Answer: Correction of any hormonal abnormality (testosterone replacement for hypogonadism after carefully determining etiology, correction of thyroid dysfunction, maximal glycemic control in diabetes, treatment of hyperprolactinemia with dopamine agonist) Treatment of any underlying systemic disorders, including depression (SSRIs can cause ED but may help to prevent premature ejaculation) Mechanical devices (rings, vacuum pump device): cumbersome [...]

Answer: The most important step is to reverse the underlying organic etiologies and discontinue any offending medications, if possible. Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.

Answer: A typical initial evaluation includes history (with particular attention to medications), physical exam, and laboratory testing to rule out endocrine abnormalities. Start by checking TSH, prolactin, and testosterone and ruling out systemic disease with urinalysis, complete chemistry panel and blood count, and HbA1c level in patients with diabetes. Carefully review the patient’s medication list [...]

Answer: Hormonal: hypogonadism (primary or secondary), hyperprolactinemia (with resultant hypogonadism), hyperthyroidism or hypothyroidism, and diabetes. Less common: adrenal insufficiency and Cushing’s syndrome. Pharmacologic: long list of implicated medications: antihypertensives (clonidine, beta blockers, vasodilators, thiazide diuretics, spironolactone); antidepressants (selective serotonin reuptake inhibitors [SSRIs], tetracyclic antidepressants), antipsychotics, anxiolytics, cimetidine, phenytoin, carbamazepine, ketoconazole, metoclopramide, digoxin. Alcohol is a [...]

Answer: ED is the inability to obtain and maintain an erection sufficient for sexual intercourse. ED is usually multifactorial in etiology, and most men have at least some psychogenic factors that contribute to the disorder (i.e., performance anxiety can exacerbate underlying organic etiology). Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, [...]

Answer:   Age: male ≥ 45 years, female ≥ 55 years Family history: coronary heart disease (CHD) in a male first-degree relative < 55 years or female first-degree relative < 65 years Current cigarette smoking Hypertension (≥ 140/90 mmHg or on antihypertensive medications) Low HDL cholesterol: < 40 mg/dL (Note: High HDL-c is a negative [...]

Answer: Current recommendations for screening and treatment are based on the National Cholesterol Education Program guidelines that were last revised in 2001. It is recommended that adults 20 years or older have a screening fasting lipid profile obtained every 5 years (more often if they are at high risk). Treatment is based on determining the [...]