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Erectile dysfunction in diabetes — SCE Endocrinology MCQ

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ModerateDiabetesErectile dysfunction in diabetesSCE Endocrinology

A 64-year-old man with diabetes and stable angina asks for treatment for erectile dysfunction. He uses sublingual glyceryl trinitrate twice a week and takes bisoprolol, atorvastatin and metformin. Blood pressure is 122/70 mmHg. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: BOffer a vacuum erection device and review cardiovascular risk

PDE5 inhibitors are contraindicated with nitrates because of hypotension risk, so a non-PDE5 option such as a vacuum device is safer while cardiovascular risk is reviewed. Testosterone is not given empirically without biochemical hypogonadism. The pearl is that erectile dysfunction may be a vascular warning sign as well as a quality-of-life issue.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal-nutritional-and-metabolic-conditions