Frank J. Costa: The question is whether or not treating a specific underlying disorder will result in improvement of sexual function in many of these patients who have these comorbid conditions, so to speak, a patient with diabetes, a patient with hypertension or high blood pressure, a patient with underlying heart disease, a patient with high cholesterol, and my answer to that question is it depends on the severity or the combination of those illnesses in the individual patient.
First and foremost, the important consideration is to address lifestyle changes, diet and exercise. No matter how old you are or how young you are, it's important to have a very good established exercise and diet program where healthy lifestyle behavior is instituted and also is adopted as a part of life, a routine part of life.
And I think that first and foremost, we as physicians must always underscore the fact this is of central importance to be able to have a patient restore not just sexual function but overall good health. Then once that's restored, once that is addressed, then having individual comorbid conditions such as high blood pressure, having diet controlled, watching salt intake, for instance, watching diet, losing weight, that can help restore of a more healthy lifestyle, taking care of the different specific situations whether the patient is diabetic, whether the patient has high cholesterol, using certain medications in certain instances and addressing also the lifestyle changes that I mentioned previously all go hand-in-hand in being able to restore lifestyle changes, and also in many cases, to improve or restore sexual function.
Randall B. Meacham: There are some circumstances where other diseases that are associated with erectile dysfunction. If you treat the disease itself, you may get an improvement in sexual function. I think a good example of this is someone that has very, very low levels of serum testosterone. Men that have got very low levels of serum testosterone, and sexual dysfunction may in some circumstances achieve better sexual function if that particular abnormality is corrected. Men that smoke cigarettes, men that consume alcohol in excess amount, if they stop that, they may get an improvement in their sexual function as well.
Other diseases such as high blood pressure and diabetes, it's a little bit difficult to know. Certainly patients who have diabetes will benefit in many ways from appropriate management of their condition. It may in some circumstances serve to improve sexual function, but that's a bit harder to predict.
The good news is that we have very, very good methods for treating sexual dysfunction per se. So even if correcting underlying condition doesn't have an immediate impact that the patient can identify, there are other methods we have for treating this condition very effectively.
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