The endocrinologist as the focus in a multidisciplinary approach to management of erectile dysfunction.
OBJECTIVE
To present an approach to the complete but cost-effective office evaluation and treatment of erectile dysfunction.


METHODS
The numerous medical, hormonal, and psychologic causes of erectile dysfunction are reviewed, and the various treatment strategies are outlined.


RESULTS
Erectile dysfunction, which might also include libido and ejaculatory disturbances, is the most frequently encountered type of sexual dysfunction seen in office practice. Before 1960, the assessment of this disorder was dominated by psychiatrists; later, urologists assumed a role. More recently, physicians in internal medicine have become involved in the management of this problem. Diabetes mellitus, hypertension, and tobacco abuse are the three most common causes of erectile dysfunction in men older than 50 years of age. In addition to optimizing the management of diabetes, the endocrinologist can treat other endocrine problems associated with erectile dysfunction.


CONCLUSIONS
A multidisciplinary approach to the evaluation and treatment of erectile dysfunction is logical, and the endocrinologist--because of an extensive background in internal medicine and expertise in hormonal diagnosis and treatment--should be the focal point of this diagnostic and therapeutic team.
Guay
A T
AT
Section of Endocrinology, Lahey Hitchcock Medical Center, Burlington, Massachusetts, USA.