By definition, erectile dysfunction (ED) is the inability or recurrent inability to sustain an erection that would allow for pleasurable/satisfactory engagement in sexual activity.1 The Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5) states that the symptoms need be present for six months.2 Sexual activity requires intact anatomical, behavioral, and physiological capacities.  The prevalence of ED is increasing.  In the Massachusetts Male Aging Study as many as 52% of men were reported to have ED symptoms in the that were classified as either minimal, moderate, or complete impotence.3 Forty percent of the men in the study at age 40 had some ED symptoms, and this number increased to 70% at age 70.  Sexual desire declines as male age increases and data indicate that severe ED affects about 5% of men at age 40 and 15% of men at age 70. ED symptoms are reported more in men who have poor mental and physical health.  A total of 617,000 new cases of erectile dysfunction are estimated to occur each year across the country.4

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