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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
Arteriogenic
- Diabetes mellitus
- Hypertension
- Cardiovascular disease
- Hyperlipidemia & the metabolic syndrome
- Heavy smoking
- Peripheral vascular disorders
- Recreational drug abuse
- Trauma
- Spinal cord injury
- Diabetes mellitus
- Hypogonadism/testosterone deficiency
- Hyperprolactinemia
- Hyper- & hypothyroidism
- Obesity
- Depression
- Anxiety disorders
- Relationship issues
- Stress
- Performance anxiety
- Loss of attraction
- Antiandrogens (eg Finasteride)
- Antihypertensives (beta-blockers, Spironolactone, Methyldopa, thiazide diuretics)
- Narcotics
- Cimetidine
- Antidepressants
- Tranquillizers
- Others
- Peyronie’s disease
- Severe phimosis
- 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
