madman
Super Moderator
Great presentation!
I have been stressing this numerous times over the years.
ED is multifactorial and vascular issues are the most common cause.
Stop getting caught up on T, DHT, estradiol let alone the myth that one needs high FT/DHT!
T plays a small role.
What about testosterone?
* testosterone is a hormone that works all over the body and it has a small role with erections but it has a big role with libido or sex drive so it is important but the key essential components is blood flow and nervous conduction
* deep sleep is critical to testosterone production and it's critical to erectile function cause the penis literally works out while you sleep to keep itself in shape
* only about 5% or less of erectile dysfunction is caused by hormone imbalances like a testosterone deficiency, surprisingly but its true because it has a smaller role with erections
* most erectile dysfunction is caused by vascular issues so vascular is the most common cause because many men have high blood pressure, cholesterol issues, heart disease and blood flow problems or even obesity which impedes blood flow, diabetes lots of different things
Dr. Jeff Albaugh, PhD, APRN, CUCNS, Jesse Brown VA Medical Center, Chicago, Illinois, is an advanced practice urology clinical nurse specialist and certified sexuality counselor. In this 29-minute discussion, Dr. Albaugh provides a comprehensive overview of erectile dysfunction (ED), covering its anatomy, pathophysiology, evaluation, and treatment strategies.
Dr. Albaugh emphasizes that ED often serves as an early indicator of systemic vascular disease, typically preceding major cardiovascular events by three to five years. Common etiologies include diabetes, hypertension, hyperlipidemia, cardiovascular disease, obesity, metabolic syndrome, and neurologic disorders, as well as psychological factors like depression, anxiety, and PTSD. Additionally, pelvic surgeries, prostate cancer treatments, medications, and lifestyle factors contribute significantly to ED prevalence.
Evaluation requires a detailed medical, sexual, and psychosocial history, use of validated tools like the International Index of Erectile Function (IIEF), and routine hormonal assessments. Current guidelines, particularly the 2024 Princeton IV Consensus, recommend cardiovascular risk stratification for men presenting with ED, including coronary artery calcium scoring and exercise tolerance assessments.
Albaugh shares that treatment is patient-centered and begins with lifestyle modification as first-line therapy. Pharmacological options, mechanical treatments, and surgical interventions are considered.The presentation underscores the importance of holistic management, integrating medical optimization, patient education, and partner involvement to improve outcomes in sexual health and overall well-being.
I have been stressing this numerous times over the years.
ED is multifactorial and vascular issues are the most common cause.
Stop getting caught up on T, DHT, estradiol let alone the myth that one needs high FT/DHT!
T plays a small role.
What about testosterone?
* testosterone is a hormone that works all over the body and it has a small role with erections but it has a big role with libido or sex drive so it is important but the key essential components is blood flow and nervous conduction
* deep sleep is critical to testosterone production and it's critical to erectile function cause the penis literally works out while you sleep to keep itself in shape
* only about 5% or less of erectile dysfunction is caused by hormone imbalances like a testosterone deficiency, surprisingly but its true because it has a smaller role with erections
* most erectile dysfunction is caused by vascular issues so vascular is the most common cause because many men have high blood pressure, cholesterol issues, heart disease and blood flow problems or even obesity which impedes blood flow, diabetes lots of different things
Dr. Jeff Albaugh, PhD, APRN, CUCNS, Jesse Brown VA Medical Center, Chicago, Illinois, is an advanced practice urology clinical nurse specialist and certified sexuality counselor. In this 29-minute discussion, Dr. Albaugh provides a comprehensive overview of erectile dysfunction (ED), covering its anatomy, pathophysiology, evaluation, and treatment strategies.
Dr. Albaugh emphasizes that ED often serves as an early indicator of systemic vascular disease, typically preceding major cardiovascular events by three to five years. Common etiologies include diabetes, hypertension, hyperlipidemia, cardiovascular disease, obesity, metabolic syndrome, and neurologic disorders, as well as psychological factors like depression, anxiety, and PTSD. Additionally, pelvic surgeries, prostate cancer treatments, medications, and lifestyle factors contribute significantly to ED prevalence.
Evaluation requires a detailed medical, sexual, and psychosocial history, use of validated tools like the International Index of Erectile Function (IIEF), and routine hormonal assessments. Current guidelines, particularly the 2024 Princeton IV Consensus, recommend cardiovascular risk stratification for men presenting with ED, including coronary artery calcium scoring and exercise tolerance assessments.
Albaugh shares that treatment is patient-centered and begins with lifestyle modification as first-line therapy. Pharmacological options, mechanical treatments, and surgical interventions are considered.The presentation underscores the importance of holistic management, integrating medical optimization, patient education, and partner involvement to improve outcomes in sexual health and overall well-being.
