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Author Topic: Erectile dysfunction in young people  (Read 90 times)
drgomez89 (OP)
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January 01, 2020, 04:06:51 AM
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Im Drgomez89 Im internal medicine Specialist and i have been receiving more young patients with erectile dysfunction.

I wanted to share real medical information with their respective sources. Maybe it can help someone with this everyday more common problem.


  • Erectile dysfunction (ED) is defined as a consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction.
McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT
J Sex Med. 2016 Feb; 13(2):135-43.


  • In a recent study conducted in a Urology Clinic, it has been observed that one out of four men seeking medical care for ED was younger than 40 years
Capogrosso P, Colicchia M, Ventimiglia E, Castagna G, Clementi MC, Suardi N, Castiglione F, Briganti A, Cantiello F, Damiano R, Montorsi F, Salonia A
J Sex Med. 2013 Jul; 10(7):1833-41.


  • ED has been for long time considered a problem mainly related to psychological conditions and distress. Accordingly, until phosphodiesterase type 5 inhibitors (PDE5i) were introduced, psychoanalysis and cognitive-behavioural therapy were the only option for ED
  • In the last few decades, ED has been recognized as a clinical consequence of several different organic diseases and the importance of vascular health in erectile function has been so emphasized that ED is now considered not only the result of vascular impairment, but also a harbinger of forthcoming cardiovascular (CV) events
Corona G, Monami M, Boddi V, Cameron-Smith M, Lotti F, de Vita G, Melani C, Balzi D, Sforza A, Forti G, Mannucci E, Maggi M
J Sex Med. 2010 May; 7(5):1918-27.


The Sexual Medicine and Andrology Unit of the University of Florence for sexual dysfunction, the first tertile of age (n=1,873 subjects) represents younger subjects (18–44 years) And the most common cause of erectyle dysfunction ing young patients are Organic pathologies (not psycological causes)

Corona G, Ricca V, Bandini E, Rastrelli G, Casale H, Jannini EA, Sforza A, Forti G, Mannucci E, Maggi M
J Sex Med. 2012 Aug; 9( 8 ):2017-26.

Erectile Dysfunction AS Cardiovascular RISK
  • Young patients are often reassured without any further medical investigations, including physical exam. However, organic disorders, as well as relational and psychological or psychiatric conditions, can be meaningful in determining ED in younger men
  • according to Montorsi’s hypothesis , impairment of penile artery blood flow occurs before that of coronary or carotid arteries, whose diameter is greater and needs longer time to acquire a clinically relevant damage. The clinical consequence of this pathological event is that ED often manifests earlier than myocardial infarction or stroke. In particular, it has been demonstrated that ED occurs on average three years before the first major adverse CV event (MACE)
Montorsi P, Ravagnani PM, Galli S, Rotatori F, Veglia F, Briganti A, Salonia A, Dehò F, Rigatti P, Montorsi F, Fiorentini C
Eur Heart J. 2006 Nov; 27(22):2632-9.

Endocrine Causes or erectile Dysfunction

  • This is the case of adrenal insufficiency, whose treatment with glucocorticoid and mineralocorticoid replacement is able to improve erectile function

Granata A, Tirabassi G, Pugni V, Arnaldi G, Boscaro M, Carani C, Balercia G
J Sex Med. 2013 Aug; 10(Cool:2036-43.


  • An adequate control of thyroid function in hyper- and hypothyroid patients is associated with an improvement in ED

Carani C, Isidori AM, Granata A, Carosa E, Maggi M, Lenzi A, Jannini EA
J Clin Endocrinol Metab. 2005 Dec; 90(12):6472-9.

  • testosterone (T) deficiency is frequently found in subjects with ED

Maseroli E, Corona G, Rastrelli G, Lotti F, Cipriani S, Forti G, Mannucci E, Maggi M
J Sex Med. 2015 Apr; 12(4):956-65.


INTRAPSYCHIC Causes
  • ED, depression is significantly associated with a greater severity of the impairment in erectile function

Corona G, Ricca V, Bandini E, Mannucci E, Petrone L, Fisher AD, Lotti F, Balercia G, Faravelli C, Forti G, Maggi M
J Sex Med. 2008 Feb; 5(2):458-68.

  • However, the relationship seems to be bidirectional, as also ED has been associated with the occurrence of depression . In addition, treatment with PDE5i is related with an improvement in depressive symptoms
McCabe MP, Althof SE
J Sex Med. 2014 Feb; 11(2):347-63

[/list]

In fact, young men reporting ED risk being dismissed without any specific medical assessment, including medical history or physical exam, owing to the assumption that ED in younger is a self-limiting condition, without any clinical consequence.

IF you have any question you can DM

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