title: The Global Online Sexuality Survey (GOSS): the United States of America in 2011. Chapter I: erectile dysfunction among English-speakers.
abstract: BACKGROUND
  The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, based on validated questionnaires and applying age adjustment to the World Standard Population (WSP) by the World Health Organization. In 2010, the first report of GOSS came from the Middle East, describing an erectile dysfunction (ED) prevalence rate of 47%.
  
  
  OBJECTIVE
  This report studies the prevalence rate of ED in the United States as of 2011-2012 and evaluates risk factors for ED.
  
  
  METHODS
  Prevalence of ED.
  
  
  METHODS
  GOSS was randomly deployed to English-speaking male web surfers in the United States via paid advertising on Facebook, comprising 146 questions including the abbreviated 5-item International Index of Erectile Function.
  
  
  RESULTS
  Two thousand twenty-two males participated; with a mean age was 52.38 years ± 14.5. Prevalence of ED was 37.7%, adjusted to 33.7% according to WSP, comparable across ethnic groups. The following risk factors were associated with higher risk for ED: diabetes mellitus, hypertension with and without antihypertensive treatment, coronary heart disease, obesity (defined by body mass index), difficult micturition, subjectively reported depression, interpersonal distress, subjectively reported impotence, in addition to novel factors such as subjectively reported premature ejaculation (PE) and concerns over genital size (not a smaller penis per se), low libido, and irregular coitus. Frequency of smoking and alcohol were not associated with higher prevalence of ED, although duration of smoking was.
  
  
  CONCLUSIONS
  Adjusted to WSP, prevalence rate of ED in the United States of America is 33.7% in the year 2011, in contrast to the adjusted prevalence in the Middle East (47%). Most of the classical risk factors for ED play the same role in the United States and the World, including diabetes, hypertension, and aging. Concerns over genital size and PE are emerging risk factors for ED.
authors.affiliation: Kasr El Aini Faculty of Medicine, Department of Andrology, Cairo University, Cairo, Egypt. dr.osama@alrijal.com
authors.forename: Osama
authors.initials: O
authors.lastname: Shaeer
authors.forename: Kamal
authors.initials: K
authors.lastname: Shaeer
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007398:Interpersonal Relations; D007989:Libido; D008297:Male; D008875:Middle Aged; D061686:Premature Ejaculation / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014555:Urination Disorders / Q000453:epidemiology; D055815:Young Adult