Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Perceptions and opinions of men and women on a man's sexual confidence and its relationship to ED: results of the European Sexual Confidence Survey

Abstract

The European Sexual Confidence Survey examined the opinions of men and women on the link between a man's sexual confidence and functional (erectile and orgasmic) and emotional (satisfaction and self-confidence) aspects of sex and life in general. The online survey of sexually active adults (25–64 years of age) was conducted in 12 European countries using multiple-choice questions and predefined statements on sexual confidence. Erectile function was assessed by erection hardness score (EHS). Of 8576 respondents (4246 men, 4330 women), 23.9% reported non-optimal erectile hardness (EHS3) for themselves or their partners. 79.0% believed that an ability to sexually satisfy their partner is most closely linked to a man's sexual confidence. One in three linked a man's sexual confidence to erection hardness and ability to reach orgasm. The majority (94.0%) believed that it is important for a man to be sexually confident for good sex and that being able to have good sex enables men to have greater satisfaction with life overall. Lack of sexual confidence due to insufficient erection rigidity was considered by most respondents (65.0%) to reduce a man's confidence about the next sexual encounter and also his self-confidence and self-esteem overall.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. NIH Consensus Development Panel on Impotence. Impotence—NIH Consensus Conference. JAMA 1993; 270: 83–90.

    Article  Google Scholar 

  2. Nicolosi A, Laumann EO, Glasser DB, Moreira Jr ED, Paik A, Gingell C . Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology 2004; 64: 991–997.

    Article  Google Scholar 

  3. 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.

    Article  Google Scholar 

  4. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  5. Cappelleri JC, Bell SS, Althof SE, Siegel RL, Stecher VJ . Comparison between sildenafil-treated subjects with erectile dysfunction and control subjects on the Self-Esteem And Relationship questionnaire. J Sex Med 2006; 3: 274–282.

    Article  CAS  Google Scholar 

  6. Althof SE, O’Leary MP, Cappelleri JC, Hvidsten K, Stecher VJ, Glina S et al. Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: results from an international, multi-center, double-blind, placebo-controlled trial. J Sex Med 2006; 3: 521–529.

    Article  CAS  Google Scholar 

  7. Steidle CP, Stecher VJ, Pace C, Tseng LJ . Correlation of improved erectile function and rate of successful intercourse with improved emotional well-being assessed with the Self-Esteem And Relationship questionnaire in men treated with sildenafil for erectile dysfunction and stratified by age. Curr Med Res Opin 2006; 22: 939–948.

    Article  CAS  Google Scholar 

  8. Hatzichristou D, Cuzin B, Martin-Morales A, Buvat J, Porst H, Laferriere N et al. Vardenafil improves satisfaction rates, depressive symptomatology, and self-confidence in a broad population of men with erectile dysfunction. J Sex Med 2005; 2: 109–116.

    Article  CAS  Google Scholar 

  9. Martin-Morales A, Meijide F, Garcia N, Artes M, Munoz A . Efficacy of vardenafil and influence on self-esteem and self-confidence in patients with severe erectile dysfunction. J Sex Med 2007; 4: 440–447.

    Article  CAS  Google Scholar 

  10. Chevret-Measson M, Lavallee E, Troy S, Arnould B, Oudin S, Cuzin B . Improvement in quality of sexual life in female partners of men with erectile dysfunction treated with sildenafil citrate: findings of the Index of Sexual Life (ISL) in a couple study. J Sex Med 2009; 6: 761–769.

    Article  Google Scholar 

  11. Althof SE, Rubio-Aurioles E, Kingsberg S, Zeigler H, Wong DG, Burns P . Impact of Tadalafil once daily in men with erectile dysfunction-including a report of the partners’ evaluation. Urology 2010; 75: 1358–1363.

    Article  Google Scholar 

  12. Goldstein I, Fisher WA, 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.

    Article  CAS  Google Scholar 

  13. Heiman JR, Talley DR, Bailen JL, Oskin TA, Rosenberg SJ, Pace CR et al. Sexual function and satisfaction in heterosexual couples when men are administered sildenafil citrate (Viagra) for erectile dysfunction: a multicentre, randomised, double-blind, placebo-controlled trial. BJOG 2007; 114: 437–447.

    Article  CAS  Google Scholar 

  14. Fisher WA, Rosen RC, Eardley I, Sand M, Goldstein I . Sexual experience of female partners of men with erectile dysfunction: the female experience of men's attitudes to life events and sexuality (FEMALES) study. J Sex Med 2005; 2: 675–684.

    Article  Google Scholar 

  15. Althof SE . Quality of life and erectile dysfunction. Urology 2002; 59: 803–810.

    Article  Google Scholar 

  16. Cappelleri JC, Stecher VJ . An assessment of patient-reported outcomes for men with erectile dysfunction: Pfizer's perspective. Int J Impot Res 2008; 20: 343–357.

    Article  CAS  Google Scholar 

  17. Mulhall J, Althof SE, Brock GB, Goldstein I, Junemann KP, Kirby M . Erectile dysfunction: monitoring response to treatment in clinical practice—recommendations of an international study panel. J Sex Med 2007; 4: 448–464.

