title: Male erectile dysfunction: integrating psychopharmacology and psychotherapy.
abstract: OBJECTIVE
  Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease. Risk factors for development of ED include advancing age, tobacco use, a history of pelvic irradiation or surgery and antipsychotic use (Table 1) [1]. Treatment guidelines continue to evolve for optimal management of ED. In this article, we review diagnostic and treatment strategies for ED relevant to psychiatrists.
  
  
  METHODS
  We present an integrative approach to the treatment of ED based on a review of the urologic and psychiatric literature.
  
  
  RESULTS
  ED is multifactorial in origin and responsive to a variety of therapeutic interventions, including psychopharmacology and psychotherapy in which cognitive underpinnings of poor sexual performance, including diminished self-esteem, lack of confidence and perceived failures in the male role, are examined.
  
  
  CONCLUSIONS
  Psychiatrists can readily perform a basic workup for ED as they integrate both a medical and therapeutic model when confronted with such patients.
authors.affiliation: The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC 20037, USA. eugenesi@gwu.edu
authors.forename: Eugene F
authors.initials: EF
authors.lastname: Simopoulos
authors.forename: Anton C
authors.initials: AC
authors.lastname: Trinidad
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D003863:Depression / Q000523:psychology; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D011613:Psychotherapy / Q000379:methods*; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology / Q000628:therapy*
chemical_list: D000928:Antidepressive Agents; D058986:Phosphodiesterase 5 Inhibitors