Amir Qaseem, MD, PhD, MHA; Vincenza Snow, MD; Thomas D. Denberg, MD, PhD; Donald E. Casey Jr., MD, MPH, MBA; Mary Ann Forciea, MD; Douglas K. Owens, MD, MS; Paul Shekelle, MD, PhD; for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians *
Note: Clinical practice guidelines are “guides” only and may not apply to all patients and all clinical situations. Thus, they are not intended to override clinicians' judgment. All ACP clinical practice guidelines are considered automatically withdrawn or invalid 5 years after publication, or once an update has been issued.
Disclaimer: The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Grant Support: Financial support for the development of this guideline comes exclusively from the American College of Physicians' operating budget.
Potential Conflicts of Interest:Grants received: V. Snow (Bristol-Myers Squibb, Centers for Disease Control and Prevention, Novo Nordisk, Merck Vaccines, Boehringer Ingelheim, Wyeth, Sanofi Pasteur), P. Shekelle (Pfizer). Royalties: P. Shekelle (Up-to-Date). Any financial and nonfinancial conflict of interest of the group members were declared, discussed, and resolved.
Requests for Single Reprints: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Qaseem and Snow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Denberg: 12631 East 17th Avenue, B180, Academic Office 1, Aurora, CO 80045.
Dr. Casey: 475 South Street, PO Box 1905, Morristown, NJ 07962.
Dr. Forciea: 3615 Chestnut Street, Philadelphia, PA 19104.
Dr. Owens: 117 Encina Commons, Stanford, CA 94305.
Dr. Shekelle: 1776 Main Street, Santa Monica, CA 90401.
Author Contributions: Conception and design: A. Qaseem, V. Snow, D.E. Casey Jr., D.K. Owens.
Analysis and interpretation of the data: A. Qaseem, D.E. Casey Jr., M.A. Forciea, D.K. Owens.
Drafting of the article: A. Qaseem, V. Snow, T.D. Denberg, D.E. Casey Jr., M.A. Forciea, D.K. Owens.
Critical revision of the article for important intellectual content: A. Qaseem, V. Snow, T.D. Denberg, D.E. Casey Jr., M.A. Forciea, D.K. Owens, P. Shekelle.
Final approval of the article: A. Qaseem, V. Snow, T.D. Denberg, D.E. Casey Jr., M.A. Forciea, D.K. Owens, P. Shekelle.
Statistical expertise: A. Qaseem.
Administrative, technical, or logistic support: A. Qaseem.
Collection and assembly of data: A. Qaseem.
The American College of Physicians developed this guideline to present the available evidence on hormonal testing in and pharmacologic management of erectile dysfunction. Current pharmacologic therapies include phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil, and hormonal treatment.
Published literature on this topic was identified by using MEDLINE (1966 to May 2007), EMBASE (1980 to week 22 of 2007), Cochrane Central Register of Controlled Trials (second quarter of 2007), PsycINFO (1985 to June 2007), AMED (1985 to June 2007), and SCOPUS (2006). The literature search was updated by searching for articles in MEDLINE and EMBASE published between May 2007 and April 2009. Searches were limited to English-language publications. This guideline grades the evidence and recommendations by using the American College of Physicians' clinical practice guidelines grading system.
The American College of Physicians recommends that clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contraindication to PDE-5 inhibitor use (Grade: strong recommendation; high-quality evidence).
The American College of Physicians recommends that clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile (Grade: weak recommendation; low-quality evidence).
The American College of Physicians does not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with erectile dysfunction (Grade: insufficient evidence to determine net benefits and harms).
Table. The American College of Physicians' Guideline Grading System
The American College of Physicians guideline on hormonal testing and pharmacologic treatment of erectile dysfunction.
PDE-5 = phosphodiesterase-5.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Study author discusses ACP guideline on the benefit and risks of PED-5 Inhibitor Drugs for patients suffering from erectile dysfunction.
Qaseem A, Snow V, Denberg TD, Casey DE, Forciea MA, Owens DK, et al. Hormonal Testing and Pharmacologic Treatment of Erectile Dysfunction: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. ;151:639–649. doi: 10.7326/0003-4819-151-9-200911030-00151
Download citation file:
Published: Ann Intern Med. 2009;151(9):639-649.
Endocrine and Metabolism, Guidelines.
Results provided by:
Copyright © 2018 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use