    Article  Google Scholar 

  18. Cappelleri JC, Bushmakin AG, Symonds T, Schnetzler G . Scoring correspondence in outcomes related to erectile dysfunction treatment on a 4-point scale (SCORE-4). J Sex Med 2009; 6: 809–819.

    Article  Google Scholar 

  19. Mulhall J, King R, Glina S, Hvidsten K . Importance of and satisfaction with sex among men and women worldwide: results of the global better sex survey. J Sex Med 2008; 5: 788–795.

    Article  Google Scholar 

  20. ICC and ESOMAR. ICC/ESOMAR International Code of Market and Social Research, 2008.

  21. Althof SE, O’ Leary MP, Cappelleri JC, Glina S, King R, Tseng LJ et al. Self-esteem, confidence, and relationships in men treated with sildenafil citrate for erectile dysfunction: results of two double-blind, placebo-controlled trials. J Gen Intern Med 2006; 21: 1069–1074.

    Article  Google Scholar 

  22. Moncada I, Martinez-Jabaloyas JM, Rodriguez-Vela L, Gutierrez PR, Giuliano F, Koskimaki J et al. Emotional changes in men treated with sildenafil citrate for erectile dysfunction: a double-blind, placebo-controlled clinical trial. J Sex Med 2009; 6: 3469–3477.

    Article  CAS  Google Scholar 

  23. Mulhall JP, Goldstein I, Bushmakin AG, Cappelleri JC, Hvidsten K . Validation of the erection hardness score. J Sex Med 2007; 4: 1626–1634.

    Article  Google Scholar 

  24. National Readership Survey. Lifestyle data. Accessed 2010 Apr 1; Available from: http://www.nrs.co.uk/lifestyle.html.

  25. Loran OB, Stroberg P, Lee SW, Park NC, Kim SW, Tseng LJ et al. Sildenafil citrate 100 mg starting dose in men with erectile dysfunction in an international, double-blind, placebo-controlled study: effect on the sexual experience and reducing feelings of anxiety about the next intercourse attempt. J Sex Med 2009; 6: 2826–2835.

    Article  CAS  Google Scholar 

  26. Althof SE, Berner ME, Goldstein I, Claes HIM, Cappelleri JC, Bushmakin AG et al. Interrelationship of sildenafil treatment effects on the physiological and psychosocial aspects of erectile dysfunction of mixed or organic etiology. J Sex Med 2010; 7: 3170–3178.

    Article  CAS  Google Scholar 

  27. Sand MS, Fisher W, Rosen R, Heiman J, Eardley I . Erectile dysfunction and constructs of masculinity and quality of life in the multinational Men's Attitudes to Life Events and Sexuality (MALES) study. J Sex Med 2008; 5: 583–594.

    Article  Google Scholar 

  28. Fisher WA, Eardley I, McCabe M, Sand M . Erectile dysfunction (ED) is a shared sexual concern of couples I: couple conceptions of ED. J Sex Med 2009; 6: 2746–2760.

    Article  Google Scholar 

  29. Fisher WA, Eardley I, McCabe M, Sand M . Erectile dysfunction (ED) is a shared sexual concern of couples II: association of female partner characteristics with male partner ED treatment seeking and phosphodiesterase type 5 inhibitor utilization. J Sex Med 2009; 6: 3111–3124.

    Article  Google Scholar 

  30. Tourangeau R, Yan T . Sensitive questions in surveys. Psychol Bull 2007; 133: 859–883.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Brian Larkin and Mandira Ray of Double Helix Ltd London, UK for assistance in conducting the study, Sarah Bowen, a contractor employed by Pfizer Global Research and Development Ltd, Sandwich, UK for performing analysis of the data, and Jamie Ashman, PhD of Prism Ideas CH GmbH, Basel, Switzerland for providing editorial support in the preparation of the manuscript. This study and editorial support for the preparation of the manuscript were funded by Pfizer.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C San Martín.

Ethics declarations

Competing interests

Carlos San Martín has acted as a consultant or speaker for Lilly, Bayer and Pfizer. Chiara Simonelli has acted as a consultant for Boehringher Ingelheim and as a consultant or speaker for Lilly, Bayer, Takeda, Abbott and Pfizer. Jens Sønksen has acted as a consultant or speaker for Lilly and Pfizer. Gabriel Schnetzler has acted as a consultant for Pfizer and was previously an employee of Pfizer. Seema Patel is an employee of Pfizer.

Additional information

Parts of the study have been presented at the 12th Congress of the European Society for Sexual Medicine, 15–18 November 2009, Lyon, France (Abstract PO-03-030).

Supplementary Information accompanies the paper on International Journal of Impotence Research website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

San Martín, C., Simonelli, C., Sønksen, J. et al. Perceptions and opinions of men and women on a man's sexual confidence and its relationship to ED: results of the European Sexual Confidence Survey. Int J Impot Res 24, 234–241 (2012). https://doi.org/10.1038/ijir.2012.23

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2012.23

Keywords

This article is cited by

Search

Quick links