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Contemporary Treatment of Erectile Dysfunction pp 57–70Cite as

Erectile Dysfunction: Etiology and Risk Factors

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Erectile dysfunction (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 etiologies of ED are classified as organic or psychogenic, with the majority of causes being organic. The most common organic cause of ED is vasculogenic, although other major classes of ED etiologies include neurologic, endocrine, drug-induced, iatrogenic, and other medical and urological disorders. Clinicians are well served to keep in mind that virtually all cases of apparently organic ED have a psychogenic component. The risk factors for ED include cardiovascular disease and its associated risk factors, and men with ED should be routinely screened for cardiovascular disease. Additional risk factors for developing ED include diabetes, lower urinary tract symptoms, hypogonadism, and other chronic conditions. Having a clear understanding of the etiologies and risk factors for ED facilitates the workup of ED and the development of a personalized, effective treatment approach.

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References

  1. Braun M, et al. Epidemiology of erectile dysfunction: results of the 'Cologne Male Survey'. Int J Impot Res. 2000;12(6):305–11.

    Article  CAS  PubMed  Google Scholar 

  2. Lindau ST, et al. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA. 1993;270(1):83–90.

    Article  Google Scholar 

  4. Mykletun A, et al. Assessment of male sexual function by the Brief Sexual Function Inventory. BJU Int. 2006;97(2):316–23.

    Article  PubMed  Google Scholar 

  5. O'Leary MP, et al. Distribution of the Brief Male Sexual Inventory in community men. Int J Impot Res. 2003;15(3):185–91.

    Article  PubMed  Google Scholar 

  6. Panser LA, et al. Sexual function of men ages 40 to 79 years: the Olmsted County Study of Urinary Symptoms and Health Status Among Men. J Am Geriatr Soc. 1995;43(10):1107–11.

    Article  CAS  PubMed  Google Scholar 

  7. Muller MJ, et al. Quality of partnership in patients with erectile dysfunction after sildenafil treatment. Pharmacopsychiatry. 2001;34(3):91–5.

    Article  CAS  PubMed  Google Scholar 

  8. Litwin MS, Nied RJ, Dhanani N. Health-related quality of life in men with erectile dysfunction. J Gen Intern Med. 1998;13(3):159–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Shabsigh R, et al. Increased incidence of depressive symptoms in men with erectile dysfunction. Urology. 1998;52(5):848–52.

    Article  CAS  PubMed  Google Scholar 

  10. Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84(1):50–6.

    Article  CAS  PubMed  Google Scholar 

  11. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342(24):1802–13.

    Article  CAS  PubMed  Google Scholar 

  12. Lewis RW, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–607.

    Article  PubMed  Google Scholar 

  13. Feldman HA, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151(1):54–61.

    CAS  PubMed  Google Scholar 

  14. Selvin E, Burnett SL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151–7.

    Article  PubMed  Google Scholar 

  15. Laumann EO, et al. Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey. J Sex Med. 2007;4(1):57–65.

    Article  PubMed  Google Scholar 

  16. Tsertsvadze A, et al. Diagnosis and treatment of erectile dysfunction. Evidence reports/technology assessments, vol. 171. Rockville, MD: Agency for Healthcare Research and Quality (US); 2009.

    Google Scholar 

  17. Shabsigh R, et al. Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone. J Urol. 2004;172(2):658–63.

    Article  CAS  PubMed  Google Scholar 

  18. Lin CS, Lin G, Lue TF. Cyclic nucleotide signaling in cavernous smooth muscle. J Sex Med. 2005;2(4):478–91.

    Article  CAS  PubMed  Google Scholar 

  19. Shamloul R, Ghanem H. Erectile dysfunction. Lancet. 2013;381(9861):153–65.

    Article  CAS  PubMed  Google Scholar 

  20. Jin L, Burnett AL. RhoA/Rho-kinase in erectile tissue: mechanisms of disease and therapeutic insights. Clin Sci (Lond). 2006;110(2):153–65.

    Article  CAS  Google Scholar 

  21. Rosen RC. Psychogenic erectile dysfunction. Classification and management. Urol Clin North Am. 2001;28(2):269–78.

    Article  CAS  PubMed  Google Scholar 

  22. Lizza EF, Rosen RC. Definition and classification of erectile dysfunction: report of the Nomenclature Committee of the International Society of Impotence Research. Int J Impot Res. 1999;11(3):141–3.

    Article  CAS  PubMed  Google Scholar 

  23. Deveci S, et al. Can the International Index of Erectile Function distinguish between organic and psychogenic erectile function? BJU Int. 2008;102(3):354–6.

