Endocrine Abstracts

Introduction: Erectile dysfunction (ED) is highly prevalent and negatively impacts the patient’s and the partner’s quality of life. It is a well-established red flag for ongoing neuro-vascular disease and a predictor of coronary, cerebral and peripheral arterial disease (PAD). Our aim was to document how often do clinicians investigate ED and use it as a predictor of neuro-vascular pathology to trigger a thorough revision of cardiovascular risk factors (CVRF). This assessment was indirectly performed, using an original questionnaire (Qr) aiming to identify the patient’s/clinician’s awareness of ED. The Qr ascertained self-considered ED; ED approach at any hospital visit; ED presence and degree by the IIEF-5 questionnaire and investigated hypogonadism, comorbidities and life-style. The participants filled the Qr voluntarily, autonomously and anonymously.

Results: Participants (n=52) with mean age 52.5 (32–72) y.o., 65% within 40–70 y.o. range, self-reported ED in 40.6% cases. Of these, 6% said to have been questioned by their doctors about ED. The remaining 84%, though they answered they would have liked to have discussed ED in a visit, only 9% had ever had that initiative. Among all patients, only 9.6% had been interrogated by their physicians about ED. Of the patients self-reporting ED using drugs (11.5%), 5.7% did so with over the counter. Hypogonadism symptoms/signs were reported by 23% (50% self-considered to have ED) and only 6% had ever been questioned about related symptoms. Patients reporting 2 or more hypogonadism specific symptoms (n=3), had moderate ED on the IIEF-5 questionnaire. IIEF-5 assessment revealed an ED prevalence of 60%. In 44% it was moderate-severe, 89% of these patients had self-reported ED but only 1 had been ever questioned about it and only 2 had ever had the initiative to mention it. Obesity, hypertension, dyslipidaemia, inactivity, smoking, alcohol consumption, stroke, AMI and PAD were more prevalent in the group with ED (IIEF-5), but not in the group who considered to suffer from ED.

Conclusions: The prevalence of ED was significant. Most clinicians didn’t actively seek ED and most patients didn’t inform their doctors about their problem. Self-reported ED validated by the IIEF-5 questionnaire was useful in the identification of patients with CVRF and established cardiovascular disease. The identification and treatment of ED impact positively not only quality of life but also cardiovascular mortality: an underestimated chance for intervention that shouldn’t be missed.