Factors contributing to erectile dysfunction in a male with heart failure:
(1) atherosclerotic vascular disease
(2) fatigue and impaired exercise tolerance in severe heart failure
(3) depression
(4) anxiety about having sex
(5) drugs for heart failure, hypertension and other vascular risk factors
(6) drugs used to treat depression
(7) concomitant diabetes
(8) concomitant renal failure
(9) age-related decline in performance
Many men with heart failure can safely have sexual intercourse. Some patients will require exercise testing or other evaluation to make sure that they can safely handle the exertion.
Erectile dysfunction may be treated with:
(1) a PDE5 inhibitor
(2) an implantable penile prosthesis
(3) a vacuum constriction device
