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Erectile dysfunction 

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Erectile dysfunction 

  • This is often caused by :
    • Underlying vascular disease.
    • And/ or comorbidities.
    • And/or lifestyle (little physical activity).
  • This can also be facilitated by some treatments that may be important for a patient with heart failure:
    • Beta blocker
    • MRA
    • Thiazide diuretics

      Adjustment of these medications is best done in consultation with the treating cardiologist. Benefit of reducing or stopping these must be weighed against the cardiac risk of doing so.
      In patients with HFrEF or difficult to control fluid retention, it’s better to continue therapy if possible.
  • Phosphodiestererase-5 inhibitors (PDE5I), for example sildenafil or tadalafil :
    • Safe in stable, compensated heart failure.
    • Not to be taken if there are signs of cardiac decompensation or NYHA class IV.
    • Simultaneous use with nitrates is contraindicated due to the risk of life-threatening hypotension or heart attack in pre-existing coronary artery disease.
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