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ERECTILE DYSFUNCTION
of causes of ED are not due to
low testosterone.
If the patient is well known to
the physician and the problem
is clearly not related to libido or
ejaculatory disorders, and there
are other contributing factors
that can account for the ED,
these tests can be ordered on
an individual basis. If there is
any evidence of hypogonadism
or the dysfunction is particularly
consistent at a young age, then
further hormone evaluation
is obligatory.
Management counselling
Because ED often has a
psychological component,
patient or couple counselling
may help reduce anxiety and
overcome the condition. This
therapy is sometimes used
in combination with other
treatments as directed by
the practitioner.
Lifestyle modification
Making healthy lifestyle
changes may reduce the
symptoms of ED and improve
general physical health.
Patients should understand
that lifestyle habits that
negatively affect the heart and
the peripheral vascular system
or the nervous system will also
negatively affect the penis.
Recommended
lifestyle changes:
» Stop smoking
» Reduce fat and cholesterol
in diet
» Increase exercise
» Lose weight if overweight
» Comply with prescribed
diabetes and cardiovascular
medication regimens
» Reduce stress
Changing medication regimens
to remove causative agents
is an option when good
alternatives are available and/
or the clinical situation permits
pharmacologic adjustments.
Medication changes must
be individualised depending
upon the specific clinical
circumstances. Specific
treatment regimens for ED
are varied; they include oral
The Specialist Forum | Vol. 17 No. 4
medications, transurethral
suppositories, intracavernosal
injection, vacuum devices,
and surgery.
Oral medications
The most effective and useful
drugs available are inhibitors of
phosphodiesterase type V, an
enzyme present predominantly
in the penile smooth
muscles and responsible for
vaso