Evolving medical management of erectile dysfunction: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).

Introduction: Treatment of erectile dysfunction is based on pharmacotherapy for most patients.

Aim: To review the current data on pharmacotherapy for erectile dysfunction based on efficacy, psychosocial outcomes, and safety outcomes.

Methods: A review of the literature was undertaken by the committee members. All related articles were critically analyzed and discussed, and consensus statements were developed after presentation at the 2024 ICSM.

Results: Eight recommendations are provided with the corresponding level of evidence and grade of recommendation.

Conclusions: The management of erectile dysfunction should be personalized to address the psychosocial needs and expectations of both the patient and their partner. PDE5 inhibitors remain the first-line treatment for most men, while intracavernosal injections, vacuum erection devices, and penile prostheses serve as second-line options, with treatment decisions guided by patient preferences. Key recommendations are summarized in table 1.