Erectile
Dysfunction: |
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An affirmative reply is permission to discuss. If the reply is 'No' when in fact he is concerned,
there remains an invitation for him to return. A patient coming in for a repeat prescription
provides an opportunity to discuss possible side effects: 'It is not uncommon that treatment may
also cause difficulty with sexual activity; have you any concerns about this?'
Opportunities are endless as to how the GP may ask about sexual concerns in a nonthreatening way.
Patients are often very relieved and, not infrequently, the atmosphere of trust reaches a new
level. The patient may return to discuss other related and non-related personal concerns in his life. When a patient's presenting complaint is one of a loss of interest in sexual activity, this may be secondary to organic or psychological ED. However, it is important to exclude hypogonadism (testosterone deficiency). Conway et al. (7) give a clear guide as to what constitutes androgen deficiency. It affects approximately one in 200 men and while these men may present with ED, on careful history taking, they actually lack libido (desire) rather than having ED. Not uncommonly, it is the partner who suggests seeking medical opinion. |
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