Organic Causes of Erectile Dysfunction in Men Under 40

    November 2013 in “ Urologia Internationalis
    Wesley Ludwig, Michael Phillips
    TLDR Many men under 40 with erectile dysfunction have organic causes like vascular issues, medication side effects, or hormonal problems.
    The document discussed that a significant number of men under 40 experienced erectile dysfunction (ED), with studies identifying organic causes in 15-72% of cases. These causes included vascular issues, neurogenic factors, Peyronie's disease, medication side effects, and endocrinologic sources. Vascular causes were often due to focal arterial occlusive disease, while conditions like multiple sclerosis, epilepsy, and spinal cord trauma increased ED risk. Medications such as antidepressants, NSAIDs, finasteride, antiepileptics, and neuroleptics were also implicated. Although hormonal causes were rare, they included conditions like Klinefelter's syndrome and hypogonadotropic hypogonadism. The evaluation of young men with ED should involve a detailed history and physical examination, with consideration of nocturnal penile tumescence testing and penile Doppler ultrasound. Treatment options included exercise and oral PDE-5 inhibitors.
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