Erectile dysfunction a predictor of heart disease

Cate Swannell
Med J Aust
Published online: 28 April 2019

ERECTILE dysfunction is a predictor of overall cardiovascular health and silent myocardial ischaemia, and treatment with medication and psychotherapy remains the gold standard, according to the author of a narrative review published in the Medical Journal of Australia.

Dr Christopher McMahon, a sexual health physician at the Australian Centre for Sexual Health, in Sydney, wrote that the prevalence of complete erectile dysfunction is about 5% among 40-year-old men, 10% among men in their 60s, 15% among men in their 70s and 30-40% among men in their 80s.

“Erectile dysfunction is associated with increasing age, depression, obesity, lack of exercise, diabetes mellitus, hypertension, dyslipidaemia, cardiovascular disease, lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia.

“However, only half of the men who self-report ED are concerned about it.”

A thorough medical, personal and culturally sensitive sexual history and clinical examination is essential to diagnosis of erectile dysfunction.

Treatment “requires lifestyle modification to reduce the impact of comorbid vascular risk factors and treatment of organic or psychosexual dysfunction with either pharmacotherapy alone or in combination with psychosexual therapy”, wrote Dr McMahon. “The treatment options for men with ED are effective, safe and well tolerated.”

Treatments include psychosexual therapy, oral pharmacotherapy, patient-administered intracorporal injection therapy, vacuum constriction devices, and surgery which is “usually limited to patients with major penile arterial or venous disease, corporal fibrosis or Peyronie disease, who are either unresponsive to or are not candidates for ED pharmacotherapy”.

“Treatment with ED pharmacotherapy alone or in combination with graded psychosexual therapy is effective in improving and/or restoring sexual function in most men,” Dr McMahon concluded.

“Overall, there is a high level of consensus on the management of ED in the selected guidelines with few inconsistencies.”

  • Cate Swannell



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