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Erectile dysfunction (ED) is one of the most common conditions affecting middle-aged and older men. Nearly every primary care physician, internist and geriatrician will be called upon to manage this condition or to make referrals to urologists, endocrinologists and cardiologists who will assist in the treatment of ED.
Erectile dysfunction is defined as regular difficulty getting or maintaining an erection for satisfying sex. The key word here is “regular.” It’s normal for men to have problems getting hard on occasion, but when successful erections become the exception more than the rule, or when they flat out don’t happen anymore, that’s ED and that can be a sign there’s something else going on inside.
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ED is defined as the inability to achieve a full erection or the inability to maintain an erection adequate for sexual intimacy. Other types of sexual dysfunction such as premature ejaculation and low libido may occur; however, the most common and disruptive problem in men is ED. Although most men will experience periodic episodes of ED, these episodes tend to become more frequent with advancing age.
Today, the man with erectile dysfunction (ED) has available to him a wider variety of treatment options than ever before. For nearly all of these men, a trial with a systemic agent such as sildenafil citrate will be the first option chosen. If this fails or is contraindicated, other pharmacologic treatments such as penile injections or intraurethral medication are available but are less attractive than systemic therapy and may either prove ineffective or be rejected. This review will discuss the