Sexual dysfunction

Male sexual dysfunction is common, with the most common types being erectile dysfunction, premature ejaculation, penile deformity, and priapism. Erectile dysfunction is common, becomes commoner with increasing age, and is often associated with cardiovascular disease and its risk factors. Patient assessment should seek to identify causative risk factors and treatment in the first instance is usually the management of risk factors and oral pharmacotherapy with a phosphodiesterase type 5 inhibitor. In women, sexual desire disorders are commoner in older postmenopausal women and a new treatment, flibanserin, has recently been licensed for this indication. Sexual arousal disorders in women also become more common postmenopausally and have a multifactorial aetiology. Treatment should be directed at the aetiological factor in the first instance while trials of oral pharmacotherapy for this condition have been disappointing.