What do patients expect from erectile dysfunction therapy?

Erectile insufficiency can precipitate emotional distress and a negative spiral of events and feelings. Excessive focus by the patient on the penis as the dysfunctional unit may be associated with physical and psychological problems in the female partner. With the advent of effective, well-tolerated treatments for erectile dysfunction, including the phosphodiesterase type 5 (PDE5) inhibitor sildenafil citrate, the needs and expectations of patients and their partners concerning their medications, their physicians and other factors have come into focus. In addition to the effectiveness or tolerability of a medication, a number of nonmedical outcomes may influence patients and their partners when choosing between therapeutic modalities or pharmacotherapies. These include the spontaneity and naturalness of the sexual encounter, as well as the treatment's acceptability to the sexual partner, onset/duration of action and potential interactions with food or alcohol. Patients of different ages, marital statuses or cultures may assign distinct values to each of these criteria. Couples should therefore be involved in formulating treatment plans and afforded wide latitude when initially selecting therapy and/or deciding how, or whether, to take medications. For the. physician, erectile dysfunction represents an opportunity to diagnose and treat other comorbid diseases, including hypertension, ischemic heart disease and diabetes. (C) 2002 Published by Elsevier Science B.V.