title: Erectile dysfunction and its association with metabolic syndrome and endothelial function among patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  Evidence suggests that numerous comorbid conditions contribute to erectile dysfunction (ED) among patients with type 2 diabetes mellitus (T2DM).
  
  
  OBJECTIVE
  To review the relationship and mechanism between diabetes, metabolic syndrome, cardiovascular disease (CVD), and ED.
  
  
  METHODS
  A manual review of authoritative literature from peer-reviewed publications from January 2001 through July 2010 was performed. These publications were further mined to consider the impact of metabolic syndrome as a comorbid condition. Publications from key references were also consulted.
  
  
  RESULTS
  The associations between obesity, dyslipidemia, metabolic syndrome, T2DM, CVD, and depression with sexual dysfunction suggest that sexual dysfunction, particularly ED, is a precursor to CVD. Because these conditions share important risk factors with CVD, identifying them and their relationships with the pathogenesis of ED is likely to be critical to the manner in which primary care physicians screen for and manage this condition.
  
  
  CONCLUSIONS
  Primary care physicians ought to establish trusting relationships with their patients, providing opportunities for them to probe such sensitive issues as sexual activities, as a means of addressing the possibility of ED. When making the new diagnosis of sexual dysfunction in the absence of metabolic disease or CVD, physicians ought to consider the risk for T2DM and CVD. Associations between metabolic disease, heart disease, and sexual dysfunction further suggest that all patients who are obese and have dyslipidemia, T2DM, and/or depression should be further screened for ED.
authors.affiliation: Division of Primary Care/Health Services Research and Development, Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, FL, USA. JGRyan@med.miami.edu
authors.forename: John G
authors.initials: JG
authors.lastname: Ryan
authors.forename: Jason
authors.initials: J
authors.lastname: Gajraj
mesh_terms: D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000523:psychology; D007006:Hypogonadism / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D015431:Weight Loss
chemical_list: D058986:Phosphodiesterase 5 Inhibitors