Mark · The journal of sexual medicine 2024 · cross-sectional survey · n=1822

Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing.

Cited 84 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional survey of a probability-based online panel

PubMed 38410029 · doi:10.1093/jsxmed/qdae008 · record verified 2026-08-26

What was done

Data from the 2021 National Survey of Sexual Wellbeing were analyzed using the Ipsos KnowledgePanel, a probability-based online panel representative of US adults aged 18 and older. The sample comprised 1,822 cisgender men (mean age 47.5 years, range 18–87). Erectile dysfunction (ED) was evaluated using the 5-item International Index of Erectile Function (IIEF-5), along with self-reported medical diagnoses, comorbidities, ED medications, and barriers to medical care.

What was found

Overall ED prevalence by IIEF-5 score was 24.2%. Prevalence increased with age: 17.9% in ages 18–24; 13.3% in ages 25–34; 12.7% in ages 35–44; 25.3% in ages 45–54; 33.9% in ages 55–64; 48.0% in ages 65–74; and 52.2% in ages 75+. Only 7.7% of the total sample (n = 141) reported a formal ED diagnosis from a healthcare provider. Diagnosed cases by age group were: n = 4 in 25–34, n = 6 in 35–44, n = 13 in 45–54, n = 39 in 55–64, n = 44 in 65–74, and n = 34 in ≥75-year-olds. The most common reason for not accessing care was a perceived lack of need to see a provider in the past year.

Why it matters

This study provides the first nationally representative update on US erectile dysfunction prevalence in nearly two decades. It shows that while prevalence remains highest in older men, a large gap exists between meeting symptom criteria and receiving a formal medical diagnosis.

Limits

Cross-sectional survey design based entirely on self-report via an online panel. Standard IIEF-5 administration is limited to men who had sex in the prior 6 months, excluding those avoiding sex due to severe dysfunction. The analytic sample was limited to cisgender men.

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