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
Tristan Manalac, 3 days ago
Switching insulin pumps on or off before exercise does not seem to affect blood glucose concentrations during physical activity in type 1 diabetes patients, according to a recent study.
06 Jun 2019
Having at least four pregnancies through childbearing age appears to increase the risk of diabetes in postmenopausal women without a history of gestational diabetes, a study has found.
Stephen Padilla, 07 Oct 2019
Almost half of Asian patients with dyslipidaemia and hypertension, as well as half of those on pharmacotherapy, have achieved their blood pressure (BP) treatment goals, a Singapore study has shown. Moreover, BP goal attainment is significantly associated with type 2 diabetes mellitus (T2DM) and low-density lipoprotein (LDL-C) control.
Roshini Claire Anthony, 30 Jul 2019

Individuals who adhere to a plant-based diet, particularly one consisting of healthy plant-based foods, may reduce their risk of developing type 2 diabetes (T2D), according to a recent meta-analysis.