| A. |
Importance of identifying ED |
| |
Many of the risks of ED are shared with cardiovascular disease (diabetes
mellitus, hypertension, hyperlipidemia, tobacco abuse, obesity) |
| B. |
Identification of ED if desired by patients |
| |
Primary care physicians are less likely to: |
| |
Screen their patients for sexual dysfunction symptoms |
| |
Refer treatment failures for specialty evaluation |
| |
Primary care physicians must introduce the subject |
| |
Primary care physicians must use screening tools to be efficient |
| |
The SHIM is a valuable tool |
| |
Five questions; easy scoring (21 or less consistent
with ED) |
| C. |
Proper use of sildenafil needs to be taught |
| |
Need for foreplay |
| |
Need to take several hours after eating (or 1 h before) |
| |
Need to try a particular dose 5 to 8 times before claiming failure |
| |
Need to titrate up to maximum dose of 100 mg if needed |
| |
Need to recognize negative effects of alcohol, tobacco, or fatigue |
| D. |
Follow-up of both partners important |
| |
Was treatment used properly? |
| |
Were risk factors evaluated if success of treatment declines? |
| |
Was partner encouraged to return to rule out relationship issues? |
| |
Is referral of either partner to a specialty clinic warranted? |
|
| *ED indicates erectile dysfunction; SHIM, Sex Health Inventory for Men. |