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Erectile dysfunction (ED) is defined as persistent or recurrent inability to achieve and maintain a penile erection of sufficient rigidity to permit satisfactory sexual activity occurring for at least 3 months. ED has been shown to adversely affect the physical and psychosocial wellbeing and quality of life in men, their partners and families. It is estimated that 20–30% of adult men have experienced at least one episode of sexual dysfunction.

The development of ED is frequently attributable to psychogenic factors and physiological alterations of neural, vascular, hormonal and endothelial function. The risk factors include older age, sedentary lifestyle, obesity, smoking, dyslipidaemia, and metabolic syndrome. These are similar to the established risk factors for cardiovascular disease, and the presence of ED itself serves as an important predictor marker of future cardiovascular risk, with the risks of cardiovascular disease and death increasing steadily with the severity of ED. Patients with known cardiovascular risk factors or who have a symptomatic cardiac disease should receive further investigations, with referral to cardiology where appropriate. In addition, there is a strong association between ED and lower urinary tract symptoms/benign prostatic hyperplasia.

This MJA guidelines shares more.

Learning Outcomes

1. Explain key components of the guideline
2. List main findings
3. Recognise that ED patients with medical comorbidities need to be thoroughly evaluated and managed.

Details

Author: Eric Chung, Michael Lowy, Michael Gillman, Chris Love, Darren Katz and Graham Neilsen

Article Type: Guideline