Erectile Dysfunction: Initial Evaluation

Abstract

Erectile dysfunction (ED) is defined as the consistent inability to obtain and/or maintain an erection sufficient for satisfactory relations. It is estimated to affect 50 % of men over 40 years of age. This translates into more than 20 million men in the USA and over 100 million men worldwide suffering from this problem. It is associated with significant decrease in self-confidence, self-esteem, and quality of life. In its organic form it is most commonly associated with vascular risk factors such as hypertension, dyslipidemia, diabetes, obesity, cigarette smoking, and coronary artery disease. Other conditions associated with the development of ED include radical pelvic surgery or radiation, sleep apnea syndrome, neurological conditions (lumbosacral disk disease, Parkinson’s disease, stroke), medications including some antidepressants and antihypertensives (Table 7.1) and endocrine conditions including hypogonadism, hyperprolactinemia, and thyroid dysfunction.