The penis as a barometer of endothelial health.

Erectile dysfunction (ED) has only within the past 25 years been recognized as being largely organic in cause. The introduction of phosphodiesterase-5 inhibitor therapy represents a major breakthrough in the treatment of ED and has resulted in a fast-growing body of knowledge regarding the etiology of the disorder, including its close association with cardiovascular disease. ED symptoms are often an early manifestation of endothelial dysfunction and, as such, should prompt further evaluation of not only the sexual dysfunction but also cardiovascular risk. This article discusses the importance of recognizing ED as much more than a quality-of-life issue.