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Trends in reported male sexual dysfunction over the past decade: an evolving landscape


We investigated changes in patterns of reported male SDs at a single academic centre over a 10-year time frame. Comprehensive data of 2013 patients consecutively assessed for the first time by a single Sexual Medicine expert between 2006 and 2019 has been analysed. All patients were assessed with a thorough sexual and medical history. Primary reason for seeking medical help at first assessment was recorded for all patients and categorized as: erectile dysfunction (ED), premature ejaculation (PE), low/reduced sexual desire/interest (LSD/I), Peyronie’s disease (PD), and other SDs. Linear and logistic regression models tested the association between different reasons for seeking medical help and the time at first evaluation. Local polynomial regression model explored the probability of reporting different SDs over the analysed time frame. Median (IQR) age at first clinical assessment was 50 (38–61) years. Overall, most patients were assessed for ED (824; 41%), followed by PD (369; 18%), PE (322; 16%), LSD/I (204; 10%) and other SDs (294; 15%). Significant changes in terms of reported SD over the analysed time frame were observed. The likelihood of assessing patients for ED significantly increased up to 2013, with a decrease in the past 5 years (p < 0.001). PE assessment at presentation linearly decreased over time (OR: 0.94; 95% CI: 0.91–0.96; p < 0.001). Patients assessed during the past few years were more likely to report PD (OR: 1.20; 95% CI: 1.15–1.25; p < 0.001) and LSD/I (OR: 1.21; 95% CI: 1.16–1.26; p < 0.001), with a linear increase over the evaluated time frame. Likewise, patients were also more likely to report other SDs (Coeff: 1.06; 95% CI: 1.02–1.10; p = 0.004), with a linear increase over time. These results may reflect real changes in SD incidence, increased public awareness towards different SDs and the possible impact of novel treatments available on the market throughout the same time frame.

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Fig. 1: Patients seeking help for sexual dysfunction (any type) over time.
Fig. 2: Probability of reporting different sexual dysfunctions over time.


  1. 1.

    Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res. 2005;17:39–57.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–44.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, et al. Definitions of sexual dysfunctions in women and men: a Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13:135–43.

    Article  PubMed  Google Scholar 

  4. 4.

    McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, et al. Incidence and prevalence of sexual dysfunction in women and men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13:144–52.

    Article  PubMed  Google Scholar 

  5. 5.

    Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003;44:360–4. Discussion 364–5.

    Article  Google Scholar 

  6. 6.

    Ribeiro S, Alarcão V, Simões R, Miranda FL, Carreira M, Galvão-Teles A. General practitioners’ procedures for sexual history taking and treating sexual dysfunction in primary care. J Sex Med. 2014;11:386–93.

    Article  PubMed  Google Scholar 

  7. 7.

    Boeri L, Capogrosso P, Ventimiglia E, Schifano N, Montanari E, Montorsi F, et al. Sexual dysfunction in men with prediabetes. Sex Med Rev. 2019.

  8. 8.

    Montorsi F, Adaikan G, Becher E, Giuliano F, Khoury S, Lue TF, et al. Summary of the recommendations on sexual dysfunctions in men. J Sex Med. 2010;7:3572–88.

    Article  PubMed  Google Scholar 

  9. 9.

    Hatzimouratidis K, Salonia A, Adaikan G, Buvat J, Carrier S, El-Meliegy A, et al. Pharmacotherapy for erectile dysfunction: recommendations from the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med. 2016;13:465–88.

    Article  PubMed  Google Scholar 

  10. 10.

    Hui J, He S, Liu R, Zeng Q, Zhang H, Wei A. Trends in erectile dysfunction research from 2008 to 2018: a bibliometric analysis. Int J Impot Res. 2019.

  11. 11.

    Martin S, Atlantis E, Wilson D, Lange K, Haren MT, Taylor A, et al. Clinical and biopsychosocial determinants of sexual dysfunction in middle-aged and older Australian men. J Sex Med. 2012;9:2093–103.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Pastuszak AW, Rodriguez KM, Solomon ZJ, Kohn TP, Lipshultz LI, Eisenberg ML. Increased risk of incident disease in men with Peyronie’s disease: analysis of U.S. Claims data. J Sex Med. 2018;15:894–901.

    Article  PubMed  Google Scholar 

  13. 13.

    Graham CA, Mercer CH, Tanton C, Jones KG, Johnson AM, Wellings K, et al. What factors are associated with reporting lacking interest in sex and how do these vary by gender? Findings from the third British national survey of sexual attitudes and lifestyles. BMJ Open 2017.

  14. 14.

    Saitz TR, Serefoglu EC. The epidemiology of premature ejaculation. Transl Androl Urol. 2016;5:409–15.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Russo GI, Cacciamani G, Cocci A, Kessler TM, Morgia G, Serefoglu EC, et al. Comparative effectiveness of intralesional therapy for Peyronie’s disease in controlled clinical studies: a systematic review and network meta-analysis. J Sex Med. 2019;16:289–99.

