Does He have Drug Related Issues

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Drugs, whether prescribed or taken recreationally, may be a source of the problem. Commonly prescribed medications are known to affect erectile function

Table 7.2 Causes of Hyperprolactinaemia in Men

Physiological

Sleep (REM phase)

Nipple stimulation

Stress

Coitus

Pathological

Production by tumours

• Prolactinomas

• Occurs in some acromegalics

Interference with stalk

• Any hypothalamic or pituitary tumour

Idiopathic

• Hyperprolactinaemia

Polycystic ovary syndrome

Primary hypothyroidism

Chest wall injury

Renal failure

Liver failure

Drug-induced

Dopamine antagonists

Oestrogens

Opiates

Cimetidine

Methyldopa

Reserpine

Source: Adapted from Kumar and Clark.

Source: Adapted from Kumar and Clark.

(see Table 7.2). In addition, street drugs such as cannabis, cocaine, amphetamines, and heroin have all been linked to decreased erectile function. Alcohol in excess is a well-recognized cause of ED.

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