When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra). The physician should also check the patient’s testosterone level. If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra). Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Testosterone modulates desire, arousal and orgasmic function. Little attention has been paid to endocrine factors.
Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors.
The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction.
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