    Article  PubMed  Google Scholar 

  16. 16.

    Russo A, Capogrosso P, Ventimiglia E, La Croce G, Boeri L, Montorsi F, et al. Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review. Int J Clin Pract. 2016;70:723–33.

    CAS  Article  PubMed  Google Scholar 

  17. 17.

    Di Mauro M, Russo GI, Della Camera PA, Di Maida F, Cito G, Mondaini N, et al. Extracorporeal shock wave therapy in Peyronie’s disease: clinical efficacy and safety from a single-arm observational study. World J Mens Health. 2019;37:339–46.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Porst H, Burri A. Novel treatment for premature ejaculation in the light of currently used therapies: a review. Sex Med Rev. 2019;7:129–40.

    Article  PubMed  Google Scholar 

  19. 19.

    Russo GI, di Mauro M, Cocci A, Cacciamani G, Cimino S, Serefoglu EC, et al. Consulting “Dr Google” for sexual dysfunction: a contemporary worldwide trend analysis. Int J Impot Res. 2019.

  20. 20.

    Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.

    CAS  Article  Google Scholar 

  21. 21.

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

    Article  Google Scholar 

  22. 22.

    Althof SE, Abdo CHN, Dean J, Hackett G, McCabe M, McMahon CG, et al. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med. 2010;7:2947–69.

    Article  PubMed  Google Scholar 

  23. 23.

    Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. J Sex Med. 2014;11:1423–41.

    Article  PubMed  Google Scholar 

  24. 24.

    Rubio-Aurioles E, Bivalacqua TJ. Standard operational procedures for low sexual desire in men. J Sex Med. 2013;10:94–107.

    Article  PubMed  Google Scholar 

  25. 25.

    Salonia A, Clementi MC, Ventimiglia E, Colicchia M, Capogrosso P, Castiglione F, et al. Prevalence and predictors of concomitant low sexual desire/interest and new-onset erectile dysfunction - a picture from the everyday clinical practice. Andrology. 2014;2:702–8.

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Chung E, Ralph D, Kagioglu A, Garaffa G, Shamsodini A, Bivalacqua T, et al. Evidence-based management guidelines on Peyronie’s disease. J Sex Med. 2016;13:905–23.

    Article  PubMed  Google Scholar 

  27. 27.

    von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Epidemiology. 2007;18:800–4.

    Article  Google Scholar 

  28. 28.

    Stevenson FA, Kerr C, Murray E, Nazareth I. Information from the Internet and the doctor-patient relationship: the patient perspective-a qualitative study. BMC Fam Pract. 2007;8:47

    Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Gualtieri LN. The doctor as the second opinion and the internet as the first. In: CHI 09 Extended Abstracts on Human Factors in Computing Systems. Boston, MA, USA: Association for Computing Machinery; 2009. p. 2489–98.

  30. 30.

    Davis NF, Smyth LG, Flood HD. Detecting internet activity for erectile dysfunction using search engine query data in the Republic of Ireland. BJU Int. 2012;110:E939–42.

    Article  PubMed  Google Scholar 

  31. 31.

    Tozdan S, Briken P. Age of onset and its correlates in men with sexual interest in children. Sex Med. 2018;7:61–71.

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Smith WB, McCaslin IR, Gokce A, Mandava SH, Trost L, Hellstrom WJ. PDE5 inhibitors: considerations for preference and long-term adherence. Int J Clin Pract. 2013;67:768–80.

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nat Rev Dis Prim. 2016;2:16003

    Article  PubMed  Google Scholar 

  34. 34.

    Salonia A, Ferrari M, Saccà A, Pellucchi F, Castagna G, Clementi MC, et al. Delay in seeking medical help in patients with new‐onset erectile dysfunction remained high over and despite the PDE5 era—an ecological study. J Sex Med. 2012;9:3239–46.

    Article  PubMed  Google Scholar 

  35. 35.

    Salonia A, Abdollah F, Gallina A, Pellucchi F, Castillejos Molina RA, Maccagnano C, et al. Does educational status affect a patient’s behavior toward erectile dysfunction? J Sex Med. 2008;5:1941–8.

    Article  PubMed  Google Scholar 

  36. 36.

    Capogrosso P, Ventimiglia E, Boeri L, Cazzaniga W, Chierigo F, Pederzoli F, et al. Age at first presentation for erectile dysfunction: analysis of changes over a 12-yr period. Eur Urol Focus. 2018.

  37. 37.

    Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, et al. One patient out of four with newly diagnosed erectile dysfunction is a young man-worrisome picture from the everyday clinical practice. J Sex Med. 2013;10:1833–41.

    Article  PubMed  Google Scholar 

  38. 38.

