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 to some patients, but side effects are minimal
• Surgical interventions: typically used as a last resort; options include revascularization, removal of venous shunts, and penile implants
• Supportive counseling

Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, W.B. Saunders, 2003.

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