This study will be available on bmj.com on Monday 29 March 2004.
Researchers interviewed a random sample of 40 men prescribed sildenafil who had attended a men's health clinic in the year before the study. The average age of respondents was 52 years.
Erectile dysfunction caused serious distress to all those men who experienced it, with marked effects on their self-esteem and wellbeing.
Personal relationships were badly affected, with almost a quarter of men thinking that they were "letting down their partners." Misery was generally suffered alone as many men felt unable to talk about it to their partners, friends, or colleagues.
Most men had high expectations of sildenafil before taking it, largely from the impact of media reporting. When it was successful, sildenafil led to a great improvement in wellbeing. However, when treatment failed, the distress was severe, and many respondents attributed this to media hyperbole.
The media have had a major effect on expectations of the effects of sildenafil, and in retrospect, less sensational reporting would have lowered those expectations to the patients' benefit, say the authors.
Further study is needed to explore the feelings of men affected by erectile dysfunction and their perception of treatment. Health professionals should be aware of the extreme distress erectile dysfunction can cause, they conclude.