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Erectile Dysfunction, Depression, and Ischemic Heart Disease: Does the Existence of One Component of This Triad Necessitate Inquiring the Other Two? (CME)


Ahmed I. El-Sakka, MD, Andrology Clinic, Al-Noor Specialist Hospital, PO box 6251, Makkah, Saudi Arabia. Tel: 0096625667699; Fax: 009662 5667358; E-mail:


Introduction.  Erectile dysfunction (ED) depression and ischemic heart disease (IHD) had long been classified as independent medical conditions managed by unrelated medical services. Recent studies have revealed the intimate associations among the three conditions. However, when a patient presents with one component of this triad, whether the physicians should also screen for the other two components is still an important question to be answered.

Aim.  The purpose of this Continuing Medical Education article is to review contemporary knowledge regarding the reinforcing associations between the three conditions and to highlight the importance of screening for the other two components when a patient presents with one component of this triad, thus enabling best-practice management.

Methods.  An English-language MEDLINE review was performed from 1990 to present-day for the association between ED, depression and IHD.

Main Outcome Measure.  Current state of information regarding associations among the three conditions.

Results.  Recent studies have established a new paradigm for the intimate associations among the three conditions. Furthermore, various risk factors and medical co-morbidities such as age, obesity, sedentary lifestyle, smoking, heart disease, hypertension, dyslipidemia, diabetes, and related medications have been demonstrated to be highly associated with psychological disorders, cardiovascular diseases, and sexual dysfunctions.

Conclusions.  The integrative view and holistic approach with full consideration of the property of each condition is the appropriate way for the diagnosis and management of patients with these conditions. El Sakka AI. Erectile dysfunction, depression, and ischemic heart disease: Does the existence of one component of this triad necessitate inquiring the other two? J Sex Med 2011;8:937–940.

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