ERECTILE DYSFUNCTION - ARE YOU PREPARED TO DISCUSS IT

Erectile dysfunction is more common than previously thought in men old er than 40 years, perhaps because contributing medical risk factors in crease with age. The medical history is of prime importance in outlini ng these factors, the most common of which are diabetes, hypertension, and smoking. Nocturnal penile tumescence and rigidity testing with a portable home monitoring may be helpful in determining whether the cau se of erectile dysfunction is primarily organic or psychological. Spec ific therapeutic measures include sex therapy, psychotherapy, treatmen t for alcohol or tobacco dependency, replacement of offending medicati ons, improved glycemic control, constriction rings, vascular surgery, androgen replacement therapy, bromocriptine mesylate (Parlodel), and t hyroid, adrenal, or pituitary replacement therapy. Nonspecific therapi es include yohimbine hydrochloride (Yocon), use of vacuum tumescence d evices, intracorporeal injections, and penile implants.