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Feature Article

Erectile dysfunction: update on oral therapies

Douglas W Lording

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Abstract

Erectile dysfunction is an important medical problem because of its association with cardiovascular risk factors and heart disease. After medically assessment, patients seeking to re-establish sexual intercourse should be counselled about the available treatments. PDE5 inhibitors (sildenafil, tadalafil and vardenafil) are safe, effective drugs and will be first line treatment for most men with erectile dysfunction.

Key Points

  • Erectile dysfunction is an important medical problem because of its association with cardiovascular risk factors and heart disease and a psychosocial problem for affected couples desiring sexual intercourse.
  • It is necessary to do a full clinical assessment to establish the diagnosis and plan treatment, and to take the opportunity to treat any potentially reversible underlying conditions.
  • The PDE5 inhibitors are safe, effective drugs and will be first line treatment for most men with erectile dysfunction.
  • All three PDE5 inhibitors are contraindicated in men who are using nitrates.
  • If in doubt about the patient’s cardiac fitness, seek specialist advice.

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