Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-27T09:56:50.918Z Has data issue: false hasContentIssue false

Chapter 37 - Evaluation of the Male with Erectile Dysfunction

from Section 5 - Medical and Surgical Management of Issues of Male Health

Published online by Cambridge University Press:  06 December 2023

By
William T. Berg  and
Martin Miner
Edited by
Douglas T. Carrell ,
Alexander W. Pastuszak  and
James M. Hotaling
Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
Get access

Summary

The worldwide prevalence of erectile dysfunction is estimated to impact 20% of men. The evaluation of the male with erectile dysfunction can serve as an opportunity to screen men for a variety of important cardiovascular risk factors. A typical visit consists of a detailed and comprehensive patient history and a focal physical exam. Patients should be put at ease and a therapeutic relationship established to move forward with a shared decision-making process regarding treatment. Considerations during the evaluation should be toward screening for underlying risks factors for erectile dysfunction, a detailed sexual history, utilization of validated questionnaires, determination of lifestyle and social history factors, basic laboratory testing, and a psychological assessment. The goal of the evaluation is to identify the underlying causes of erectile dysfunction that will allow the clinician to develop the best therapeutic strategy.

Keywords

erectile dysfunctionmen’s healthsexual performancevascular healthdiabetes
Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
 , pp. 295 - 302
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

McCabe, MP, et al. Incidence and prevalence of sexual dysfunction in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13(2):144–152.Google Scholar
Lewis, RW, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–1607.Google Scholar
Ayta, IA, McKinlay, JB, Krane, RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84(1):50–56.Google Scholar
Guay, AT. ED2: erectile dysfunction = endothelial dysfunction. Endocrinol Metab Clin North Am. 2007;36(2):453–463.Google Scholar
Kirby, M. The circle of lifestyle and erectile dysfunction. Sex Med Rev. 2015;3(3):169–182.CrossRefGoogle ScholarPubMed
DeLay, KJ, Haney, N, Hellstrom, WJ. Modifying risk factors in the management of erectile dysfunction: a review. World J Mens Health. 2016;34(2):89–100.Google Scholar
Kostis, JB, Dobrzynski, JM. The effect of statins on erectile dysfunction: a meta-analysis of randomized trials. J Sex Med. 2014;11(7):1626–1635.Google Scholar
Grundy, SM, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433–438.Google Scholar
Feldman, DI, et al. Subclinical vascular disease and subsequent erectile dysfunction: the multiethnic study of atherosclerosis (MESA). Clin Cardiol. 2016;39(5):291–298.CrossRefGoogle ScholarPubMed
Lloyd-Jones, DM, et al. Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: a special report from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2019;73(24):3153–3167.Google Scholar
Burnett, AL, et al. Erectile dysfunction: AUA Guideline. J Urol. 2018;200(3):633–641.CrossRefGoogle ScholarPubMed
Selvin, E, Burnett, AL Platz, EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151–157.CrossRefGoogle ScholarPubMed
Hatzichristou, D, et al. Recommendations for the clinical evaluation of men and women with sexual dysfunction. J Sex Med. 2010;7(1 Pt 2):337–348.Google Scholar
O’Leary, MP, et al. A brief male sexual function inventory for urology. Urology. 1995;46(5):697–706.Google Scholar
Romeo, JH, et al. Sexual function in men with diabetes type 2: association with glycemic control. J Urol. 2000;163(3):788–791.CrossRefGoogle ScholarPubMed
Nehra, A, et al. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2012;87(8):766–778.Google Scholar
Ghanem, HM, Salonia, A, Martin-Morales, A. SOP: physical examination and laboratory testing for men with erectile dysfunction. J Sex Med. 2013;10(1):108–110.CrossRefGoogle ScholarPubMed
Saenz de Tejada, I, et al. Pathophysiology of erectile dysfunction. J Sex Med. 2005;2(1):26–39.Google Scholar
Chung, F, et al. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Br J Anaesth. 2012;108(5):768–775.Google Scholar
Liu, PY. A clinical perspective of sleep and andrological health: assessment, treatment considerations, and future research. J Clin Endocrinol Metab. 2019;104(10):4398–4417.CrossRefGoogle ScholarPubMed
Gerbild, H, et al. Physical activity to improve erectile function: a systematic review of intervention studies. Sex Med. 2018;6(2):75–89.CrossRefGoogle ScholarPubMed
Wang, F, et al. Erectile dysfunction and fruit/vegetable consumption among diabetic Canadian men. Urology. 2013;82(6):1330–1335.Google Scholar
Esposito, K, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978–2984.Google Scholar
Jarecki, P, et al. Can low SHBG serum concentration be a good early marker of male hypogonadism in metabolic syndrome? Diabetes Metab Syndr Obes. 2019;12:2181–2191.Google Scholar
Diver, MJ, et al. Diurnal rhythms of serum total, free and bioavailable testosterone and of SHBG in middle-aged men compared with those in young men. Clin Endocrinol (Oxf). 2003;58(6):710–717.CrossRefGoogle ScholarPubMed
Mulhall, JP, et al. Evaluation and management of testosterone deficiency: AUA Guideline. J Urol. 2018;200(2):423–432.Google Scholar
Carson, CC, et al. Textbook of erectile dysfunction. 2nd ed. Informa Healthcare; 2009.Google Scholar
Montorsi, P, et al. Association between erectile dysfunction and coronary artery disease. Role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J. 2006;27(22):2632–2639.Google Scholar
Miner, MM. Erectile dysfunction and the “window of curability”: a harbinger of cardiovascular events. Mayo Clin Proc. 2009;84(2):102–104.Google Scholar
Greenland, P, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). Circulation. 2007;115(3):402–426.Google Scholar
Greenland, P, et al. Coronary calcium score and cardiovascular risk. J Am Coll Cardiol. 2018;72(4):434–447.Google Scholar
Agatston, AS, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15(4):827–832.Google Scholar
Liu, Q, et al. Erectile dysfunction and depression: a systematic review and meta-analysis. J Sex Med. 2018;15(8):1073–1082.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613.Google Scholar
Linschoten, M, Weiner, L, Avery-Clark, C. Sensate focus: a critical literature review. Sex Relatsh Ther. 2016;21(2):230–247.Google Scholar
Wein, AJ, Kavoussi, LR, Campbell, MF. Campbell–Walsh urology [Wein, AJ, ed.-in-chief; Kavoussi, LR et al., eds.]. 10th ed. Elsevier Saunders; 2012.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×