Erectile dysfunction is a distressing condition that may result from organic or psychological causes. Organic ED results from neurological, hormonal or vascular pathologies, and may also have drug-related causes. Cardiovascular disease and diabetes are the most common vascular risk factors. Due to a reluctance of patients to mention ED, healthcare professionals should discuss sexual dysfunction with patients who have increased risk of ED. This article considers underlying aetiologies and outlines treatment options.
NIH Consensus Development Panel on Impotence.NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA1993;270:83-90.
2.
Burchardt M. , Burchard T., Anastasiadis AG et al. Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension . Int J Impot Res2001;13:276-81.
3.
Feldman HA, Goldstein I., Hatzichristou DG, Krane RJ, McKinlay JBImpotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol1994;151:54-61.
4.
Aytac IA, McKinlay JB, Krane RJThe likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int1999;84:50-6.
5.
Impotence Association.Survey: attitudes towards erectile dysfunction. London ; 2002.
6.
Eardley I.Pathophysiology of erectile dysfunction. Br J Diabetes Vasc Dis2002;2:272-6.
7.
Jackson G., Betteridge J., Dean J. et al. A systematic approach to erectile dysfunction in the cardiovascular patient: a consensus statement update -2002. Int J Clin Pract2002;56:663-71.
8.
Fedele D., Bortolotti A., Coscelli C. et al. Erectile dysfunction in type 1 and type 2 diabetics in Italy. On behalf of Gruppo Italiano Studio Deficit Erettile nei Diabetici. Int J Epidemiol2000;29:524-31.
9.
Jones RWA , Gingell JCThe vascular system and erectile dysfunction in diabetes - the role of penile doppler. Br J Diabetes Vasc Dis2002;2:263-5.
10.
Ellenberg M.Impotence in diabetes: the neurologic factor . Ann Intern Med1971;75:213-19.
11.
Saenz de Tejada I., Goldstein I., Azadzoi K., Krane RJ, Cohen RAImpaired neurogenic and endothelium-mediated relaxation of penile smooth muscle from diabetic men with impotence. N Engl J Med1989;320:1025-30.
12.
Cartledge JJ , Eardley I., Morrison JFNitric oxide-mediated corpus cavernosal smooth muscle relaxation is impaired in ageing and diabetes . BJU Int2001;87:394-401.
13.
Seftel AD, Vaziri ND, Ni Z. et al. Advanced glycation end products in human penis: elevation in diabetic tissue, site of deposition, and possible effect through iNOS or eNOS . Urology1997;50:1016-26.
14.
Mannino DM, Klevens RM, Flanders WDCigarette smoking: an independent risk factor for impotence?Am J Epidemiol1994;140:1003-08.
15.
Chung WS, Sohn JH, Park YYIs obesity an underlying factor in erectile dysfunction?Eur Urol1999;36:68-70.
16.
Araujo AB, Durante R., Feldman HA, Goldstein I., McKinlay JBThe relationship between depressive symptoms and male erectile dysfunction: cross-sectional results from the Massachusetts Male Aging Study. Psychosom Med1998;60:458-65.
17.
Pagani M.Hypertension, stress and erectile dysfunction: potential insights from the analysis of heart rate variability. Curr Med Res Opin2000;16(suppl 1):S3-S8.
18.
Guay A., Spark R., Bansal S. et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: a couple's problem - 2003 update. Endocr Pract2003;9:77-95.
19.
Barksdale JD , Gardner SFThe impact of first-line antihypertensive drugs on erectile dysfunction. Pharmacotherapy1999;19:573-81.
20.
Singer C., Weiner WJ, Sanchez-Ramos J., Ackerman M.Sexual function in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry1991; 54:942.
21.
Ghezzi A., Malvestiti GM, Baldini S., Zaffaroni M., Zibetti A.Erectile impotence in multiple sclerosis: a neurophysiological study . J Neurol1995; 242:123-6.
22.
Mirone V., Imbimbo C., Palmieri A., Longo N., Fusco F.Erectile dysfunction after surgical treatment. Int J Androl2003;26:137-40.
23.
Ricchiuti V. , Haas C., Seftel A., Chelimsky T., Goldstein I.Pudendal nerve injury associated with avid bicycling. J Urol1999;162:2099-100.
24.
Munarriz R. , Yan Q., Nehra A., Udelson D., Goldstein I.Blunt trauma: the pathophysiology of hemodynamic injury leading to erectile dysfunction . J Urol1995;153:1831-40.
25.
Lue TFErectile dysfunction. N Engl J Med2000;342:1802-13.
26.
Miller T.Diagnostic evaluation of erectile dysfunction. Am Fam Physician2000;61:95-104.
27.
Fahmy A., Mitra S., Blacklock A., Desai K.Is the measurement of serum testosterone routinely indicated in men with erectile dysfunction?BJU Int1999;84:482-4.
28.
Rosner W.Errors in the measurement of plasma testosterone. J Clin Endocrinol Metab1997;82:2014-15.
29.
Marwick C.Survey says patients expect little physician help on sex. JAMA1999;281:2173-4.
30.
Ali W., Besarini D., Kirby R.Modern treatment of erectile dysfunction. Br J Diabetes Vasc Dis2002;2:255-61.