Dr. Morrow’s Show Notes on Erectile Dysfunction
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance It is a common problem, affecting at least 12 million U.S. men, about 1 in 3 after age 50. Probability increases with age.
Causes include vascular, neurologic, psychological, and hormonal factors. Contributing factors may be diabetes mellitus, hypertension, hyperlipidemia, obesity, testosterone deficiency, and prostate cancer treatment; probability of undiagnosed diabetes mellitus (DM) is 1 in 50 in men without ED and 1 in 10 in men with ED. ED typically occurs two to five years before coronary artery disease (CAD), providing a potential window during which men diagnosed with ED can make lifestyle changes to prevent CAD.
Performance anxiety and relationship issues are common psychological causes.
Medications and substance use can cause or exacerbate ED; antidepressants (SSRI and SNRI), tobacco and alcohol use are the most common. Marijuana might cause ED but little data on that so far.
ED is associated with an increased risk of cardiovascular disease, particularly in men with metabolic syndrome (2.5 times more likely). Workup: A1C or fasting glucose level can be used to assess for diabetes. A lipid panel can assess for hyperlipidemia. A thyroid-stimulating hormone level is recommended for men with signs or symptoms of hypothyroidism.
Lifestyle interventions: Tobacco cessation, regular exercise, weight loss, and improved control of diabetes, hypertension, and hyperlipidemia are recommended initial lifestyle interventions.
Oral phosphodiesterase-5 inhibitors are the first-line treatments for ED. Headache, flushing, and dyspepsia are common adverse effects, NOT when taking nitrates at all. Second-line treatments include vacuum devices and alprostadil. This comes as a suppository or an injectable. Surgically implanted penile prostheses are an option when other treatments have been ineffective.
Counseling is recommended for men with psychogenic ED.
About Morrow Family Medicine and Dr. Jim Morrow
Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.
Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.
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