    Article  PubMed  Google Scholar 

  24. Siddiqui MA, et al. Erectile dysfunction in young surgically treated patients with lumbar spine disease: a prospective follow-up study. Spine (Phila PA 1976). 2012;37(9):797–801.

    Article  Google Scholar 

  25. Saenz de Tejada I, et al. Pathophysiology of erectile dysfunction. J Sex Med. 2005;2(1):26–39.

    Article  PubMed  Google Scholar 

  26. Jackson G. The importance of risk factor reduction in erectile dysfunction. Curr Urol Rep. 2007;8(6):463–6.

    Article  PubMed  Google Scholar 

  27. Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet. 1985;1(8422):181–4.

    Article  CAS  PubMed  Google Scholar 

  28. Sullivan ME, et al. Nitric oxide and penile erection: is erectile dysfunction another manifestation of vascular disease? Cardiovasc Res. 1999;43(3):658–65.

    Article  CAS  PubMed  Google Scholar 

  29. Chew KK, et al. Erectile dysfunction as a predictor for subsequent atherosclerotic cardiovascular events: findings from a linked-data study. J Sex Med. 2010;7(1 Pt 1):192–202.

    Article  PubMed  Google Scholar 

  30. Giuliano FA, et al. Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology. 2004;64(6):1196–201.

    Article  PubMed  Google Scholar 

  31. Martin-Morales A, et al. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study. J Urol. 2001;166(2):569–74. discussion 574-5.

    Article  CAS  PubMed  Google Scholar 

  32. Corona G, et al. Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study. Eur J Endocrinol. 2011;165(5):687–701.

    Article  CAS  PubMed  Google Scholar 

  33. Mulhall JP. Penile rehabilitation following radical prostatectomy. Curr Opin Urol. 2008;18(6):613–20.

    Article  PubMed  Google Scholar 

  34. Traish AM, et al. Effects of castration and androgen replacement on erectile function in a rabbit model. Endocrinology. 1999;140(4):1861–8.

    CAS  PubMed  Google Scholar 

  35. Traish AM, et al. Adipocyte accumulation in penile corpus cavernosum of the orchidectomized rabbit: a potential mechanism for veno-occlusive dysfunction in androgen deficiency. J Androl. 2005;26(2):242–8.

    Article  PubMed  Google Scholar 

  36. Morgentaler A, Feibus A, Baum N. Testosterone and cardiovascular disease – the controversy and the facts. Postgrad Med. 2015;127(2):159–65.

    Article  PubMed  Google Scholar 

  37. Rhoden EL, et al. The relationship of serum testosterone to erectile function in normal aging men. J Urol. 2002;167(4):1745–8.

    Article  CAS  PubMed  Google Scholar 

  38. Corona G, et al. Aging and pathogenesis of erectile dysfunction. Int J Impot Res. 2004;16(5):395–402.

    Article  CAS  PubMed  Google Scholar 

  39. Isidori AM, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment-a systematic review. Eur Urol. 2014;65(1):99–112.

    Article  CAS  PubMed  Google Scholar 

  40. Wang C, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. J Clin Endocrinol Metab. 2000;85(8):2839–53.

    CAS  PubMed  Google Scholar 

  41. Corona G, et al. Effect of hyperprolactinemia in male patients consulting for sexual dysfunction. J Sex Med. 2007;4(5):1485–93.

    Article  CAS  PubMed  Google Scholar 

  42. Aversa A, et al. Early endothelial dysfunction as a marker of vasculogenic erectile dysfunction in young habitual cannabis users. Int J Impot Res. 2008;20(6):566–73.

    CAS  PubMed  Google Scholar 

  43. Thomas A, et al. Urologic complications of nonurologic medications. Urol Clin North Am. 2003;30(1):123–31.

    Article  PubMed  Google Scholar 

  44. Baumhakel M, et al. Cardiovascular risk, drugs and erectile function—a systematic analysis. Int J Clin Pract. 2011;65(3):289–98.

    Article  CAS  PubMed  Google Scholar 

  45. Serretti A, Chiesa A. A meta-analysis of sexual dysfunction in psychiatric patients taking antipsychotics. Int Clin Psychopharmacol. 2011;26(3):130–40.

    Article  PubMed  Google Scholar 

  46. El-Sakka AI. Association of risk factors and medical comorbidities with male sexual dysfunctions. J Sex Med. 2007;4(6):1691–700.

