Erectile dysfunction

Patient with erectile dysfunction.

• • Check total Testosterone AM (does not have to be a fasting sample)

  • Prolactin and

  • PSA

    • Result: Testosterone <300 ng/mL, normal prolactin and PSA

  • Tx: with Testosterone replacement:

    • Testosterone enanthate, 200 mg IM q2 - 3 weeks, OR

    • Topicl gel (AndroGel or Testim)

    • Sildenafil, 50 - 100 mg PO, 1 hour prior to sexual activity

    • Varedenafil, 10 mg PO , 1 hour prior to sexual activity

    • Tadafil, 10 mg PO prior to sexual activity

  • C/I: with nitrates

  • Check cardiovascular status, macular edema.