The Global Online Sexuality Survey (GOSS): erectile dysfunction among Arabic-speaking internet users in the Middle East.

INTRODUCTION: Epidemiologic studies exploring sexuality across different cultures and geographic regions are scanty, particularly from the Middle East. The Global Online Sexuality Survey (GOSS) is an Internet-based survey investigating male and female sexual function. GOSS-Arabic-Males is the Arabic version targeting males in the Middle East, exploring prevalence rate of and factors affecting erectile dysfunction and its therapeutic trends, as well as premature ejaculation, attitudes toward genital size, and contraception. AIM: To explore epidemiologic aspects of male sexuality through an online survey. MAIN OUTCOME MEASURES: Prevalence rate of erectile dysfunction, its relationship to risk factors, and therapeutic trends. METHODS: The online survey was randomly offered to Web surfers in the Middle East. RESULTS: Eight hundred four subjects completed the survey. The overall prevalence of ED was 45.1%, strongly correlating with various risk factors studied, including age, diabetes, hypertension under treatment, depression, concerns over genital size, interpersonal distress, premature ejaculation, low libido, and subjective reports of penile deviation. Adjusted to the World Standard Population, the prevalence rate for ED was 47%. Phosphodiesterase (PDE) inhibitors gave a poor response among those with low libido and interpersonal distress, emphasizing the need for proper diagnosis and psychological counseling parallel to medical treatment. Furthermore, PDE inhibitors were stigmatized with unrealistic concerns that decreased their utility to a great extent. CONCLUSION: In the study population of Arab-speaking Internet users, prevalence of erectile dysfunction and effect of risk factors have proven similar to reports from different parts of the world, though not unanimously. Premature ejaculation, low desire, concerns over penile size, and penile curvature are factors to be considered in the evaluation of ED patients. PDE inhibitors are stigmatized with false beliefs that should be addressed through mass media and counseling if this population is to take full benefit from this therapeutic option.