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Many herbs and dietary supplements are marketed to help sexual performance or desire. There are several special concerns for people taking alternative remedies for erectile dysfunction. Also, none of these remedies have been proven effective for treating erectile dysfunction.
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Diseases (e.g., diabetes, kidney disease, alcoholism, atherosclerosis) account for as many as 70% of chronic ED cases and psychological factors (e.g., stress, anxiety, depression) may account for 10–20% of cases. Between 35 and 50% of men with diabetes experience ED.
Monitoring erections that occur during sleep (nocturnal penile tumescence) can help distinguish between erectile dysfunction of psychological and physical causes. If nocturnal erections do not occur, then the cause of erectile dysfunction is likely to be physical rather than psychological, however, tests of nocturnal erections are not completely reliable. Scientists have not standardized the tests and have not determined in whom they should be done.
OBJECTIVE: To review the pharmacologic and clinical trial data of the Food and Drug Administration–approved phosphodiesterase 5 (PDE5) inhibitors for the treatment of erectile dysfunction (ED).
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