In total, 1122 men completed non-validated structured interviews on sexual attitudes and on erectile dysfunction treatment expectations and barriers. Dimensions of sexual attitudes and treatment expectations and barriers were extracted by factor analysis and subjects were grouped into types by cluster analysis. Five types emerged: the sensation seeker, the sensuous, the anxious, the confident and the abstinent. The majority of men agreed on the importance of sex for the partnership. For the majority of anxious, sensuous and sensation-seeking men, sex was important for self-esteem. Expecting quality of life, enjoyment, self-esteem and hard reliable erections from treatment with phosphodiesterase-5 inhibitors, anxieties for side effects and loss of control, sexual abstinence and desire for an intensive sex life had the strongest impact on the likelihood of use. Men's sexual attitudes vary considerably and impact reactions to erection difficulties. A typology of five groups was developed, which will contribute to research on and understanding of men's sexual and treatment-seeking behaviors.
Your institute does not have access to this article
Open Access articles citing this article.
BMC Urology Open Access 05 November 2010
Subscribe to Journal
Get full journal access for 1 year
only $14.88 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U . Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res 2000; 12: 305–311.
Levy L, Guiliano F, Allaert FA, Girerd X, Pouchain D, Schaetz D et al. Screening for erectile dysfunction in an at-risk population. J Sex Med 2005; 2 (Suppl 1): 53.
Shabsigh R, Perelman MA, Laumann EO, Lockhart DC . Drivers and barriers to seeking treatment for erectile dysfunction: a comparison of six countries. BJU Int 2004; 94: 1055–1065.
Buddeberg C, Bucher T, Hornung R . Erektile Dysfunktion bei Männern in der zweiten Lebenshälfte. Urologe 2005; 44: 1045–1051.
Berner M, Kriston L, Harms A . Efficacy of PDE-5-inhibitors for erectile dysfunction. A comparative meta-analysis of fixed-dose regimen randomized controlled trials administering the International Index of Erectile Function in broad spectrum populations. Int J Impot Res 2006; 18: 229–235.
Hartmann U, Niccolosi A, Glasser DB, Gingell C, Buvat J, Moreira E et al. Sexualität in der Arzt-Patient-Kommunikation. Ergebnisse der Globalen Studie zu sexuellen Einstellungen und Verhaltensweisen. Sexuologie 2002; 9: 50–60.
Rosen RC, Fisher WA, Eardley I, Niederberger C, Nadel A, Sand M . The multinational Men's Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence of erectile dysfunction and related health concerns in the general population. Curr Med Res Opin 2004; 20: 607–617.
Perelman M, Shabsigh R, Seftel A, Althof S, Lockhart D . Attitudes of men with erectile dysfunction: a cross-national survey. J Sex Med 2005; 2: 397–406.
Fischer WA, Rosen RC, Eardley I, Niederberger C, Nadel A, Kaufman J . The Multinational Men's Attitudes to Life Events and Sexuality (MALES) Study Phase II: Understanding PDE-5-inhibitor treatment seeking patterns, among men with erectile dysfunction. J Sex Med 2004; 1: 150–160.
Hartmann U, Burkart M . Erectile dysfunctions in patient–physician-communication: optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire. J Sex Med 2007; 4: 38–46.
Stamogiannou I, Grunfeld EA, Denison K, Muir G . Beliefs about illness and quality of life among men with erectile dysfunction. Int J Impot Res 2005; 17: 142–147.
Ha BT, Jayasuriya R, Owen N . Predictors of men's acceptance of modern contraceptive practice: study in rural Vietnam. Health Educ Behav 2005; 32: 738–750.
Holden CA, McLachlan RI, Cumming R, Wittert G, Handelsman DJ, de Kretser DM et al. Sexual activity, fertility and contraceptive use in middle-aged and older men: Men in Australia, Telephone Survey (MATeS). Human Reprod 2005; 20: 3429–3434.
