Erectile dysfunction: they don't talk, we don't ask

Abstract

Erectile dysfunction is an under-reported complication of diabetes mellitus affecting over half of male patients [1]. Although many men with diabetes consider that erectile dysfunction has a negative influence on their quality of life, they are reluctant to report it; and while most would like treatment, they prefer physicians to start the conversation [2][3][4]. Erectile dysfunction predicts future cardiovascular disease, and screening for erectile dysfunction is advocated in several cardiovascular risk assessment algorithms [5]. Despite these facts, physicians surveyed in different cultures were found to be reluctant to broach the subject of erectile dysfunction with patients [6,7].We assessed the prevalence, causes and barriers to reporting erectile dysfunction in patients with diabetes attending routine outpatient visits at a teaching hospital in Dublin, Ireland. Men attending the clinics were invited to complete a questionnaire, and to undergo a physical examination and blood testing where indicated.Of 124 men attending during the study period, 73 (59%) were screened for erectile dysfunction, 66 completed the International Index of Erectile Function (IIEF-5) and other questionnaires, 46 agreed to a genital examination and 36 attended for blood testing [8].The majority of patients (51 of 73 screened, 70%) repor-

Frequency of Hypogonadism and Erectile Dysfunction in Type-II Diabetic Patients

“…The results of the present study also showed that with an increasing duration of diabetes mellitus, the prevalence of erectile dysfunction also increased. The same trend has been shown by earlier studies, which showed that as the duration of diabetes increased, so did the prevalence of erectile dysfunction in the population [ 14 - 16 ]. The underlying mechanism may be a severe vascular compromise in the form of atherosclerosis in the vascular corporal tissues, causing an inability to initiate, attain, and/or maintain penile erection [ 17 - 19 ].…”

“…Inquires about sexual health and its related symptoms demand a lot of empathy and rapport-building with the patients so that they can express all their hidden symptoms and concerns freely with the treating physician [ 16 ]. In a culture where sexual health is considered taboo, a lot of responsibility lies on endocrinologists to educate the patients about sexual health so that can be treated for any underlying diabetes-related underlying erectile dysfunction and hypogonadism [ 18 , 20 ].…”