Erectile dysfunction case study

Erectile dysfunction has been reported in 12% of 339 men treated with fibrate derivatives or statins, compared with 5.6% of similar patients not taking these drugs (62). The mechanism is unknown and should be confirmed in randomized studies. A class effect has been suggested by the case of a 57-year-old man who had impotence after taking lovastatin for 2 weeks and also when he later tried pravastatin (63). 

Arteriography of the pudendal artery (using the transfemoral or transbrachial approach) and cavernosography have been used before the introduction of color Doppler imaging to detect the nature of the erectile dysfunction (Delcour et al. 1986 Bookstein 1987 Rosen et al. 1991). At present the role of these techniques is limited to selected cases with specific clinical problems already studied with sonography. 

Sexual complaints attributed to interferon alfa, namely decreased hbido, impotence, or erectile failure, are usually concomitant to other neuropsychiatric symptoms, and cases of reversible impotence are anecdotal (315). The mechanisms accounting for these adverse effects are unclear, and changes in sex hormone concentrations have not been consistently reported. In one study in healthy women, interferon alfa produced falls in serum progesterone and estradiol concentrations (316), but neither impairment of libido nor impairment of fertility has apparently been reported in women. No evidence of gonadal toxicity or sexual dysfunction was found in 43 men with hairy cell leukemia who received interferon alfa for 2-12 months compared with 33 patients who... 

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