The development of erectile dysfunction is associated with an underlying cause which is organic in nature. Drug induced causes of erectile dysfunction are common and can complicate the medical management of underlying conditions such as hypertension, depression, and BPH. Beta blockers, selective serotonin reuptake inhibitors (SSRIs), and the uroselective alpha adrenergic receptor antagonists have been associated with the loss of libido or ejaculatory disorders, which can result in drug discontinuation by patients and suboptimal treatment of these conditions. Despite the high prevalence of erectile disorders, identifying the presence of this condition remains challenging for the physician as patients are often reluctant to discuss this sensitive problem. Although patients may be more inclined to share these issues when the discussion is initiated by their healthcare provider. In 1998, sildenafil (Viagra) was introduced to the U.S. market which was the first FDA approved oral PDE 5 inhibitor, followed by vardenafil (Levitra) and tadalafil (Cialis) in 2003, marking a shift in the management of ED as more patients began to seek treatment with the availability of these more convenient pharmacologic options. Although several drugs have been evaluated in clinical trials to improve ejaculatory control and reduce personal distress, none of these agents are currently approved by FDA for the treatment of PE.
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