Richters J, Grulich AE, de Visser RO, Smith AM, Rissel CE . Sex in Australia: autoerotic, esoteric and other sexual practices engaged in by a representative sample of adults. Aust N Z J Public Health 2003; 27: 180–190.
Migneault JP, Adams TB, Read JP . Application of the transtheoretical model to substance abuse: historical development and future directions. Drug Alcohol Rev 2005; 24: 437–448.
Herlitz C, Ramstedt K . Assessment of sexual behavior, sexual attitudes, and sexual risk in Sweden (1989–2003). Arch Sex Behav 2005; 34: 219–229.
Tierney DW, McCabe MP . The utility of the trans-theoretical model of behavior change in the treatment of sex offenders. Sex Abuse 2005; 17: 153–170.
Bien TH, Miller WR, Tonigan JS . Brief interventions for alcohol problems: a review. Addiction 1993; 88: 315–335.
Bertholet N, Daeppen J-B, Wietlinsbach V, Fleming M, Burnand B . Reduction of alcohol consumption by brief alcohol intervention in primary care. Arch Intern Med 2005; 165: 986–995.
Berner MM, Härter M, Zeidler C, Kriston L, Mundle G . German general practitioners' perceived role in the management of alcohol use disorders: responsible but undertrained. Prim Care Community Psychiatr 2006; 11: 29–35.
Tomlinson J, Wright D . Impact of erectile dysfunction and its subsequent treatment with sildenafil: qualitative study. BMJ 2004; 328: 1037–1041.
Hanson-Divers C, Jackson SE, Lue TF, Crawford SY, Rosen RC . Health outcomes variables important to patients in the treatment of erectile dysfunction. J Urol 1998; 159: 1541–1547.
Low WY, Wong YL, Zulkifli SN, Tan HM . Malaysian cultural differences in knowledge, attitudes and practices related to erectile dysfunction: focus group discussions. Int J Impot Res 2002; 14: 440–445.
Pfizer Inc.. The Pfizer Global Study of Sexual Attitudes and Behaviours, New York, NY, USA.
Rissel CE, Richters J, Grulich AE, de Visser RO, Smith AM . Sex in Australia: attitudes towards sex in a representative sample of adults. Aust N Z J Public Health 2003; 27: 118–123.
Corona G, Petrone L, Mannucci E, Magini A, Lotti F, Ricca V et al. Assessment of the relational factor in male patients consulting for sexual dysfunction: the concept of couple sexual dysfunction. J Androl 2006; 27: 795–801.
Heiman JR, Talley DR, Bailen JL, Shumel B, Pace CR, Creanga DL et al. Female partners of men with erectile dysfunction treated with sildenafil citrate report greater satisfaction and enjoyment from sexual intercourse: a multicenter, randomize, double-blind, placebo-controlled study. J Urol 2005; 173 (4 Suppl): 5.
Muller MJ, Ruof J, Graf-Morgenstern M, Porst H, Benkert O . Quality of partnership in patients with erectile dysfunction after sildenafil treatment. Pharmacopsychiatry 2001; 34: 91–95.
Fisher WA, Rosen RC, Mollen M, Brock G, Karlin G, Pommerville P . Improving the sexual quality of life of couples affected by erectile dysfunction: a double-blind, randomized, placebo-controlled trial of vardenafil. J Sex Med 2005; 2: 699–708.
Goldstein I, Fisher A, Sand M, Rosen RC, Mollen M, Brock G et al. Women's sexual function improves when partners are administered vardenafil for erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled trial. J Sex Med 2005; 2: 819–832.
Edwards D, Hackett G, Collins O, Curram J . Vardenafil improves sexual function and treatment satisfaction in couples affected by erectile dysfunction (ED): a randomized, double-blind, placebo-controlled trial in PDE5 inhibitor-näive men with ED and their partners. J Sex Med 2006; 3: 1028–1036.
Althof SE . Quality of life and erectile dysfunction. Urology 2002; 59: 803–810.
