Erectile dysfunction: a sentinel marker for cardiovascular disease in primary care.

Erectile dysfunction (ED) is a common, age-related disorder that diminishes quality of life for affected men and their partners. While most ED is now recognized as organic in origin, both organic and psychogenic causes often conspire to reduce sexual function in men with ED. Vasculopathy has come to be recognized as the most common cause of ED, which has elevated ED's importance in the primary care setting as a sentinel to underlying cardiovascular disease. Identification of cardiovascular risk factors should be a routine part of the evaluation for ED and is as important as taking the patient's sexual, medication, and psychosocial histories. Involving the patient's partner in evaluation and management is often valuable. Treatment with phosphodiesterase type 5 inhibitors is effective in restoring sexual function for most men with ED, but patients and their partners should be encouraged to make an informed choice from among all available treatment options.