Author Affiliation: Dr Morgentaler is Director, Men's Health Boston, and Associate Clinical Professor of Surgery (Urology), Harvard Medical School, Boston, Mass.
Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.
DR BURNS: Mr G is a 66-year-old man with a
history of hypertension and sleep apnea. He lives in a suburb of Boston with
his wife and has commercial indemnity insurance.
Mr G first developed erectile dysfunction (ED) several years ago. Four
months ago when he saw his primary care physician for a routine checkup, he
asked about using sildenafil (Viagra). He noted decreased libido and difficulty
attaining an erection. He had slight urinary urgency, but no difficulty initiating
urination. He had no history of diabetes or cardiovascular disease. In the
past, he had used a dental device to treat his sleep apnea but was no longer
using one. His other past medical history was a colonic adenoma found on a
screening colonoscopy in 2001. His medications were aspirin (81 mg daily),
hydrochlorothiazide (12.5 mg daily), and ibuprofen (600 mg 4 times a day as
needed). His wife had metastatic breast cancer and was doing well with maintenance
therapy. He was working part-time and noted considerable stress due to a home
Morgentaler A. A 66-Year-Old Man With Sexual Dysfunction. JAMA. 2004;291(24):2994-3003. doi:10.1001/jama.291.24.2994