    Article  PubMed  Google Scholar 

  47. Montorsi F, et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol. 2003;44(3):360–4. discussion 364-5.

    Article  PubMed  Google Scholar 

  48. Jackson G, et al. Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus. Int J Clin Pract. 2010;64(7):848–57.

    Article  CAS  PubMed  Google Scholar 

  49. Montorsi P, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006;27(22):2632–9.

    Article  PubMed  Google Scholar 

  50. Vlachopoulos C, et al. Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol. 2005;48(6):996–1002. discussion 1002-3.

    Article  PubMed  Google Scholar 

  51. Inman BA, et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc. 2009;84(2):108–13.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Vlachopoulos CV, et al. Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circ Cardiovasc Qual Outcomes. 2013;6(1):99–109.

    Article  PubMed  Google Scholar 

  53. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2011;58(13):1378–85.

    Article  PubMed  Google Scholar 

  54. Guo W, et al. Erectile dysfunction and risk of clinical cardiovascular events: a meta-analysis of seven cohort studies. J Sex Med. 2010;7(8):2805–16.

    Article  PubMed  Google Scholar 

  55. Thompson IM, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005;294(23):2996–3002.

    Article  CAS  PubMed  Google Scholar 

  56. Polonsky TS, et al. The association between erectile dysfunction and peripheral arterial disease as determined by screening ankle-brachial index testing. Atherosclerosis. 2009;207(2):440–4.

    Article  CAS  PubMed  Google Scholar 

  57. Ponholzer A, et al. Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol. 2005;48(3):512–8. discussion 517-8.

    Article  PubMed  Google Scholar 

  58. Nehra A, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012;87(8):766–78.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Pastuszak AW, et al. Erectile dysfunction as a marker for cardiovascular disease diagnosis and intervention: a cost analysis. J Sex Med. 2015;12(4):975–84.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Mittawae B, et al. Incidence of erectile dysfunction in 800 hypertensive patients: a multicenter Egyptian national study. Urology. 2006;67(3):575–8.

    Article  PubMed  Google Scholar 

  61. Burchardt M, et al. Hypertension is associated with severe erectile dysfunction. J Urol. 2000;164(4):1188–91.

    Article  CAS  PubMed  Google Scholar 

  62. Montorsi P, Montorsi F, Schulman CC. Is erectile dysfunction the "tip of the iceberg" of a systemic vascular disorder? Eur Urol. 2003;44(3):352–4.

    Article  PubMed  Google Scholar 

  63. Malavige LS, Levy JC. Erectile dysfunction in diabetes mellitus. J Sex Med. 2009;6(5):1232–47.

    Article  PubMed  Google Scholar 

  64. Ponholzer A, et al. Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol. 2005;47(1):80–5. discussion 85-6.

    Article  PubMed  Google Scholar 

  65. Bacon CG, et al. Association of type and duration of diabetes with erectile dysfunction in a large cohort of men. Diabetes Care. 2002;25(8):1458–63.

    Article  PubMed  Google Scholar 

  66. Kalter-Leibovici O, et al. Clinical, socioeconomic, and lifestyle parameters associated with erectile dysfunction among diabetic men. Diabetes Care. 2005;28(7):1739–44.

    Article  PubMed  Google Scholar 

  67. Weinberg AE, et al. Diabetes severity, metabolic syndrome, and the risk of erectile dysfunction. J Sex Med. 2013;10(12):3102–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Wessells H, et al. Effect of intensive glycemic therapy on erectile function in men with type 1 diabetes. J Urol. 2011;185(5):1828–34.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Kapoor D, et al. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: correlations with bioavailable testosterone and visceral adiposity. Diabetes Care. 2007;30(4):911–7.

    Article  CAS  PubMed  Google Scholar 

  70. Cordero A, et al. Erectile dysfunction may improve by blood pressure control in patients with high-risk hypertension. Postgrad Med. 2010;122(6):51–6.

    Article  PubMed  Google Scholar 

  71. Cordero A, et al. Erectile dysfunction in high-risk hypertensive patients treated with beta-blockade agents. Cardiovasc Ther. 2010;28(1):15–22.

    Article  CAS  PubMed  Google Scholar 

  72. Tostes RC, et al. Cigarette smoking and erectile dysfunction: focus on NO bioavailability and ROS generation. J Sex Med. 2008;5(6):1284–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Feldman HA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med. 2000;30(4):328–38.

    Article  CAS  PubMed  Google Scholar 

  74. Mannino DM, Klevens RM, Flanders WD. Cigarette smoking: an independent risk factor for impotence? Am J Epidemiol. 1994;140(11):1003–8.

    CAS  PubMed  Google Scholar 

  75. Cao S, et al. Smoking and risk of erectile dysfunction: systematic review of observational studies with meta-analysis. PLoS One. 2013;8(4), e60443.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Pourmand G, et al. Do cigarette smokers with erectile dysfunction benefit from stopping? A prospective study. BJU Int. 2004;94(9):1310–3.

