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April 1, 1983, Vol 249, No. 13 >
ARTICLE | April 1, 1983

Impotence in Medical Clinic Outpatients FREE

Michael F. Slag, MD; John E. Morley, MB, BCh; Michael K. Elson, PhD; Dace L. Trence, MD; Carrie J. Nelson, MD; Averial E. Nelson, MD; William B. Kinlaw, MD; H. Stephen Beyer, MD; Frank Q. Nuttall, MD, PhD; Rex B. Shafer, MD
[+] Author Affiliations

Reprint requests to the Neuroendocrine Research Laboratory (111G), Minneapolis Veterans Administration Medical Center, Minneapolis, MN 55417 (Dr Morley).


JAMA. 1983;249(13):1736-1740. doi:10.1001/jama.1983.03330370046029
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References

One thousand one hundred eighty men in a medical outpatient clinic were screened as to the presence of impotence. Four hundred one men (34%) were impotent, and of those, 188 (47%) chose to be examined for their problem. After a comprehensive evaluation the following diagnoses were obtained: medication effect, 25%; psychogenic, 14%; neurological, 7%; urologic, 6%; primary hypogonadism, 10%; secondary hypogonadism, 9%; diabetes mellitus, 9%; hypothyroidism, 5%; hyperthyroidism, 1%; hyperprolactinemia, 4%; miscellaneous, 4%; and unknown causes, 7%. The mean age of the impotent patients was 59.4 years, and the prevalence of alcoholism was 7%. Luteinizing hormone, follicle-stimulating hormone, testosterone, thyroxine, triiodothyronine (T3), T3 resin uptake, and prolactin studies were necessary to diagnose individual cases. We conclude that erectile dysfunction is a common and often overlooked problem in middle-aged men followed in a medical clinic.

(JAMA 1983;249:1736-1740)

REFERENCES

1 +
Sparks RF, White RA, Connolly PB:  Impotence is not always psychogenic: Newer insights into hypothalamic-pituitary-gonadal dysfunction . JAMA 1980;;243:750-755.
2 +
Strauss EB:  Impotence from a psychiatric standpoint . Br Med J 1950;;1:697-699.
3 +
Montague DK, James RE, DeWolf VG, et al:  Diagnostic evaluation, classification and treatment of men with sexual dysfunction . Urology 1979;;14:545-548.
4 +
Thorn GW:  Disturbances of sexual function , in Thorn GW, Adams RD, Braunwald E, et al (eds): Harrison's Principles of Internal Medicine , ed 8. New York, McGraw-Hill Book Co Inc, 1977;, p 245.
5 +
Wershub LP: Sexual impotence in the male . Springfield, Ill, Charles C Thomas Publisher, 1959;.
6 +
Burger H, Rose N:  Sexual impotence . Med J Aust 1979;;2:24-26.
7 +
Levine SB:  Marital sexual dysfunction: Erectile dysfunction . Ann Intern Med 1976;; 85:342-350.
8 +
Legros JJ, Mormont C, Servais J:  A psychoneuro-endocrinological study of erectile `psychogenic impotence': A comparison between normal patients and patients with abnormal reaction to glucose tolerance test , in Carenza L, Pancheri P, Zichella L (eds): Clinical Psychoneuroendocrinology in Reproduction . New York, Academic Press Inc, 1978;, pp 301-319.
9 +
Colp R, Colp CR:  One of the 'least understood areas of sexuality .' Arch Intern Med 1981;;141:424-425.
10 +
Kaplan HS:  Sexual medicine, a progress report . Arch Intern Med 1980;;140:1575-1576.
11 +
Segraves RT, Schoenberg HW, Zarins CK, et al:  Characteristics of erectile dysfunction as a function of medical care system entry point . Psychosom Med 1981;;43:227-234.
12 +
Ewing DJ, Campbell IW, Burt AS, et al:  Vascular reflexes in diabetic autonomic neuropathy . Lancet 1973;;2:1354-1356.
13 +
Morley JE, Melmed S:  Gonadal dysfunction in systemic disorders . Metabolism 1979;; 28:1051-1073.
14 +
Alcohol and Health, US Dept of Health, Education, and Welfare publication (HSM) 72:9099. Government Printing Office, 1971.
15 +
Abeyaratne MR, Aherne WA, Scott JES:  The vanishing testis . Lancet 1969;;2:822.
16 +
Slag MF, Morley JE, Elson MK, et al:  Hypothyroxinemia in critically ill patients as a predictor of high mortality . JAMA 1981;;245:43-45.
17 +
Sawin CT, Chopra D, Azizi F, et al:  The aging thyroid: Increased prevalence of elevated serum thyrotropin levels in the elderly . JAMA 1979;;242:247-250.
18 +
Bohlen JG:  Sleep erection monitoring in the evaluation of male erectile failure . Urol Clin North Am 1981;;8:119-134.
19 +
Varma MM, Huseman CA, Johanson AJ, et al:  Effect of prolactin on adrenocortical and gonadal function in normal men . J Clin Endocrinol Metabol 1977;;44:760-764.
20 +
Magrini G, Ebiner JR, Burckhardt P, et al:  Study on the relationship between plasma prolactin levels and androgen metabolism in man . J Clin Endocrinol Metabol 1976;;43:944-947.
21 +
Glassman CN, Rife CC, Wilson CB:  Prolactin—added dimension in male genitosexual disorders . Urology 1980;;15:49-52.

