Patient Assessment and Diagnosis of Sexual Dysfunction in Men: Beyond Prescribing 5-alpha-Reducatase-Inhibitors

Kathy Maupin, M.D.

Founder and Medical Director, BioBalance Health

Male sexual dysfunction is much more than ED and must be approached diagnostically by evaluating multiple physiologic systems, ruling out lifestyle and medication etiologies, anatomic abnormalities, and in some cases relationship counseling. The initial evaluation is complex and doesn’t begin with a prescription of a 5-alpha-reductase inhibitor but by diagnosing the physiologic dysfunction. Proper evaluation includes blood laboratory analysis of hormonal adequacy, diagnosis of contributing vascular and other medical diseases, which often requires radiologic tests, and relationship counseling. The optimal treatment plan is prioritized by normalizing all hormonal deficiencies, primarily by treating men with bioidentical testosterone, then treating medical diseases concomitantly, then adjusting medications that may worsen sexual performance and libido, defining and improving contributing lifestyle choices, and finally adding 5-alpha-reductase inhibitors, prostaglandin injections or referral for penile implantation if the result is not as robust as the patient desires. Patients appreciate the complete evaluation and treatment plan that this approach offers.