erectile%20dysfunction
ERECTILE DYSFUNCTION

Erectile dysfunction is the inability to attain and maintain an erection enough to have satisfactory sexual performance for ≥3 months.

It is when the patient complains of partial erection that could not attain vaginal penetration.

Complete loss of penile rigidity is uncommon.

Initial penile erections can penetrate but early detumescence occurs without ejaculation.

Definition

  • Inability to attain & maintain an erection enough to have satisfactory sexual performance for at least 3 months

Etiology

  • Increasing evidence have shown that erectile dysfunction can be an early manifestation of coronary artery & peripheral vascular disease

Signs and Symptoms

  • Complete loss of penile rigidity is uncommon
  • A patient may complain of partial erection that could not attain vaginal penetration
  • Initial penile erections can penetrate but early detumescence occurs without ejaculation
  • Nocturnal penile tumescence
  • Inability to maintain erection during private masturbation and/or erections related to erotic materials or other partners

Risk Factors

  • Erectile dysfunction has common risk factors as w/ cardiovascular diseases
  • Studies have shown that erectile dysfunction has been associated w/ lower urinary tract symptoms, benign prostatic hyperplasia, & sexual dysfunction regardless of age & other comorbidities & various lifestyle factors
Comorbidities & other risk factors that may contribute to erectile dysfunction:
Arteriogenic
  • Diabetes mellitus
  • Hypertension
  • Cardiovascular disease
  • Hyperlipidemia & the metabolic syndrome
  • Heavy smoking
  • Peripheral vascular disorders
  • Recreational drug abuse
Neurogenic
  • Trauma
  • Spinal cord injury
Endocrine
  • Diabetes mellitus
  • Hypogonadism/testosterone deficiency
  • Hyperprolactinemia
  • Hyper- & hypothyroidism
  • Obesity
Psychiatric & Psychogenic
  • Depression
  • Anxiety disorders
  • Relationship issues
  • Stress
  • Performance anxiety
  • Loss of attraction
Drugs
  • Antiandrogens (eg Finasteride) 
  • Antihypertensives (beta-blockers, Spironolactone, Methyldopa, thiazide diuretics)
  • Narcotics
  • Cimetidine
  • Antidepressants
  • Tranquillizers
  • Others
Penile Disorders
  • Peyronie’s disease
  • Severe phimosis
Others
  • Alcohol abuse
  • Obstructive sleep apnea 
  • Pelvic and prostatic radiation therapy
  • Pelvic and prostate surgery [eg transuretheral resection of the prostate (TURP), radical prostatectomy 
  • Sedentary lifestyle
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Endocrinology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
3 days ago
In patients with type 2 diabetes, obesity may be protective against vision-threatening diabetic retinopathy, a recent Korea study has shown.
6 days ago
Atrial fibrillation (AF) carries an excess risk of stroke recurrence independent of comorbidity with and heart failure (HF), while HF without AF also poses a significant risk of recurrence, a study has shown.
Roshini Claire Anthony, 2 days ago

Men with metastatic hormone-sensitive prostate cancer (mHSPC) who receive testosterone suppression therapy may have a better survival outcome with the addition of enzalutamide over other non-steroidal anti-androgen (NSAA) therapies, according to the phase III ENZAMET* trial.

07 Jun 2019
Low-dose aspirin therapy does not confer significant benefits to elderly patients with hypertension, but treatment appears to increase the risk of haemorrhagic events, suggest a Japan study.