    Article  PubMed  Google Scholar 

  77. Harte CB, Meston CM. Association between smoking cessation and sexual health in men. BJU Int. 2012;109(6):888–96.

    Article  PubMed  Google Scholar 

  78. Blanker MH, et al. Correlates for erectile and ejaculatory dysfunction in older Dutch men: a community-based study. J Am Geriatr Soc. 2001;49(4):436–42.

    Article  CAS  PubMed  Google Scholar 

  79. Bacon CG, et al. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med. 2003;139(3):161–8.

    Article  PubMed  Google Scholar 

  80. Esposito K, Giugliano D. Obesity, the metabolic syndrome, and sexual dysfunction. Int J Impot Res. 2005;17(5):391–8.

    Article  CAS  PubMed  Google Scholar 

  81. Derby CA, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urology. 2000;56(2):302–6.

    Article  CAS  PubMed  Google Scholar 

  82. Bacon CG, et al. A prospective study of risk factors for erectile dysfunction. J Urol. 2006;176(1):217–21.

    Article  PubMed  Google Scholar 

  83. Esposito K, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978–84.

    Article  CAS  PubMed  Google Scholar 

  84. Lamina S, Okoye CG, Dagogo TT. Therapeutic effect of an interval exercise training program in the management of erectile dysfunction in hypertensive patients. J Clin Hypertens (Greenwich). 2009;11(3):125–9.

    Article  Google Scholar 

  85. Cheng JY, et al. Physical activity and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res. 2007;19(3):245–52.

    Article  CAS  PubMed  Google Scholar 

  86. Vlachopoulos C, et al. Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links. Eur Urol. 2007;52(6):1590–600.

    Article  CAS  PubMed  Google Scholar 

  87. Trepels T, Zeiher AM, Fichtlscherer S. The endothelium and inflammation. Endothelium. 2006;13(6):423–9.

    Article  PubMed  Google Scholar 

  88. Yao F, et al. Subclinical endothelial dysfunction and low-grade inflammation play roles in the development of erectile dysfunction in young men with low risk of coronary heart disease. Int J Androl. 2012;35(5):653–9.

    Article  CAS  PubMed  Google Scholar 

  89. Billups KL, et al. Relation of C-reactive protein and other cardiovascular risk factors to penile vascular disease in men with erectile dysfunction. Int J Impot Res. 2003;15(4):231–6.

    Article  CAS  PubMed  Google Scholar 

  90. Glina S, Glina FP. Pathogenic mechanisms linking benign prostatic hyperplasia, lower urinary tract symptoms and erectile dysfunction. Ther Adv Urol. 2013;5(4):211–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Nicolosi A, et al. Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction. Urology. 2003;61(1):201–6.

    Article  PubMed  Google Scholar 

  92. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537–44.

    Article  CAS  PubMed  Google Scholar 

  93. Chang S, et al. Increased corpus cavernosum smooth muscle tone associated with partial bladder outlet obstruction is mediated via Rho-kinase. Am J Physiol Regul Integr Comp Physiol. 2005;289(4):R1124–30.

    Article  CAS  PubMed  Google Scholar 

  94. Kobayashi K, et al. Animal model for the study of the relationship between lower urinary tract symptoms/bladder outlet obstruction and erectile dysfunction. Int J Urol. 2011;18(10):710–5.

    Article  PubMed  Google Scholar 

  95. Tinel H, et al. Pre-clinical evidence for the use of phosphodiesterase-5 inhibitors for treating benign prostatic hyperplasia and lower urinary tract symptoms. BJU Int. 2006;98(6):1259–63.

    Article  CAS  PubMed  Google Scholar 

  96. Gacci M, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with alpha-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012;61(5):994–1003.

    Article  CAS  PubMed  Google Scholar 

  97. Ozturk MI, et al. Acute effects of sildenafil on uroflowmetric parameters in erectile dysfunction patients with and without lower urinary tract symptoms. J Androl. 2012;33(6):1165–8.

    Article  CAS  PubMed  Google Scholar 

  98. Yan H, et al. The efficacy of PDE5 inhibitors alone or in combination with alpha-blockers for the treatment of erectile dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia: a systematic review and meta-analysis. J Sex Med. 2014;11(6):1539–45.

    Article  CAS  PubMed  Google Scholar 

  99. Gore J, Rajfer J. The role of serum testosterone testing: routine hormone analysis is an essential part of the initial screening of men with erectile dysfunction. Rev Urol. 2004;6(4):207–10.

