Cardiovascular Aspects of Sexual Medicine

Introduction. Erectile dysfunction (ED) is common and considered to be predominantly of vascular origin. Aim. To evaluate the link between ED and coronary artery disease (CAD) and provide a consensus report regarding evaluation and management. Methods. A committee of eight experts from six countries was convened to review the worldwide literature concerning ED and CAD and provide a guideline for management. Main Outcome Measure. Expert opinion was based on grading the evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Results. ED and CAD frequently coexist. Between 50-70% of men with CAD have ED. ED can arise before CAD is symptomatic with a time window of 3-5 years. ED and CAD share the same risk factors, and endothelial dysfunction is the common denominator. Treating ED in cardiac patients is safe, provided that their risks are properly evaluated. Conclusion. ED is a marker for silent CAD that needs to be excluded. Men with CAD frequently have ED that can be treated safely following guidelines. Jackson G, Montorsi P, Adams MA, Anis T, El-Sakka A, Miner M, Vlachopoulos C, and Kim E. Cardiovascular aspects of sexual medicine. J Sex Med 2010;7:1608-1626.