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An exploration of men’s experience and use of treatments for erectile dysfunction (ED)

Williams, P. (2021). An exploration of men’s experience and use of treatments for erectile dysfunction (ED). (Unpublished Doctoral thesis, City, University of London)


Erectile dysfunction (ED) is defined as the consistent inability to obtain and/or maintain a penile erection sufficient for satisfactory sexual performance and can have a negative impact on men’s quality of life, as well as that of his partner. Successful treatment of ED can lead to increased sexual well-being and quality of life. There are a variety of treatments available, however, research suggests that adherence is suboptimal. Therefore, the studies presented in this thesis, are aimed at exploring the psychosocial barriers and enablers to ED treatment utilisation.

The research presented in this thesis drew on the MRC’s framework for the design and evaluation of complex interventions and is of mixed methods design. Research includes: a systematic review of the literature; a qualitative interview study to explore patients’ (n=10) experience of using treatment; and finally, a quantitative study in which patients’ (n=116) beliefs about both their treatment and their condition were explored in a cross-sectional questionnaire study.

The results of this research indicated that, approximately one third of men, regardless of treatment modality, discontinue ED treatment. Both oral and injection therapy indicated the lowest level of treatment discontinuation. Men, on average used under half of the treatment they had been prescribed. The most prominent barriers to treatment utilisation was the negative impact treatment has on men’s sense of masculinity, which was significantly associated with increased discontinuation. However, perceiving the condition as being caused by physiological problems was significantly associated with increased persistence. Finally, the perception of increased treatment necessity, related to a significantly higher frequency of sexual attempts. It is suggested that such beliefs may be amenable to change, which if addressed, may contain the possibility of improving ED treatment utilisation. Therefore, the findings of this research lay the groundwork for future behaviour change interventions, aimed at supporting the successful use of ED treatment.

Publication Type: Thesis (Doctoral)
Subjects: R Medicine > R Medicine (General)
Departments: Doctoral Theses
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
School of Health & Psychological Sciences > Healthcare Services Research & Management
[thumbnail of Paul Williams FINAL THESIS v1.0_Redacted.pdf] Text - Accepted Version
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