    PubMed  PubMed Central  Google Scholar 

  100. Jain P, Rademaker AW, McVary KT. Testosterone supplementation for erectile dysfunction: results of a meta-analysis. J Urol. 2000;164(2):371–5.

    Article  CAS  PubMed  Google Scholar 

  101. Porst H, et al. SOP conservative (medical and mechanical) treatment of erectile dysfunction. J Sex Med. 2013;10(1):130–71.

    Article  CAS  PubMed  Google Scholar 

  102. Tsertsvadze A, et al. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: a systematic review and meta-analysis. Ann Intern Med. 2009;151(9):650–61.

    Article  PubMed  Google Scholar 

  103. Buvat J, Lemaire A, Buvat-Herbaut M. Human chorionic gonadotropin treatment of nonorganic erectile failure and lack of sexual desire: a double-blind study. Urology. 1987;30(3):216–9.

    Article  CAS  PubMed  Google Scholar 

  104. Guay AT, Bansal S, Heatley GJ. Effect of raising endogenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate. J Clin Endocrinol Metab. 1995;80(12):3546–52.

    CAS  PubMed  Google Scholar 

  105. Chughtai B, et al. Metabolic syndrome and sexual dysfunction. Curr Opin Urol. 2011;21(6):514–8.

    Article  PubMed  Google Scholar 

  106. Shabsigh R. Testosterone therapy in erectile dysfunction and hypogonadism. J Sex Med. 2005;2(6):785–92.

    Article  CAS  PubMed  Google Scholar 

  107. Blute M, et al. Erectile dysfunction and testosterone deficiency. Front Horm Res. 2009;37:108–22.

    Article  CAS  PubMed  Google Scholar 

  108. Buvat J, et al. Endocrine aspects of male sexual dysfunctions. J Sex Med. 2010;7(4 Pt 2):1627–56.

    Article  PubMed  Google Scholar 

  109. Shabsigh R, et al. The evolving role of testosterone in the treatment of erectile dysfunction. Int J Clin Pract. 2006;60(9):1087–92.

    Article  CAS  PubMed  Google Scholar 

  110. Araujo AB, et al. The relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med. 1998;60(4):458–65.

    Article  CAS  PubMed  Google Scholar 

  111. Laumann EO, et al. Lower urinary tract symptoms are associated with depressive symptoms in white, black and Hispanic men in the United States. J Urol. 2008;180(1):233–40.

    Article  PubMed  Google Scholar 

  112. Perelman MA. Erectile dysfunction and depression: screening and treatment. Urol Clin North Am. 2011;38(2):125–39.

    Article  PubMed  Google Scholar 

  113. Althof SE, Wieder M. Psychotherapy for erectile dysfunction: now more relevant than ever. Endocrine. 2004;23(2-3):131–4.

    Article  CAS  PubMed  Google Scholar 

  114. Morse WI, Morse JM. Erectile impotence precipitated by organic factors and perpetuated by performance anxiety. Can Med Assoc J. 1982;127(7):599–601.

    CAS  PubMed  PubMed Central  Google Scholar 

  115. Gupta BP, et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med. 2011;171(20):1797–803.

    Article  PubMed  Google Scholar 

  116. Critchley JA, Capewell S. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA. 2003;290(1):86–97.

    Article  PubMed  Google Scholar 

  117. Bassuk SS, Manson JE. Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol (1985). 2005;99(3):1193–204.

    Article  Google Scholar 

  118. Mozaffarian D, Wilson PW, Kannel WB. Beyond established and novel risk factors: lifestyle risk factors for cardiovascular disease. Circulation. 2008;117(23):3031–8.

    Article  PubMed  Google Scholar 

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  1. Scott Department of Urology, Baylor College of Medicine, 6624 Fannin St, Suite 1700, Houston, TX, 77030, USA

    Alexander W. Pastuszak MD, PhD & Mohit Khera MD, MBA, MPH

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  1. Alexander W. Pastuszak MD, PhD
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Correspondence to Alexander W. Pastuszak MD, PhD .

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  1. Southern Illinois University School of Medicine, Springfield, Illinois, USA

    Tobias S. Köhler

  2. Division of Urology Department of Surgery, Southern Illinois University School of Medicine Hospital Affiliates, Springfield, Illinois, USA

    Kevin T. McVary

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Pastuszak, A.W., Khera, M. (2016). Erectile Dysfunction: Etiology and Risk Factors. In: Köhler, T., McVary, K. (eds) Contemporary Treatment of Erectile Dysfunction. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-31587-4_5

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