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Erectile dysfunction

A Canadian clinical summary of erectile dysfunction, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Canadian Urological Association guideline: Erectile dysfunction. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:CUA ED 2021

Source-attributed clinical priorities

  • Assess onset, libido, erections, relationship context, medicines, substance use, endocrine and neurologic factors and cardiovascular risk.
  • Address reversible contributors and offer a phosphodiesterase-5 inhibitor when suitable with correct-use counselling.
  • Do not combine a phosphodiesterase-5 inhibitor with nitrates and refer complex, refractory, painful or anatomically abnormal presentations.
  • Erectile dysfunction can be an early cardiovascular-risk marker and should prompt risk-factor assessment.
sources for this section:CUA ED 2021

Practical assessment and management workflow

1
Clarify onset, consistency, morning erections, libido, ejaculation, relationship context and distress.
2
Review diabetes, vascular, neurologic, endocrine, pelvic surgery, medicines and substance contributors.
3
Assess cardiovascular fitness for sexual activity and obtain targeted glucose, lipid or hormone tests.
4
Offer lifestyle and cause-directed care and teach correct use of an eligible first-line medicine.
sources for this section:CUA ED 2021

Safety, red flags and urgent escalation

  • Never combine a phosphodiesterase-5 inhibitor with nitrates or recreational nitrites.
  • New painful prolonged erection requires emergency treatment.
  • Penile curvature, mass, severe endocrine findings or treatment failure may need specialist referral.
sources for this section:CUA ED 2021

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:CUA ED 2021

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:CUA ED 2021

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Canadian Urological AssociationCanadian Urological Association guideline: Erectile dysfunctionaccessed 2026-08-20
    view source
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