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Clinical Crossroads
Clinician's Corner
June 23/30, 2004

A 66-Year-Old Man With Sexual Dysfunction

Author Affiliations

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.

JAMA. 2004;291(24):2994-3003. doi:10.1001/jama.291.24.2994

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 renovation project.

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