Keeping Up With Erectile Dysfunction: Why Are There So Many Men Over 50 Asking for Help?
July 18, 2011
In my current practice, every day there is at least one man over the age of 50 asking for an erectile dysfunction (ED) medication. It seems to have become an epidemic. Or it is just more openly discussed. Or both.
So what are the causes of ED? And what can you do as a health care provider to help your patients understand ED medications and use them wisely to have a good quality of life?
Some of the causes of ED can include the following:
- psychological conditions, including depression and poor self-esteem
- substance use, including tobacco
- comorbid conditions, such as diabetes, thyroid disorder, vascular disease and hypertension
- HIV infection causing hypogonadism (low testosterone)
- effects of aging
- side effects of medications, such as antidepressants and beta blockers
- abuse of hormones, such as growth hormone, testosterone and androgens, that at some point can shrink the genitalia (which means the patient can't use that excuse of just stepping out of cold water)
- laboring under the misconception, which has been reinforced by the media and society, that all men have sex like rabbits
So what can we do as care providers?
- Have an open dialogue with your patient.
- If you are not the health care provider, then refer for a diagnostic workup that includes an evaluation for hormone levels and thyroid disorder.
- Treat comorbidities, such as hypertension, diabetes mellitus and depression.
- Discuss potential side effects of treating comorbidities, including contraindication of ED medications with heart disease.
- Discuss drug-drug interactions between ED medications and antiretroviral medications for the treatment of HIV.
- Discuss the role of substance use and tobacco.
- Ascertain how the patient feels about himself.
- Just be plain ol' supportive.
Thanks to Dr. Christopher Evans for the blog title!
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