A simplified approach to the treatment of erectile dysfunction – Based on the Canadian Urology Association Erectile Dysfunction Guidelines: MAKING THE DIAGNOSIS (Part 1)

The patient’s medical history is the cornerstone of the evaluation of sexual dysfunction and ED. The patient’s history will provide the likely diagnosis in the majority of cases. There are a variety of approaches to obtaining a thorough history, the most common of which is a supportive health care professional allowing the couple to relate their concerns and express their goals of treatment in an unhurried manner.
Key components of the history are:
• Situations, onset, severity, significance of ED
• The patient’s sexual desire, relationship issues, stress at home, and stress at work
• Lifestyle factors, including smoking, and substance use and/or abuse
• Comorbid conditions, including hypertension, peripheral vascular disease, diabetes and renal disease
• Pelvic surgery or radiation
• Medications
• Psychiatric illness or conditions
• Genital pain or altered shape
Use of validated questionnaires may be of significant benefit when diagnosing ED. Questionnaires can be patient selfadministered. Their greatest utility may be in establishing a response to therapy and determining overall satisfaction with drug use over a specified length of time (eg, four weeks). The Sexual Health Inventory for Men is shown in Appendix 1. birth control pills