Men's Health Quiz

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Which statement best defines erectile dysfunction?

A A single episode of being unable to maintain an erection during intercourse
B Inability to achieve an erection on the first attempt but success on later attempts
C Occasional inability to achieve an erection when tired or after drinking alcohol
D Persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity ✓
E Loss of early morning erections with normal erections during intercourse

The answer is D: Persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity

Explanation

Why D is correct

See Risk Factors Contributing to Morbidity and Mortality in Men. Option D is correct because erectile dysfunction is the persistent inability to attain and maintain an erection sufficient for satisfactory sexual activity. It is a symptom rather than a disease, and a man may have a physical cause, a psychological cause or, most commonly, a mixture. Physical causes include vascular disease (hypertension, diabetes, smoking and obesity), nerve problems and low testosterone, and psychological causes include stress, anxiety and depression. The definition is about the erection itself, so it is separate from sexual desire (libido), ejaculation, orgasm and fertility, which a doctor asks about separately when taking a history. It matters because erectile dysfunction can be an early sign of cardiovascular disease, so a man with the symptom needs his cardiovascular risk factors reviewed as well. It can also affect confidence and relationships.

Definition: persistent inability to attain and maintain an erection sufficient for satisfactory sexual activity.
Causes: physical, psychological or most commonly a mixture of the two.
Separate problems: sexual desire, ejaculation, orgasm and fertility are asked about separately.
Warning sign: it can be an early sign of cardiovascular disease.

Why the other options are incorrect

A. A single episode of being unable to maintain an erection during intercourse: Erectile dysfunction is defined as a persistent inability, not a single episode. One failed attempt does not meet the definition of erectile dysfunction.
B. Inability to achieve an erection on the first attempt but success on later attempts: Erectile dysfunction is a persistent inability sufficient for satisfactory sexual activity. Difficulty on the first attempt with later success is not persistent enough to be erectile dysfunction.
C. Occasional inability to achieve an erection when tired or after drinking alcohol: Erectile dysfunction requires a persistent problem, not an occasional one. Temporary difficulty when tired or after drinking alcohol does not meet the definition of erectile dysfunction.
E. Loss of early morning erections with normal erections during intercourse: Loss of early morning erections while erections during intercourse are normal does not mean the man cannot achieve an erection sufficient for satisfactory sexual activity. It does not match the definition of erectile dysfunction.

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1
Which factor is a major explanation for differences in illness burden and mortality among men living in different regions of the UK?
2
A 52-year-old man presents to his GP with a six-month history of erectile dysfunction. He has hypertension that is well controlled and drinks alcohol socially. After addressing lifestyle factors, an oral medication is considered as first-line pharmacological management. Which mechanism best explains how sildenafil improves erectile function?

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