THURSDAY, Feb. 1 (HealthDay News) -- More than 18 million men in the United States are affected by erectile dysfunction, a new study finds.

The problem is particularly acute among men with cardiovascular disease, diabetes, and those who get little exercise, researchers at the Johns Hopkins Bloomberg School of Public Health report.

"The association of erectile dysfunction with diabetes and other cardiovascular risk factors can serve as a powerful motivator for men in whom diet and lifestyle changes are really indicated," said study author Elizabeth Selvin, a postdoctoral fellow at Johns Hopkins.

"If you control your diabetes, and treat existing risk factors and do things to prevent diabetes and control your blood pressure and cholesterol levels, not only will you reduce your risk of cardiovascular disease and diabetes, but you will also improve your sexual function," she said.

The findings are published in the Feb. 1 issue of the American Journal of Medicine.

In the study, Selvin's team collected data on more than 2,100 men who participated in the National Health and Nutrition Examination Survey. Men who said they were "sometimes able" or "never able" to achieve and keep an erection were classified as having erectile dysfunction, while men who said they were "always or almost always able" or "usually able" were not.

"There is a high prevalence of erectile dysfunction among men with cardiovascular risk factors and men with diabetes," Selvin said. "Screening for erectile dysfunction among men with hypertension and diabetes may be important," she added.

The researchers found that the overall prevalence of erectile dysfunction among U.S. men was 18.4 percent. Age was a strong risk factor -- men 70 and older accounted for 70 percent of those with erectile dysfunction. In contrast, just 5 percent of men with erectile problems were between the ages of 20 and 40.

Erectile dysfunction was especially linked to diabetes. "It's important for physicians to know that more than 50 percent of their male diabetic patients are affected by erectile dysfunction," Selvin said.

In addition, almost 90 percent of men with erectile dysfunction had at least one risk factor for heart disease, including diabetes, high blood pressure, high cholesterol or smoking.

"Moreover, men who are physically inactive and had high rates of sedentary behavior, such as watching three or more hours of TV per day, were much more likely to have erectile dysfunction compared with men who were physically active," Selvin said, so, "increasing exercise may be an effective non-pharmacologic treatment."

One expert agreed that erectile dysfunction is a widespread problem.

"This study reiterates what we know, that erectile dysfunction is highly prevalent in the Unites States," said Dr. Hossein Sadeghi-Nejad, director of the Center for Male Reproductive Medicine at Hackensack University Medical Center and an associate professor of urology at UMD New Jersey Medical School.

Sadeghi-Nejad believes that doctors should screen men for erectile dysfunction. "It's an important quality-of-life issue, and the factors that help prevent cardiovascular disease and diabetes may help decrease erectile dysfunction," he added.

By changing lifestyle and treating underlying heart disease and diabetes, you can decrease the chances of developing erectile dysfunction, Sadeghi-Nejad said. "Erectile dysfunction is not a mandatory side effect of aging," he said. "Don't think of it as a normal process of aging."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases can tell you more about erectile dysfunction.