    Mas M, García-Giralda L, Rey JR, Martínez-Salamanca JI, Guirao L, Turbí C. Evaluating a continuous medical education program to improve general practitioners awareness and practice on erectile dysfunction as a cardiovascular risk factor. J Sex Med. 2011;8:1585–93.

    Article  PubMed  Google Scholar 

  39. 39.

    Verze P, Arcaniolo D, Palmieri A, Cai T, La Rocca R, Franco M, et al. Premature ejaculation among Italian men: prevalence and clinical correlates from an observational, non-interventional, cross-sectional, epidemiological study (IPER). Sex Med. 2018;6:193–202.

    Article  PubMed  PubMed Central  Google Scholar 

  40. 40.

    Castiglione F, Albersen M, Hedlund P, Gratzke C, Salonia A, Giuliano F. Current pharmacological management of premature ejaculation: a systematic review and meta-analysis. Eur Urol. 2016;69:904–16.

    CAS  Article  PubMed  Google Scholar 

  41. 41.

    James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1789–858.

    Article  Google Scholar 

  42. 42.

    Sugimori H, Yoshida K, Tanaka T, Baba K, Nishida T, Nakazawa R, et al. Relationships between erectile dysfunction, depression, and anxiety in Japanese subjects. J Sex Med. 2005;2:390–6.

    Article  PubMed  Google Scholar 

  43. 43.

    Capogrosso P, Ventimiglia E, Boeri L, Pozzi E, Chierigo F, Schifano N, et al. Should we tailor the clinical management of erectile dysfunction according to different ages? J Sex Med. 2019;16:999–1004.

    Article  PubMed  Google Scholar 

  44. 44.

    Pozzi E, Capogrosso P, Chierigo F, Pederzoli F, Ventimiglia E, Boeri L, et al. Clinical profile of young patients with erectile dysfunction: preliminary findings of a real-life cross-sectional study. Eur Urol Focus. 2020;6:184–9.

    Article  PubMed  Google Scholar 

  45. 45.

    Boeri L, Capogrosso P, Ventimiglia E, Cazzaniga W, Pederzoli F, Gandaglia G, et al. Depressive symptoms and low sexual desire after radical prostatectomy: early and long-term outcomes in a real-life setting. J Urol. 2018;199:474–80.

    Article  PubMed  Google Scholar 

  46. 46.

    Bravi CA, Tin A, Montorsi F, Mulhall JP, Eastham JA, Vickers AJ. Erectile function and sexual satisfaction: the importance of asking about sexual desire. J Sex Med. 2020;17:349–52.

    Article  PubMed  Google Scholar 

  47. 47.

    Salonia A, Adaikan G, Buvat J, Carrier S, El-Meliegy A, Hatzimouratidis K, et al. Sexual rehabilitation after treatment for prostate cancer-Part 2: recommendations from the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med. 2017;14:297–315.

    Article  PubMed  Google Scholar 

  48. 48.

    Corona G, Isidori AM, Aversa A, Burnett AL, Maggi M. Endocrinologic control of men’s sexual desire and arousal/erection. J Sex Med. 2016;13:317–37.

    Article  PubMed  Google Scholar 

  49. 49.

    Salonia A, Rastrelli G, Hackett G, Seminara SB, Huhtaniemi IT, Rey RA, et al. Paediatric and adult-onset male hypogonadism. Nat Rev Dis Prim. 2019;5:38

    Article  PubMed  Google Scholar 

  50. 50.

    Hellstrom WJG, Tue Nguyen HM, Alzweri L, Chung A, Virasoro R, Tapscott A, et al. Intralesional collagenase Clostridium histolyticum causes meaningful improvement in men with Peyronie’s disease: results of a multi-institutional analysis. J Urol. 2019.

  51. 51.

    Cocci A, Cito G, Urzì D, Minervini A, Di Maida F, Sessa F, et al. Sildenafil 25 mg ODT + collagenase Clostridium hystoliticum vs collagenase Clostridium hystoliticum alone for the management of Peyronie’s disease: a matched-pair comparison analysis. J Sex Med. 2018;15:1472–7.

    Article  PubMed  Google Scholar 

  52. 52.

    Sun AJ, Li S, Eisenberg ML. The impact of Clostridium histolyticum collagenase on the prevalence and management of Peyronie’s disease in the United States. World J Mens Health. 2019;37:234–9.

    Article  PubMed  Google Scholar 

  53. 53.

    Cocci A, Russo GI, Salamanca JIM, Ralph D, Palmieri A, Mondaini N. The end of an era: withdrawal of Xiapex (Clostridium histolyticum collagenase) from the European Market. Eur Urol. 2019.

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Correspondence to Andrea Salonia.

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Pozzi, E., Capogrosso, P., Boeri, L. et al. Trends in reported male sexual dysfunction over the past decade: an evolving landscape. Int J Impot Res (2020).

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