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Public release date: 26 November 2009
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Hormonal testing and pharmacologic treatment of erectile dysfunction
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.
This guideline grades the evidence and recommendations by using the American College of Physicians' clinical
practice guidelines grading system
- Recommendation 1: 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).
- Recommendation 2: 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).
- Recommendation 3: 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).
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