Counseling the patient with erectile dysfunction: a primary care physician perspective

Primary care physicians might be tempted to avoid addressing the topic of erectile dysfunction because they mistakenly believe that hectic work schedules, unforeseen reimbursement issues, or complexity of disease management preclude effectively dealing with this important disorder. Yet, it is eminently possible to complete a targeted history and physical examination within the constraints of the typical ambulatory visit. The pertinent typical medical, sexual, and psychosocial history should take about 4 to 6 minutes, and a physical examination can be done in approximately 2 to 4 minutes. Whenever feasible, partner input can be a highly valuable asset for correctly diagnosing erectile dysfunction and treating the patient. Inclusion of the partner can provide additional information, identify obstacles to success, and ensure partner readiness for resumption of coital activity. In addition, evaluation tools such as the Sexual Health Inventory for Men can be highly effective in initiating discussion on an uncomfortable subject.