Hoesl CE, Woll EM, Burkart M, Altwein JE . Erectile dysfunction (ED) is prevalent, bothersome and underdiagnosed in patients consulting urologists for Benign Prostatic Syndrome (BPS). Eur Urol 2005; 47: 551–557.
Cappelleri JC, Althof SE, Siegel RL, Shpilsky A, Bell SS, Duttagupta S . Development and validation of the self-esteem and relationship (SEAR) questionnaire in erectile dysfunction. Int J Impot Res 2004; 16: 30–38.
Wayman C, Hornby S, Burden A, Casey J . Sildenafil increases erection hardness by potentiating pudendal artery blood flow and intracavernosal pressure in the anaesthesised dog. J Sex Med 2006; 3 (5 Suppl): 393.
Wayman C, Hornby S, Burden A, Casey J . Sildenafil increases erection hardness by improved penile oxygenation in the anaesthesised dog. J Sex Med 2006; 3 (5 Suppl): 397.
Jünemann KP, Levinson IP, Creanga DL . VIAGRA (sildenafil citrate) 100 mg helps men with erectile dysfunction achieve completely hard erections and improved sexual intercourse success, enjoyment, and satisfaction. J Sex Med 2006; 3 (5 Suppl): 423.
Son H, Park K, Kim SW, Paick JS . Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function. Asian J Androl 2004; 6: 117–120.
Günzler C, Kriston L, Stodden V, Leiber C, Berner MM . Can written information material help to increase treatment motivation in patients with erectile dysfunction? – a survey of 1188 men. Int J Impot Res 2007; 19: 330–335.
Stodden V, Berner MM . Comorbidity and treatment patterns in patients with erectile dysfunction. Int J Impot Res 2002; 14 (Suppl 4): 4.
Berner MM, Dieken J, Kriston L, Wetterauer U . Communication, initiative and effective treatment as determinants of sexual satisfaction in patients with ED and their partners. Int J Impot Res 2003; 15 (Suppl 6): 48.
Papaharitou S, Nakopoulou E, Kirana P, Iraklidou M, Athanasiadis L, Hatzichristou D . Women's sexual concerns: data analysis from a help-line. J Sex Med 2005; 2: 652–657.
Bos AR, Visser GC, Tempert BF, Schaalma HP . Evaluation of the Dutch AIDS information helpline: an investigation of information needs and satisfaction of callers. Patient Educ Couns 2004; 54: 201–206.
Fugl-Meyer KS, Arrhult H, Pharmanson H, Backman AC, Fugl-Meyer AM, Fugl-Meyer AR . A Swedish telephone help-line for sexual problems: a 5-year survey. J Sex Med 2004; 1: 278–283.
The study was initiated and funded by Pfizer Pharma GmbH, Karlsruhe, Germany. Michael Berner has received honoraria and research funds from Bundesministerium für Bildung und Forschung, Bayer, Böhringer Ingelheim, Lilly, Pfizer and Willmar Schwabe. Sinus sociovision GmbH, Heidelberg, Germany, conducted the study. Martin Burkart is an employee of Pfizer Pharma GmbH, Karlsruhe, Germany.
About this article
Cite this article
Berner, M., Plöger, W. & Burkart, M. A typology of men's sexual attitudes, erectile dysfunction treatment expectations and barriers. Int J Impot Res 19, 568–576 (2007). https://doi.org/10.1038/sj.ijir.3901571
- phosphodiesterase inhibitors
Men with serious chronic illnesses and malignancies are less likely to seek treatment for erectile dysfunction
International Journal of Impotence Research (2020)
Treatment expectations of men with ED and their female partners: an exploratory qualitative study based on grounded theory
International Journal of Impotence Research (2015)
International Journal of Impotence Research (2014)
Psychometric validation of the Confidence in Performing Sexual Intercourse Questionnaire and Difficulty in Performing Sexual Intercourse Questionnaire
International Journal of Impotence Research (2014)
BMC Urology (2010)