madman
Super Moderator
CONCLUSION
ED has historically been referred to as a condition of older men; however, recent epidemiologic studies have shown that ED prevalence is significant in younger men, too. Recent studies have demonstrated that the prevalence of ED in this population might be underestimated due to under-reporting and could be as high as 30%. This suggests that ED is becoming increasingly more common in younger men and that clinicians need to expand their awareness and screening for ED in this specific population.
Although previously hypothesized to be almost exclusively psychogenic in nature, ED in young men is currently recognized to have a number of organic risk factors. Vasculogenic and structural changes such as focal arterial occlusive disease, subclinical endothelial dysfunction, and PD can contribute to ED by impeding arterial flow or causing veno-occlusive dysfunction. The complexity of this disorder also calls for vigilant screening and counseling for men engaging in at-risk activities for ED, such as prolonged cycling. When screening for ED, physicians need to consider endocrinologic risk factors such as diabetes, thyroid disease, excessive soy consumption, and KS. This is especially important with the increasing incidence of obesity and diabetes within the younger population. Further investigation on the role of soy products and ED in younger men is warranted. In addition, neurogenic risk factors such as MS, epilepsy, intramedullary nailing of femoral fractures, and lumbar spine procedures should be taken into consideration in screening and counseling patients with ED. Young men should be made aware of these contributors to ED before undergoing such procedures. Moreover, physicians should warn young men that ED might be precipitated as an adverse effect of taking certain medications. It is important to note that the most prevalent risk factors for ED among young men are psychogenic in nature. It is essential to address the intrapsychic and relational risk factors in screening and treating young men with ED. The bidirectional relation between ED and psychogenic risk factors also is noteworthy, and suggests more involvement of PDE5 inhibitors and cognitive behavioral therapy in treating ED and psychogenic risk factors such as depression and relational conflicts.
For treatment of ED in young men, oral PDE5 inhibitors such as sildenafil, tadalafil, vardenafil, and avanafil remain first-line used oral agents and have very good success rates due to proven efficacy, good tolerability, and ease of administration. However, there is a growing interest in developing therapies to cure ED in young men, because oral PDE5 inhibitors provide only short-term symptomatic relief. Therapies such as ICI, penile revascularization, inflatable penile prosthesis, hormonal supplementation, and SC therapies are being more widely investigated and used in the treatment of ED in young men. This article summarizes the prevalence and risk factors of ED in young men and highlights psychogenic and organic risk factors that must be taken into consideration by physicians when
working up or screening for ED in this specific population.
ED has historically been referred to as a condition of older men; however, recent epidemiologic studies have shown that ED prevalence is significant in younger men, too. Recent studies have demonstrated that the prevalence of ED in this population might be underestimated due to under-reporting and could be as high as 30%. This suggests that ED is becoming increasingly more common in younger men and that clinicians need to expand their awareness and screening for ED in this specific population.
Although previously hypothesized to be almost exclusively psychogenic in nature, ED in young men is currently recognized to have a number of organic risk factors. Vasculogenic and structural changes such as focal arterial occlusive disease, subclinical endothelial dysfunction, and PD can contribute to ED by impeding arterial flow or causing veno-occlusive dysfunction. The complexity of this disorder also calls for vigilant screening and counseling for men engaging in at-risk activities for ED, such as prolonged cycling. When screening for ED, physicians need to consider endocrinologic risk factors such as diabetes, thyroid disease, excessive soy consumption, and KS. This is especially important with the increasing incidence of obesity and diabetes within the younger population. Further investigation on the role of soy products and ED in younger men is warranted. In addition, neurogenic risk factors such as MS, epilepsy, intramedullary nailing of femoral fractures, and lumbar spine procedures should be taken into consideration in screening and counseling patients with ED. Young men should be made aware of these contributors to ED before undergoing such procedures. Moreover, physicians should warn young men that ED might be precipitated as an adverse effect of taking certain medications. It is important to note that the most prevalent risk factors for ED among young men are psychogenic in nature. It is essential to address the intrapsychic and relational risk factors in screening and treating young men with ED. The bidirectional relation between ED and psychogenic risk factors also is noteworthy, and suggests more involvement of PDE5 inhibitors and cognitive behavioral therapy in treating ED and psychogenic risk factors such as depression and relational conflicts.
For treatment of ED in young men, oral PDE5 inhibitors such as sildenafil, tadalafil, vardenafil, and avanafil remain first-line used oral agents and have very good success rates due to proven efficacy, good tolerability, and ease of administration. However, there is a growing interest in developing therapies to cure ED in young men, because oral PDE5 inhibitors provide only short-term symptomatic relief. Therapies such as ICI, penile revascularization, inflatable penile prosthesis, hormonal supplementation, and SC therapies are being more widely investigated and used in the treatment of ED in young men. This article summarizes the prevalence and risk factors of ED in young men and highlights psychogenic and organic risk factors that must be taken into consideration by physicians when
working up or screening for ED in this specific population.
