F52.2/N48.4 + (E29.1)
DESCRIPTION
The inability to attain and maintain an erect penis with sufficient rigidity for sexual intercourse.
Many cases are psychogenic.
Organic causes include neurogenic, vasculogenic or endocrinological disorders; many systemic diseases; pelvic trauma/surgery; and certain medicines.
GENERAL MEASURES
Thorough medical and psychosexual history.
Examination should exclude gynaecomastia, testicular atrophy or penile abnormalities.
Review all medicines and, if possible, withdraw medicines that may be associated with erectile dysfunction.
Identify and treat cardiovascular risk factors e.g. obesity, hypertension, and dyslipidaemia.
Advise on lifestyle modification e.g. cessation of smoking and excessive alcohol use, physical activity, and weight loss.
MEDICINE TREATMENT
Treat the underlying condition.
In patients with proven testosterone deficiency: (E29.1)
- Testosterone. Specialist initiated.
See: Androgen deficiency .
REFERRAL
To an urologist or appropriate specialist if surgical intervention is needed, e.g. penile prostheses, vascular surgery and pelvic fractures.