ORIGINAL ARTICLE Alfredo Nicolosi Æ Jacques Buvat Æ Dale B. Glasser Uwe Hartmann Æ Edward O. Laumann Clive Gingell For the GSSAB Investigators’ Group Sexual behaviour, sexual dysfunctions and related help seeking patterns in middle-aged and elderly Europeans: the global study of sexual attitudes and behaviors Received: 4 November 2004 / Revised: 23 July 2005 / Accepted: 7 April 2006 / Published online: 19 July 2006 Ó Springer-Verlag 2006 Abstract To study the sexual activity and the prevalence of sexual dysfunctions and related help seeking behav- iour, among people in Europe aged 40–80 years. A telephone survey was carried out in 2001–2002 in Swe- den, the UK, Belgium, Germany, Austria, France, Spain and Italy, of 4,977 men and 5,023 women, using a structured, standardized questionnaire Eighty-three percent of men and 66% of women had sexual inter- course during the year preceding the interview. The sexual dysfunctions most frequently reported were early ejaculation (11%) and erectile dysfunction (8%) in men; and a lack of sexual interest (18%), an inability to reach orgasm (13%) and lubrication difficulties (11%) in wo- men. Of the 23% of men and 32% of women who re- ported sexual dysfunction, 26% had consulted a physician, with considerable between-country differ- ences. Sexual activity is widespread among adult middle- aged and elderly people, but many experience sexual dysfunctions and few seek medical care. Keywords Age groups Æ Epidemiology Æ Health surveys Æ Impotence Æ Prevalence Æ Sexual disorders Introduction Interest in the sexual behaviour and sexual problems of middle-aged and elderly people has recently grown as a consequence of increased life expectancy and the avail- ability of new and effective treatments for male sexual dysfunctions. The few studies examining sexuality among middle-aged and older adults have reported that interest in sex persists in these age groups [5, 11, 17]. The prevalence of sexual problems among European middle-aged and elderly people has been studied at na- tional level [6, 24, 25], but differences in study design and definitions hamper rigorous cross-country comparisons. A number of population studies have investigated the prevalence of erectile dysfunction (ED) and premature ejaculation, and the related risk factors [3, 4, 10, 12, 14, 15, 16, 21, 23], but fewer studies of sexual problems in women have been carried out in Europe [2, 22]. The global study of sexual attitudes and behaviors (GSSAB) was a population survey of 27,500 men and women aged 40–80 years in 29 countries around the world [13, 20]. Here, we report the results from the eight European countries involved, and compare the sexual behaviours, and the prevalence of sexual dysfunctions and help-seeking patterns in these countries. Methods Using a random-digit dialling sampling design, com- puter-assisted telephone interviews (CATI) were carried out in Sweden, the UK, Belgium, Germany, Austria, A. Nicolosi (&) Department of Epidemiology and Medical Informatics, Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, 20090 Segrate (MI)Milan, Italy E-mail: alfredo.nicolosi@itb.cnr.it Tel.: +39-02-26422736 Fax: +39-02-26422770 A. Nicolosi G H Sergievsky Center, School of Public Health, Columbia University, New York, USA J. Buvat Centre ETPARP, Lille, France D. B. Glasser Pfizer Inc, New York, USA U. Hartmann Department of Clinical Psychology, Hannover Medical School, Hannover, Germany E. O. Laumann Department of Sociology, University of Chicago, Chicago, USA C. Gingell Bristol Urological Institute, Southmead Hospital, Bristol, England World J Urol (2006) 24: 423–428 DOI 10.1007/s00345-006-0088-9