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1 +
Sparks RF, White RA, Connolly PB:  Impotence is not always psychogenic: Newer insights into hypothalamic-pituitary-gonadal dysfunction . JAMA 1980;;243:750-755.
2 +
Strauss EB:  Impotence from a psychiatric standpoint . Br Med J 1950;;1:697-699.
3 +
Montague DK, James RE, DeWolf VG, et al:  Diagnostic evaluation, classification and treatment of men with sexual dysfunction . Urology 1979;;14:545-548.
4 +
Thorn GW:  Disturbances of sexual function , in Thorn GW, Adams RD, Braunwald E, et al (eds): Harrison's Principles of Internal Medicine , ed 8. New York, McGraw-Hill Book Co Inc, 1977;, p 245.
5 +
Wershub LP: Sexual impotence in the male . Springfield, Ill, Charles C Thomas Publisher, 1959;.
6 +
Burger H, Rose N:  Sexual impotence . Med J Aust 1979;;2:24-26.
7 +
Levine SB:  Marital sexual dysfunction: Erectile dysfunction . Ann Intern Med 1976;; 85:342-350.
8 +
Legros JJ, Mormont C, Servais J:  A psychoneuro-endocrinological study of erectile `psychogenic impotence': A comparison between normal patients and patients with abnormal reaction to glucose tolerance test , in Carenza L, Pancheri P, Zichella L (eds): Clinical Psychoneuroendocrinology in Reproduction . New York, Academic Press Inc, 1978;, pp 301-319.
9 +
Colp R, Colp CR:  One of the 'least understood areas of sexuality .' Arch Intern Med 1981;;141:424-425.
10 +
Kaplan HS:  Sexual medicine, a progress report . Arch Intern Med 1980;;140:1575-1576.
11 +
Segraves RT, Schoenberg HW, Zarins CK, et al:  Characteristics of erectile dysfunction as a function of medical care system entry point . Psychosom Med 1981;;43:227-234.
12 +
Ewing DJ, Campbell IW, Burt AS, et al:  Vascular reflexes in diabetic autonomic neuropathy . Lancet 1973;;2:1354-1356.
13 +
Morley JE, Melmed S:  Gonadal dysfunction in systemic disorders . Metabolism 1979;; 28:1051-1073.
14 +
Alcohol and Health, US Dept of Health, Education, and Welfare publication (HSM) 72:9099. Government Printing Office, 1971.
15 +
Abeyaratne MR, Aherne WA, Scott JES:  The vanishing testis . Lancet 1969;;2:822.
16 +
Slag MF, Morley JE, Elson MK, et al:  Hypothyroxinemia in critically ill patients as a predictor of high mortality . JAMA 1981;;245:43-45.
17 +
Sawin CT, Chopra D, Azizi F, et al:  The aging thyroid: Increased prevalence of elevated serum thyrotropin levels in the elderly . JAMA 1979;;242:247-250.
18 +
Bohlen JG:  Sleep erection monitoring in the evaluation of male erectile failure . Urol Clin North Am 1981;;8:119-134.
19 +
Varma MM, Huseman CA, Johanson AJ, et al:  Effect of prolactin on adrenocortical and gonadal function in normal men . J Clin Endocrinol Metabol 1977;;44:760-764.
20 +
Magrini G, Ebiner JR, Burckhardt P, et al:  Study on the relationship between plasma prolactin levels and androgen metabolism in man . J Clin Endocrinol Metabol 1976;;43:944-947.
21 +
Glassman CN, Rife CC, Wilson CB:  Prolactin—added dimension in male genitosexual disorders . Urology 1980;;15:49-52.

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