-reported erectile function, attitudes and treatment-seeking patterns in men with erectile dysfunction.
abstract: OBJECTIVE
  To identify the prevalence of erectile dysfunction (ED) in men with diabetes, and to compare the perceptions of ED and the treatment-seeking behaviour of these men with men with ED without diabetes.
  
  
  METHODS
  Phase I of this multinational study involved 27,839 men who were questioned about a number of men's health issues including ED, diabetes and cardiovascular conditions (i.e. hypertension, high cholesterol and angina). Epidemiological associations between these conditions were explored. Phase II involved 2912 men with self-reported ED, aged 20-75 years. Participants completed questionnaires concerning their ED, efforts to seek treatment for their ED, and potential influences that might affect treatment-seeking behaviour. Comparison of these responses was made between men with ED and diabetes and men with ED without diabetes.
  
  
  RESULTS
  There was a clear association between self-reported ED and diabetes, hypertension, angina and high cholesterol. Men with diabetes were more likely to consider their ED to be severe and permanent and to speak to a physician or a nurse about their ED, compared with men without diabetes. Sildenafil use was similar in both groups, but men with diabetes were more likely to have discontinued use, mainly because of the lack of treatment efficacy.
  
  
  CONCLUSIONS
  Men with diabetes were more likely to consider their ED to be severe and permanent, compared with men without diabetes. Furthermore, men with diabetes were more likely to discontinue sildenafil therapy, primarily because of poor efficacy. These findings suggest a need for alternative treatments for ED, especially in men with diabetes.
authors.affiliation: Pyrah Department of Urology, St. James University Hospital, Leeds, UK. ian.eardley@btinternet.com
authors.forename: I
authors.initials: I
authors.lastname: Eardley
authors.forename: W
authors.initials: W
authors.lastname: Fisher
authors.forename: R C
authors.initials: RC
authors.lastname: Rosen
authors.forename: C
authors.initials: C
authors.lastname: Niederberger
authors.forename: A
authors.initials: A
authors.lastname: Nadel
authors.forename: M
authors.initials: M
authors.lastname: Sand
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D048909:Diabetes Complications / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D013020:South America / Q000453:epidemiology