Cardiovascular aspects of sexual medicine.

Introduction: Erectile dysfunction (ED) is common and considered to be predominantly of vascular origin.
Aim: To evaluate the link between ED and coronary artery disease (CAD) and provide a consensus report regarding evaluation and management.
Methods: A committee of eight experts from six countries was convened to review the worldwide literature concerning ED and CAD and provide a guideline for management.
Main Outcome Measure: Expert opinion was based on grading the evidence-based medical literature, widespread internal committee discussion, public presentation, and debate.
Results: ED and CAD frequently coexist. Between 50-70% of men with CAD have ED. ED can arise before CAD is symptomatic with a time window of 3-5 years. ED and CAD share the same risk factors, and endothelial dysfunction is the common denominator. Treating ED in cardiac patients is safe, provided that their risks are properly evaluated.
Conclusion: ED is a marker for silent CAD that needs to be excluded. Men with CAD frequently have ED that can be treated safely following guidelines.