Testosterone can influence sexual drive, but it is not well understood how it affects erectile function. The pituitary gland produces luteinizing hormone and prolactin. Luteinizing hormone stimulates the testicles to produce t Figure 1. Erectile Cylinders Within the Penis estosterone while prolactin blocks the effects of testosterone. A discussion of sexual health should be part of the health assessment.
Sexual health is important to overall health.
ED may signal serious underlying disease, for example, diabetes, hypertension, coronary artery disease, or peripheral vascular disease. Clinicians should pay special attention to the sensitivity of the topic and to their patients' comfort level in discussing sexual problems. The history taking is also an opportunity for the clinician to initiate patient and partner education and to facilitate communication. When evaluating for ED, during the first encounter between the physician and patient it is helpful if the partner can be present. If the partner is positive about supporting the patient's physical and emotional problems and is involved in the treatment decision, it will greatly affect the success of any interventions.