DEFINITION, PREVALENCE, ETIOLOGY

DEFINITION 

Erectile dysfunction (ED): Inability to achieve or maintain an erection sufficient for sexual intercourse

PREVALENCE 

52% of men aged 40-70 years

Increases with age

ETIOLOGY 

1. Organic causes:

• Vascular: hypertension, hyperlipidaemia, cardiovascular disease, PAD
• Metabolic: diabetes mellitus, hepatic disease, obesity        – Type 2 diabetes
• Lifestyle: smoking (20% present with ED – Neurological: MS, Parkinson’s, stroke, spinal cord injury    as first symptom)
• Peripheral neuropathy: cycling, diabetes mellitus, CKD, liver disease
• Urological: prostate cancer, OSA, BPH, Iatrogenic surgical complications – Endocrine: diabetes mellitus, hypogonadism, hyperprolactinaemia

2. Psychological:

• Stress
• Anxiety

3. Medication-related:

• Antihypertensives – Digoxin
• Diuretics      – Amiodarone
• Antidepressants       – 5-alpha reductase inhibitors
• Antipsychotics         – Corticosteroids
• Antiepileptics          – Ghrelin
• Antiarrhythmics

4. Recreational drugs:

• Alcohol
• Cocaine
• Opiates
• Anabolic steroids
• Cannabis