Week 6: Mens' health (erectile dysfunction)

Question 1

ED

Answer 1

Inability to attain and maintain an erection sufficient for satisfactory sexual performance

Question 2

RF for ED

Answer 2

• lack of exercise
• obesity
• smoking
• hypertension
• DM
• metabolic syndrome

Question 3

biological causes of ED

Answer 3

• Vascular factors
  
  • atherosclerosis
  • hypertension
  • DM
• Hormonal
  
  • hypogonadism etc
• Drugs
  
  • beta blockers
  • diuretics
  • antidepressants
  • antipsychotics
  • recreational drugs
  • anticonvulsants
• Neurological
  
  • central: parkinsons, stroke, MS, TBI
  • peripheral: DM, alcoholism, surgery

Question 4

psychological causes of ED

Answer 4

• general – lack of arousability
• situation (partner, performance or stress)
• GAD
• depression

Question 5

History suggesting psychogenic causes

Answer 5

• Sudden onset.
• Early collapse of erection.
• Self-stimulated or waking erections.
• Premature ejaculation or inability to ejaculate.
• Problems or changes in a relationship.
• Major life events.
• Psychological problems.

Question 6

history suggesting organic causes

Answer 6

• Gradual onset.
• Normal ejaculation.
• Normal libido (except hypogonadal men).
• Risk factor in medical history (cardiovascular, endocrine or neurological).
• Operations, radiotherapy, or trauma to the pelvis or scrotum.
• A current drug recognised as associated with ED.
• Smoking, high alcohol consumption, use of recreational or bodybuilding drugs

Question 7

non pharmacological management of ED

Answer 7

• lifestyle and drug related
• psychosexual therapy
• penis vaccum

Question 8

pharmacological management of ED

Answer 8

• Testicular failure- treat with testosterone
• High dose phosphodiesterase inhibitors (sildenafil)→ Viagra
  
  • Headaches
  • Flushing
  • Drop in blood pressure
  • Contraindicated in people with CVD
• Injection therapy/topical (alprostadil) relaxes blood vessels and muscles, although increased blood flow and producing an erection with 15 minute
• MUSE also uses alprostadil→ administered by means of a pellet inserted into urethra

Question 9

surgical options for ED

Answer 9

Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail.

Question 10

other treatment for erectile dysfunction

Answer 10

ED is often a marker that heart disease or other cardiovascular diseases may soon develop. Therefore, you should review your lifestyle to see if any changes can be made to minimise the risk of developing these problems.

Also, your doctor may prescribe a statin medicine to lower your blood cholesterol level if your risk of developing cardiovascular disease is high.