title: The Global Online Sexuality Survey (GOSS): the United States of America in 2011 chapter II: phosphodiesterase inhibitors utilization among English speakers.
abstract: BACKGROUND
  Utility of phosphodiesterase inhibitors (PDEi's) for the treatment of erectile dysfunction (ED) has been the focus of experimental and clinical studies. However, public preferences, attitudes, and experiences with PDEi's are rarely addressed from a population/epidemiology viewpoint. The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, first launched in the Middle East in 2010, followed by the United States in 2011.
  
  
  OBJECTIVE
  To describe the utilization rates, trends, and attitudes toward PDEi's in the United States in the year 2011.
  
  
  METHODS
  GOSS was randomly deployed to English-speaking male Web surfers in the United States via paid advertising on Facebook®, comprising 146 questions.
  
  
  METHODS
  Utilization rates and preferences for PDEi's by brand.
  
  
  RESULTS
  Six hundred three subjects participated; mean age 53.43 years ± 13.9. Twenty-three point seven percent used PDEi's on more consistent basis, 37.5% of those with ED vs. 15.6% of those without ED (recreational users). Unrealistic safety concerns including habituation were pronounced. Seventy-nine point six percent of utilization was on prescription basis. PDEi's were purchased through pharmacies (5.3% without prescription) and in 16.5% over the Internet (68% without prescription). Nine point six percent nonprescription users suffered coronary heart disease. Prescription use was inclined toward sildenafil, generally, and particularly in severe cases, and shifted toward tadalafil in moderate ED and for recreational use, followed by vardenafil. Nonprescription utilization trends were similar, except in recreational use where sildenafil came first.
  
  
  CONCLUSIONS
  In the United States unrealistic safety concerns over PDEi's utility exist and should be addressed. Preference for particular PDEi's over the others is primarily dictated by health-care providers, despite lack of guidelines that govern physician choice. Online and over-the-counter sales of PDEi's are common, and can expose a subset of users to health risks. Recreational use of PDEi's is common, and could be driven by undiagnosed premature ejaculation.
authors.affiliation: Department of Andrology, Kasr El Aini Faculty of Medicine, Cairo University, Cairo, Egypt. dr.osama@alrijal.com
authors.forename: Osama
authors.initials: O
authors.lastname: Shaeer
mesh_terms: D000328:Adult; D000368:Aged; D002243:Carbolines / Q000600:supply & distribution / Q000627:therapeutic use; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D004363:Drug Utilization / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D013287:Illicit Drugs / Q000600:supply & distribution; D007093:Imidazoles / Q000600:supply & distribution / Q000627:therapeutic use; D020407:Internet; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000600:supply & distribution / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000600:supply & distribution / Q000627:therapeutic use; D055553:Prescription Drugs / Q000600:supply & distribution / Q000627:therapeutic use; D011687:Purines / Q000600:supply & distribution / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000600:supply & distribution / Q000627:therapeutic use; D000068581:Tadalafil; D014227:Triazines / Q000600:supply & distribution / Q000627:therapeutic use; D014481:United States; D000069058:Vardenafil Dihydrochloride
chemical_list: D002243:Carbolines; D013287:Illicit Drugs; D007093:Imidazoles; D004366:Nonprescription Drugs; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D055553:Prescription Drugs; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate