Erectile dysfunctions in patient-physician communication: optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire

J Sex Med. 2007 Jan;4(1):38-46. doi: 10.1111/j.1743-6109.2006.00385.x. Epub 2006 Nov 6.


Introduction: Erectile dysfunctions are prevalent but underdiagnosed and undertreated health problems. Communication barriers between patients and physicians are one of the main reasons for this and responsible for a low report rate of sexual dysfunction.

Aim: The main aim of the study was to investigate which phrasing and communication strategies gained the highest acceptance from physicians and their patients and were considered the most effective.

Main outcome measures: A documentation form on which each consultation was rated by the participating physicians.

Methods: A large group of physicians was asked to hand out a short patient questionnaire to all male patients over 30 years. The physician was instructed to discuss the questionnaire with the patient and to ask him about sexual problems. A total of 1,191 physicians took part in the study that documented a total of 10,622 consultations with an average duration of 15 minutes.

Results: The main results were: (i) the patient questionnaire found a high level of acceptance and 54% of discussions of sexual health were prompted by it; (ii) the patients' reaction to physicians addressing sexual health was positive in more than two-thirds of the sample and characterized by openness, willingness to communicate, and relief that their sexual problems had been addressed; (iii) from the physicians' perspective, the most favored communication strategies were a clear signaling of a willingness to talk, and addressing treatment possibilities or signaling that help was available; and (iv) the resulting discussion led to further diagnostic measures in 25% of patients and to further therapeutic measures in 60% of patients.

Conclusions: There are good grounds for concluding that: (i) addressing a patient's sexual health as part of a physician's everyday routine is feasible in terms of duration and content; and (ii) a short patient questionnaire is an excellent aid for patients and physicians for initiating communication on the topic.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Communication Barriers
  • Erectile Dysfunction / diagnosis*
  • Erectile Dysfunction / epidemiology
  • Germany
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medical History Taking / methods
  • Middle Aged
  • Needs Assessment / organization & administration*
  • Patient Participation / psychology
  • Patient Participation / statistics & numerical data*
  • Physicians, Family / organization & administration*
  • Physicians, Family / statistics & numerical data
  • Professional-Patient Relations*
  • Sex Education / methods
  • Surveys and Questionnaires