Continuing professional development: In order to be able to provide a high’quality service to men and couples affected by ED, it is essential to maintain the appropriate knowledge and skills. This task should be approached in a holistic manner; to provide high’quality care, the physician needs to have a wide range of resources in sexology, urology, gynecology, and internal medicine.
While factual knowledge can be obtained from reading and personal study, skill acquisition is more difficult. Many doctors will find talking about sexual issues uncomfortable and struggle for appropriate language that is intelligible to clients without being too simplistic or too crude. Read the rest of this entry »

Individuals and couples will have their own preference for a particular therapy, as it may suit their own sexual lifestyle. The majority of men will select a PDE5 inhibitor as their first treat’ ment of choice. Although the three currently available drugs in this class share a common mode of action, there are subtle pharmacO’ kinetic differences among them that may be of importance to the couple that is unrecognized by the physician. Read the rest of this entry »

Taking a sexual history presents different challenges to the physician, not least because most physicians have had little or no training or experience in doing so. Many people, both lay and professional, find talking about sex uncomfortable to a greater or lesser degree. Many people, again both lay and professional, have their own beliefs, rooted in the culture and religion of their upbringing, about what is acceptable sexual behavior and what is not. The ability to talk freely about sexual behavior and lifestyles is a skill that must be acquired if the physician is to help people with sexual problems. If, for whatever reason, they find themselves unable to do this, it is better that they acknovsledge the fact and promptly refer people with sexual problems to a colleague. Read the rest of this entry »

ED is frequently described by its presumed etiology; for example, ‘vasculogenic’, ‘diabetogenic’, and’psychogenic’. Thesedescrip’ tions can be very misleading and it is better always to think of ED as a health problem with multifactorial etiology. This is illustrated in the following two examples.
Originally, psychological factors were considered to be the most common cause of ED. However, it is now apparent that psychological factors alone account for a minority of cases of ED, particularly in older men. It is far more common for psychological and organic factors to co-exist. Read the rest of this entry »

Intimate relationships are central to the hmnan experience. We are, by nature, social creatures and, aside from a small minority of ascetics and hermits, we need each other’s company. Without the ability to share intimate relationships, most of us will become isolated, lonely, anxious, and depressed.
Most people would not consider their life complete without sharing intimate relationships. Sexuality and sexual behavior are very important within the vast majority of those relationships. The frequency of sexual feelings and behavior usually varies during the course of a relationship. Early on in a relationship, sex is relatively frequent, irrespective of whether the partners are young or old. This is may be a major concern for older men, in their 60s and 70s, when they begin a new relationship. Read the rest of this entry »