title: Erectile dysfunction diagnosis and treatment as a means to improve medication adherence and optimize comorbidity management.
abstract: BACKGROUND
  Optimal pharmacologic management of diseases comorbid with erectile dysfunction (ED), such as cardiovascular disease, depression, diabetes, dyslipidemia, hypertension, and benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS), is dependent upon long-term treatment compliance and may be complicated by poor adherence to medication use. ED may contribute to poor adherence to medication use because poor quality erectile function may be an unwanted adverse effect of antihypertensives, antidepressants, and 5-α reductase inhibitors for treatment of BPH/LUTS. Diminished erectile spontaneity, rigidity, and/or sustaining capability also negatively affects mood, self-esteem, and confidence, which compromise motivation to be compliant with medications that treat diseases comorbid with ED.
  
  
  OBJECTIVE
  Literature review was performed to explore the role of ED diagnosis and effective treatment in enhancing overall management of selected ED comorbidities, highlighting the role of medication adherence.
  
  
  METHODS
  Several PubMed searches were performed.
  
  
  RESULTS
  Diagnosis and successful treatment of concomitant ED may promote improved adherence and management of comorbid diseases. Concomitant ED management may improve treatment outcome, decrease healthcare costs, and possibly prevent or even improve deterioration in medical conditions comorbid with ED. Because ED is a silent marker and predictor of comorbidities, especially cardiovascular disease, earlier diagnosis of ED may provide an opportunity to prevent future cardiovascular events. In men presenting with complaints of ED, screening for, monitoring, and appropriately treating diseases that are comorbid with ED is essential. Screening for and appropriately treating ED is important for enhanced life quality and improved motivation in men with existing ED comorbidities or risk factors.
  
  
  CONCLUSIONS
  Appropriate management of ED and its risk factors may have beneficial effects on diseases that are comorbid with ED, and vice versa, most likely via shared pathophysiological pathways. Clinicians may need to consider men's health overall, of which sexual health is a central component, in order to provide optimal disease management.
authors.affiliation: Clinical Scientist Consulting, Framingham, MA 01701, USA. richardscrantonmd@gmail.com
authors.forename: Richard E
authors.initials: RE
authors.lastname: Scranton
authors.forename: Irwin
authors.initials: I
authors.lastname: Goldstein
authors.forename: Vera J
authors.initials: VJ
authors.lastname: Stecher
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000009:adverse effects; D000339:Affect / Q000187:drug effects; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D002243:Carbolines / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008134:Long-Term Care; D008297:Male; D055118:Medication Adherence; D058986:Phosphodiesterase 5 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011687:Purines / Q000009:adverse effects / Q000627:therapeutic use; D012649:Self Concept; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000009:adverse effects / Q000627:therapeutic use*; D000068581:Tadalafil; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use; D000069058:Vardenafil Dihydrochloride
chemical_list: D058891:5-alpha Reductase Inhibitors; D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D002243:Carbolines; D007093:Imidazoles; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride; D000068581:Tadalafil; D000068677:Sildenafil Citrate