Erectile Dysfunction

While over 52% of American men suffer from some degree of erectile dysfunction (ED), it is surprising to me how very little patients know about the causes and treatments for this disease. Erectile dysfunction can have a significant psychological impact on a man and can significantly impair his relationship with his partner. There are also cultural differences that dictate which men are more likely to seek treatment.  ED affects a growing number of men in the United States and abroad, with significant impacts on sexual function and overall quality of life.  The risk factors for ED are numerous, and include a strong link to cardiovascular disease, such that men with ED should be screened for cardiovascular disease.  The evaluation of men presenting with ED includes a comprehensive history and physical exam to aid in the identification of comorbidities, as well as laboratory testing to evaluate hormone and lipid levels, and sugar metabolism.  Adjunct studies are also available, though their utility is often limited to specific subtypes of ED.  Once the etiology of ED is established, treatment can be initiated using appropriate medical therapies, including PDE5 inhibitors, and transurethral or intracavernosal therapies, with surgical intervention via revascularization or penile prosthesis placement in men demonstrating lack of response to medical therapy.