Quilter Merrin, Hodges Lynette, von Hurst Pamela, Borman Barry, Coad Jane
School of Food and Nutrition, Massey University, Palmerston North, New Zealand.
School of Sport and Exercise, Massey University, Palmerston North, New Zealand.
J Sex Med. 2017 Jul;14(7):928-936. doi: 10.1016/j.jsxm.2017.05.011.
Sexual function declines with age and erectile dysfunction (ED) is a common condition worldwide; however, prevalence rates vary markedly between populations and reliable data specific to New Zealand (NZ) are lacking.
To assess the prevalence of ED in NZ men using a population-based cross-sectional survey.
Postal questionnaires were sent, according to a modified Dillman method, to a randomly selected age-stratified population-based sample of 2,000 men 40 to 70 years old obtained from the electoral roll. Self-reported erectile function was assessed using the five-item International Index of Erectile Function (IIEF-5) and the single-question self-assessment tool.
The prevalence of ED is presented as crude, age-adjusted to the distribution of the NZ population, and standardized to the World Health Organization World Standard Population (WSP). Associations between sexual function and age were analyzed using χ test.
The response rate was 30% (599) and 28% (562) were complete for analysis. The crude prevalence of ED was 42% (22% mild, 10% mild to moderate, 6% moderate, and 4% severe), the age-adjusted prevalence was 38%, and the WSP-adjusted prevalence was 37%. Among men reporting ED, 16% were medically diagnosed and 22% were treated. ED affected 24% of men in their 40s, 38% in their 50s, and 60% in their 60s (P < .001). Age was associated with a significant increase in diagnosed ED (P = .001), treated ED (P = .006), dissatisfaction with current sexual function (P < .001), associated anxiety or depression (P = .023), and a decrease in sexual activity (P < .001).
Approximately one in three NZ men 40 to 70 years old might have ED. Although comparable to overseas populations, this prevalence is high.
This study provides the most reliable, comprehensive, and current information on ED and its risk factors in NZ men. Strengths include the large sample, the use of random selection from a population-based sampling frame, established effective survey methods, and the validated IIEF-5. Limitations include the inability of cross-sectional data to determine causation, non-sampling errors associated with the population-based sampling frame, the low response rate, the inability to assess non-respondents, the possibility of men with ED who were sexually inactive not responding or not completing the IIEF-5, and the inherent inability to rule out recall bias.
ED is a marker of subclinical cardiovascular disease. The high prevalence and low levels of diagnosis and treatment indicate a lost opportunity for timely intervention to delay or prevent the progression toward clinical disease. Quilter M, Hodges L, von Hurst P, et al. Male Sexual Function in New Zealand: A Population-Based Cross-Sectional Survey of the Prevalence of Erectile Dysfunction in Men Aged 40-70 Years. J Sex Med 2017;14:928-936.
性功能会随着年龄增长而衰退，勃起功能障碍（ED）在全球范围内都是一种常见病症；然而，不同人群中的患病率差异显著，且缺乏新西兰（NZ）的具体可靠数据。
通过一项基于人群的横断面调查评估新西兰男性勃起功能障碍的患病率。
按照改良的迪尔曼方法，向从选民名册中随机抽取的2000名40至70岁男性的年龄分层人群样本邮寄调查问卷。使用国际勃起功能指数（IIEF-5）的五项指标和单问题自我评估工具对自我报告的勃起功能进行评估。
勃起功能障碍的患病率以粗患病率、根据新西兰人口分布进行年龄调整后的患病率以及根据世界卫生组织世界标准人口（WSP）进行标准化后的患病率呈现。使用χ检验分析性功能与年龄之间的关联。
回复率为30%（599人），其中28%（562人）的问卷可用于完整分析。勃起功能障碍的粗患病率为42%（轻度22%，轻度至中度10%，中度6%，重度4%），年龄调整后的患病率为38%，WSP调整后的患病率为37%。在报告患有勃起功能障碍的男性中，16%接受过医学诊断，22%接受过治疗。勃起功能障碍在40多岁男性中影响24%，50多岁男性中影响38%，60多岁男性中影响60%（P <.001）。年龄与确诊的勃起功能障碍显著增加（P =.001）、接受治疗的勃起功能障碍（P =.006）、对当前性功能的不满（P <.001）、相关焦虑或抑郁（P =.023）以及性活动减少（P <.001）相关。
在40至70岁的新西兰男性中，约三分之一可能患有勃起功能障碍。尽管与海外人群相当，但这一患病率较高。
本研究提供了关于新西兰男性勃起功能障碍及其危险因素最可靠、全面和最新的信息。优势包括样本量大、从基于人群的抽样框架中随机选择、采用成熟有效的调查方法以及经过验证的IIEF-5。局限性包括横断面数据无法确定因果关系、与基于人群的抽样框架相关的非抽样误差、低回复率、无法评估未回复者、性功能障碍的无性活动男性可能不回复或未完成IIEF-5的可能性，以及无法排除回忆偏倚的固有局限性。
勃起功能障碍是亚临床心血管疾病的一个标志。高患病率以及低诊断和治疗水平表明错失了及时干预以延迟或预防向临床疾病进展的机会。奎尔特M、霍奇斯L、冯·赫斯特P等。新西兰男性性功能：对40 - 70岁男性勃起功能障碍患病率的基于人群的横断面调查。《性医学杂志》2017年；14：928 - 936。
