Organic causes of erectile dysfunction with androgen deficiency may be
associated with aging, systemic illness, and a number of specific end
ocrine disorders stemming from pituitary, thyroid, and adrenal dysfunc
tion. Central hypogonadism is the main mechanism in the majority. Erec
tile dysfunction in diabetes mellitus is caused by chronic complicatio
ns due to poor metabolic control. Diagnosis and management of these di
sorders are discussed, as is the need for tight glycemic control in me
n with diabetes.