Erectile dysfunction: The perspectives of patients and partners on counselling

Jc, Lee; Surridge, DHC

doi:10.4172/1488-5069.1000023

Cited by 3 publications

(3 citation statements)

References 13 publications

(9 reference statements)

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“…In one example, Lee et al (1) examined the attitudes of patients and their partners toward joint sessions and psychological counselling as a means of treating ED. After an initial consultation (conducted at the Human Sexuality Clinic, Kingston, Ontario, 100 consecutive patients were asked to return with their partners.…”

Section: Does the Partner Need To Be Involved In The Ed Treatment Plan?mentioning

confidence: 99%

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction

Casey¹

2003

J Sex Reprod Med

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Section: Does the Partner Need To Be Involved In The Ed Treatment Plan?mentioning

confidence: 99%

Opinion piece: Myths surrounding the investigation and treatment of erectile dysfunction

Casey¹

2003

J Sex Reprod Med

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“…Unfortunately, testosterone has traditionally been associated with sexual performance and is a frequent request of patients pursuing improvements in their sexual health. The success of testosterone therapy in men with reduced libido is variable and dependant on an appropriate initial diagnosis (10). The effort necessary to sort out the other psychosocial and lifestyle issues to insure a proper diagnosis is not one physicians readily accept.…”

mentioning

confidence: 99%

“…The effort necessary to sort out the other psychosocial and lifestyle issues to insure a proper diagnosis is not one physicians readily accept. ED patients are even more resistant to counseling and lifestyle modifications (10). It is likely that the same pattern will be seen in the andropausal patient.…”

mentioning

confidence: 99%

Testosterone replacement therapy

Casey¹

2003

J Sex Reprod Med

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CURRENT OPINIONT he recent introduction of a variety of novel preparations have stimulated the medical community to consider their application in a subpopulation of aging males.Androgen deficiency in the aging male (ADAM) or andropause is purported to be a common condition in men over 40, characterized by a constellation of symptoms including increased mental irritability, decreased muscle strength and libido, and vasomotor manifestations loosely correlated with falling testosterone levels. In addition, the accompanying effects of this hypogonadal state include osteopenia and possibly increased cardiac morbidity (1).If we use current acceptable testosterone ranges, 7% of men aged 40 to 50 years, 20% aged 60 to 80 years and 35% of men over 80 years of age would have below-normal serum testosterone (2). Not all of these men will exhibit the ADAM symptom complex, although few men over the age of 40 years will not admit to decrease in sexual appetite and energy levels, contributing to the difficulty in establishing a proper diagnosis. (3) Without significant scientific evidence to support this therapeutic intervention, physicians have been asked to consider treating these men with testosterone. In addition to declining testosterone levels with age, many other factors such as a decrease in adrenal hormones (dehydroepiandrosterone sulfate) and growth hormone as well as a decrease in physical activity, are thought to play a role in these age-related changes (4).Little is known about the outcome of longterm treatment of older men with testosterone. In elderly hypogonadal men, testosterone administration positively affects biochemical markers of muscle and bone metabolism and can increase lumbar spinal bone density (5). We do not have clear evidence that this translates to a reduction in age-related falls and fractures. At the present time, there are good therapeutic interventions supported by prospective well-controlled trials that can increase bone density to the same degree as testosterone administration without the need for daily drug administration. (5).The relationship between testosterone and libido is strong but inconsistent. Despite the significant difference in bioavailable testosterone levels in older men, complaints of decreased libido are rare; the most common sexual complaint being erectile dysfunction (ED). Depression is the most common clinical condition producing decreased libido in all ages (6). Depressed men with significantly reduced testosterone levels may benefit from addition of testosterone to antidepressant therapy, but again the results are variable and scientific support scarce.

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