Feldman · The Journal of urology 1994 · cross-sectional population survey · n=?

Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study.

Cited 5122 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional community-based observational survey

PubMed 8254833 · doi:10.1016/s0022-5347(17)34871-1 · record verified 2026-08-27

What was done

The Massachusetts Male Aging Study surveyed a community-based random sample of noninstitutionalized men aged 40 to 70 years in cities and towns near Boston between 1987 and 1989. Trained interviewers conducted home visits to gather blood samples, physiological metrics, socio-demographic variables, psychological indexes, health status, medication usage, smoking history, and lifestyle factors. Erectile potency was assessed using a self-administered sexual activity questionnaire.

What was found

The combined prevalence of minimal, moderate, and complete impotence was 52%. Complete impotence tripled from 5% at age 40 to 15% at age 70, with subject age being the variable most strongly associated with erectile dysfunction. After age adjustment, higher rates of impotence were directly correlated with heart disease, hypertension, diabetes, related medications, and indexes of anger and depression. Impotence was inversely correlated with serum dehydroepiandrosterone, high-density lipoprotein cholesterol, and a dominant personality index. Cigarette smoking was associated with a higher likelihood of complete impotence specifically among men with heart disease and hypertension.

Why it matters

This landmark study establishes baseline population prevalence for erectile dysfunction and links it directly to cardiovascular disease risk factors and modifiable physiological and psychological traits rather than chronological age alone.

Limits

The abstract does not report the total sample size (n). The cross-sectional design cannot establish causality, erectile function was assessed via self-report questionnaire, and the geographic sample was limited to the Boston area.

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