Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Although often perceived as a localized condition, ED frequently reflects systemic vascular pathology.
Penile erection depends on nitric oxide-mediated vasodilation. Conditions such as hypertension, diabetes mellitus, dyslipidemia, and endothelial dysfunction compromise this mechanism. Indeed, ED may precede overt cardiovascular events by several years.
Phosphodiesterase type 5 inhibitors, such as Sildenafil, improve erectile function by enhancing nitric oxide signaling. However, comprehensive management must address underlying metabolic and vascular risk factors.
The andrologist’s role extends beyond erotic symptom treatment to preventive cardiovascular screening and lifestyle counseling.
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