ED is a common disorder in men, affecting up to 52% of men between the age of 40 and 70 years.²

Beside aging, diabetes is the most common risk factor for erectile dysfunction, which is reported to occur in 35-90% of men affected by diabetes worldwide.³

ED and coronary artery disease share the same risk factors

The incidence of erectile dysfunction increases with age.²

Erectile dysfunction affects the quality of life for both patients and partners and is associated with relationship difficulties.²

DRUGS THAT MAY CONTRIBUTE TO ED

• Antihypertensives: methyldopa, clonidine, reserpine, beta-blockers, guanethidine, and verapamil
• Diuretics: thiazides and spironolactone
• Cardiac/circulatory: clofibrate, gemfibrozil, and digoxin
• Tranquilisers: phenothiazines and butyrophenones
• Anticholinergics: disopyramide and anticonvulsants
• Antidepressants: tricyclic antidepressants, MAOIs, lithium, and SSRIs
• Hormones: oestrogens/progesterone, corticosteroids, cyproterone, acetate, 5-alpha reductase inhibitors, and LHRH agonists
• H2agonists: cimetidine and ranitidine
• Cytotoxic agents: cyclophosphamide, methotrexate, and Roferon-A⁴

ED IS TREATABLE

In SA, three potent selective PDE5Is have been approved for the treatment of ED, namely Tadalafil, Sildenafil, and Vardenafil.⁵

ED shares risk factors with cardiovascular disease.⁶ The recognition of ED as a warning sign of silent vascular disease has led to the concept that a man with ED and no cardiac symptoms is a cardiac patient until proven otherwise.⁷

REFERENCES

1. Muneer A, Kalsi J, Nazareth I, Arya M. Erectile dysfunction BMJ 2014; 348 :g129 doi:10.1136/bmj.g129. https://www.bmj.com/content/348/bmj.g129
2. Frajese GV, Pozzi F, Frajese G. Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence. Clin Interv Aging. 2006;1(4):439-49. doi: 10.2147/ciia.2006.1.4.439. PMID: 18046921; PMCID: PMC2699638. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699638/
3. Maiorino MI, Bellastella G, Della Volpe E, Casciano O, Scappaticcio L, Cirillo P, Giugliano D, Esposito K. Erectile dysfunction in young men with type 1 diabetes. Int J Impot Res. 2017 Jan;29(1):17-22. doi: 10.1038/ijir.2016.38. Epub 2016 Sep 22. PMID: 27654032. https://www.nature.com/articles/ijir201638
4. Hackett G, Kirby M, Wylie K, Heald A, Ossei-Gerning N, Edwards D, Muneer A. British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction in Men-2017. J Sex Med. 2018 Apr;15(4):430-457. doi: 10.1016/j.jsxm.2018.01.023. Epub 2018 Mar 14. PMID: 29550461. http://www.bssm.org.uk/wp-content/uploads/2018/09/BSSM-ED-guidelines-2018-1.pdf
5. N Schellack (Senior Lecturer) & A Agoro (2014) A review of phosphodiesterase type 5 inhibitors, South African Family Practice, 56:2, 96-101, DOI: 10.1080/20786204.2014.10855345 https://www.ajol.info/index.php/safp/article/view/105444#:~:text=Currently%2C%20three%20phosphodiesterase%20type%205,the%20treatment%20of%20pulmonary%20hypertension
6. Ramlachan P, Campbell M M. Male sexual dysfunction. SAMJ, S. Afr. med. j.[Internet]. 2014  June [cited 2022  July  04] ;  104( 6 ): 446-447. Available from: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742014000600028&lng=en.
7. Jackson G, Rosen RC, Kloner RA, Kostis JB. The second Princeton consensus on sexual dysfunction and cardiac risk: New guidelines for sexual medicine. J Sex Med 2006;3(1):28-36 https://doi.org/10.1111/j.1743-6109.2005.00196.x