ED Flashcards
How and when should screening be done for ED?
Also? What test should be run?
Often neglected.
Screen upon diagnosis and regularly.
Use validated questionnaires
Investigate hypogonadism
Is daily PDE5 effective for men with D?
Yes! Can also help with urinary symptoms and have less ADRS that prn use.
What should you do if a man does not respond to PDE5?
Refer to specialist in ED. Second line therapies may be considered.
Vacume
Intracorporal inj etc.
Ejaculatory dysfunction may happen in what percentage of men?
32-67%
Retrograde ejaculation occurs when the ejaculate moves into the bladder and is usually secondary to AUTONOMIC neuropathy causing incomplete closure of the bladder neck during ejaculation.
What % men with D are affected by ED?
What percentage have ED at diagnosis?
34-45%
Up to 1/3 at diagnosis of D!!
ED is correlated to the extent of CAD. It is a predictor of:
All cause death
CV death, MI, stroke and HF.
ED occurs this many more years earlier in men with D as men without?
5-8 years earlier
Is ED more common in Type 1 or type 2?
There is insufficient data to determine this.
Is retinopathy a risk factor for ED?
Yes
are t1dm more susceptible to acquiring sexually transmitted infections?
NO
Do women w t1 or t2 report sexual dysfunction?
- one trial of 127 women demonstrated female sexual dysfunction was very common in women with type 1 diabetes (71%) compared to control subjects (37%)
- many women with t1dm have sexual desire, arousal and lubrication issues
- causes of female sexual dysfunction in patients with diabetes include vascular changes, psychosexual problems and neuropathy
Autonomic neuropathy can cause what form of ED?
Retrograde ejaculation
Is hypogonadism
More
Common in men with D?
Yes. Prevalence of 40-60%
What time of day should testosterone levels be measured?
Before 11am or within 3 hours of waking
