Barriers to recognition of erectile dysfunction among diabetic Mexican-American men.

BACKGROUND Diabetes is widespread among Mexican-Americans, and erectile dysfunction is a well-recognized complication for which effective treatments are available. Men who desire treatment, however, might not volunteer erectile complaints to their physician, especially across cultural lines. METHODS We surveyed diabetic Mexican-American men cared for in two community health centers to estimate the prevalence of self-reported erectile dysfunction, to learn how frequently they discuss sexual function with their physician, and to evaluate factors that facilitate or inhibit discussion. RESULTS Of the participants surveyed, 59 percent (95 percent confidence interval [CI] 48-70) reported always lacking erection in one or more proposed circumstances, whereas 82 percent (95 percent CI 73-91) reported frequent erectile insufficiency in the same circumstances. Patients reporting erectile problems were no more likely to have discussed sexual function with their physician than those who denied frequent erectile dysfunction. Of those with frequent erectile dysfunction, only 47 percent had had a discussion about sexual function with their physician. We found that these men did not initiate discussion because they were embarrassed or expect the physician to initiate the dialogue. CONCLUSIONS Erectile dysfunction is common in diabetic Mexican-American men and is underrecognized by clinicians and underreported by patients. Because effective treatments exist, primary care physicians should routinely ask their diabetic patients about erectile function.