Comparison of Phosphodiesterase Type 5 (PDE5) Inhibitors

P. J. Wright


Int J Clin Pract. 2006;60(8):967-975. 

In This Article

Erectile Dysfunction

Erectile dysfunction is a failure to achieve an erect penis sufficient for satisfactory sexual performance.[4] It is an age-related problem that becomes increasingly common in men aged over 40 years.[5] In the past, ED was often assumed to be either a psychological problem or a normal part of the ageing process, to be tolerated with other signs of aging. However, ED is now known to be primarily organic resulting from vascular, hormonal or neurological complications. In addition, ED can be a marker of many other pathological conditions. For example, patients with vascular disorders, such as cardiovascular disease and diabetes, have a high incidence of ED. Crucially, ED may frequently prove to be an important marker for undiagnosed organic diseases such as hypertension, diabetes, ischaemic heart disease, hyperlipidaemia, neurological conditions and endocrine disease. In addition to the physical symptoms of ED, quality of life (QOL) is significantly reduced and depression, fear and loss of self-confidence are frequent.[6] Unsurprisingly, therefore, ED can have a negative impact on a man's relationship with his partner.[7]

Despite increased awareness, ED still remains underdiagnosed and undertreated.[8] Although the taboo surrounding discussion of ED has lessened, the discomfort of patients and healthcare providers in discussing sexual issues can still remain a barrier to the diagnosis and treatment of ED. Consequently, despite wanting to confront sexual dysfunction, many men can take up to 2 years to seek treatment for their ED.[9]

Unfortunately, ED is considered a low priority by many government health departments, with little or no central funding allocated for ED treatment for the majority of genuine sufferers, who arguably have the most to gain from therapeutic intervention. This is seen by many clinicians as a lost opportunity for promoting 'better' men's health.


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