![]() Hormone-affecting – anti-androgens, corticosteroids, chronic opioid use.Anticonvulsants, anti-Parkinson’s agents.Psychotrophic medications (eg selective serotonin reuptake inhibitors and other antidepressants, antipsychotics, anxiolytics).Antihypertensive (eg diuretics, alpha and beta blockers).Other disorders of arousal or orgasm: hypoactive sexual desire disorder, sexual aversion disorder, anorgasmia, postorgasmic illness syndrome.Generalised anxiety disorder, depression, psychosis.Self-image problems, low self-esteem, history of sexual abuse, highly restricted sexual upbringing.Partner-related, stress, guilt, situational anxiety.Psychological and psychiatric conditions.Penile abnormalities (eg Peyronie’s disease, venous leak). ![]() Endocrinological (eg hypogonadism, hyperprolactinaemia, thyroid disorder).Pelvic surgery (eg radical prostatectomy), radiation, trauma.Peripheral nerve disorder (eg diabetic neuropathy).Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, stroke.Atherosclerosis-related risk factors (eg cardiovascular disease, cigarette smoking, hypertension, dyslipidaemia, diabetes mellitus). ![]() Risk factors for erectile dysfunction are listed in Table 1. 4 Consequently, nearly all organic erectile dysfunction will eventually become ‘mixed’. In reality, however, anxiety and depression commonly accompany erectile dysfunction, irrespective of the original aetiology. Psychogenic aetiology may be generalised or situational. Organic causes include anatomical, vasculogenic (ie arterial or venous), neurogenic, endocrinological and drug-related side effects. ![]() Traditionally, the aetiology of erectile dysfunction is classified into organic, psychogenic or mixed. Of the men with normal erectile function at baseline, 31.7% developed erectile dysfunction at five-year follow-up. In another Australian study of 810 men aged 35–80 years, 3 the overall prevalence of erectile dysfunction was 23.3% at baseline. A similar prevalence of significant erectile dysfunction was found in men with diabetes in their late 40s. More than 20% of healthy men aged 60–65 years with no risk factors had moderate or complete erectile dysfunction. In an Australian study measuring self-reported erectile dysfunction in 108,477 men aged 45 years or older, 2 the overall prevalence of erectile dysfunction was 61% (25% with mild erectile dysfunction 19% with moderate erectile dysfunction 17% with complete erectile dysfunction). EpidemiologyĮrectile dysfunction is very common and not limited to older peoples. This review will discuss the basics of erectile dysfunction and its management, and focus on the pivotal role of GPs. Even when specialist assistance is required, involvement of the GP is crucial for a durable positive outcome. Sexual complaints should be used as a platform to investigate possible risk factors and comorbidities, and as a means to segue into patient education and lifestyle changes. General practitioners (GPs) are instrumental in the early diagnosis and treatment of men with erectile dysfunction. 1 Although a common condition, sexual dysfunction is often neglected in clinical practice. Erectile dysfunction is defined as a man’s consistent or recurrent inability to attain and/or maintain penile erection that is sufficient for sexual activity. ![]()
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