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Erectile dysfunction

Definition

Erectile dysfunction is the inability to develop and maintain an erection for satisfactory sexual intercourse or activity in the absence of an ejaculatory disorder such as premature ejaculation). Erectile dysfunction is the preferred term rather than the more commonly used term of impotence. There are no universally agreed on criteria for how consistent the problem has to be and for what duration it needs to be present to fulfill the definition. A period of persistence for longer than 3 months has been suggested as a reasonable clinical guideline.

Signs and Symptoms

Although erectile dysfunction is a common problem, many patients are reluctant to discuss it. Certainly, some patients who present with issues relating to depression or anxiety disorders may actually have a significant problem with erectile dysfunction. Additionally, patients who are poorly compliant with medication prescribed for hypertension may be experiencing significant erectile dysfunction. The best way to elicit whether the problem is present is to ask questions about sexual function as a routine part of the examination.
Some health questionnaires help screen for and evaluate erectile dysfunction and may help in the primary care setting. It is important, however, to recognize that abbreviated questionnaires may not evaluate specific areas of the sexual cycle, such as sexual desire, ejaculation, and orgasm. Nonetheless, they can be useful in helping patients discuss the problem and in signaling the need for an evaluation